L1260 — Addition to tlso, (low profile), anterior thoracic derotation pad
HCPCS Level II L-code · short descriptor: “Anterior thoracic derotation”
- Code system
- HCPCS Level II
- Family
- L — Orthotics & prosthetics
- Medicare coverage status
- Carrier judgment — coverage decided by the DME MAC
- DMEPOS payment category
- Prosthetics & orthotics
- Prior authorization
- Not on Medicare required-PA list
- Status
- Active (April 2026 HCPCS)
Prior authorization
Not on the Medicare required-PA list as of the January 13, 2026 update (74 items). Medicare Advantage and commercial plans set their own prior-authorization rules for this code — verify per plan before delivery.
L1260 Medicare fee schedule (April 2026)
Base (no modifier) Prosthetics & orthotics
Medicare allowable ranges from $63.89 to $123.28 depending on state and rural status.
Former-CBA payment limits: ceiling $115.91 · floor $86.93
| State | Non-rural | Rural |
|---|---|---|
| AK | $115.32 | — |
| AL | $113.77 | — |
| AR | $94.04 | — |
| AZ | $103.18 | — |
| CA | $103.18 | — |
| CO | $86.93 | — |
| CT | $96.99 | — |
| DC | $101.63 | — |
| DE | $101.63 | — |
| FL | $113.77 | — |
| GA | $113.77 | — |
| HI | $123.28 | — |
| IA | $86.93 | — |
| ID | $92.09 | — |
| IL | $115.91 | — |
| IN | $115.91 | — |
| KS | $86.93 | — |
| KY | $113.77 | — |
| LA | $94.04 | — |
| MA | $96.99 | — |
| MD | $101.63 | — |
| ME | $96.99 | — |
| MI | $115.91 | — |
| MN | $115.91 | — |
| MO | $86.93 | — |
| MS | $113.77 | — |
| MT | $86.93 | — |
| NC | $113.77 | — |
| ND | $86.93 | — |
| NE | $86.93 | — |
| NH | $96.99 | — |
| NJ | $86.93 | — |
| NM | $94.04 | — |
| NV | $103.18 | — |
| NY | $86.93 | — |
| OH | $115.91 | — |
| OK | $94.04 | — |
| OR | $92.09 | — |
| PA | $101.63 | — |
| PR | $63.89 | — |
| RI | $96.99 | — |
| SC | $113.77 | — |
| SD | $86.93 | — |
| TN | $113.77 | — |
| TX | $94.04 | — |
| UT | $86.93 | — |
| VA | $101.63 | — |
| VI | $86.93 | — |
| VT | $96.99 | — |
| WA | $92.09 | — |
| WI | $115.91 | — |
| WV | $101.63 | — |
| WY | $86.93 | — |
Amounts are the Medicare DMEPOS fee-schedule allowables effective April 2026.
Medicare typically pays 80% of the allowable after the Part B deductible; the patient owes 20%.
A 2% sequestration reduction applies to the Medicare share. Former competitive-bidding-area
adjustments and non-continental rates can differ — verify with your DME MAC.
Common denial codes to watch
Related L-codes
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