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Procedure Codes
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HCPCS Level II
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Orthotic and Prosthetic Procedures and Devices
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L1000–L1990
L1050
Addition to ctlso or scoliosis orthosis, sternal pad
Back
L1000
Cervical-thoracic-lumbar-sacral orthosis (ctlso) (milwaukee), inclusive of furnishing initial orthosis, including model
→
L1001
Cervical thoracic lumbar sacral orthosis, immobilizer, infant size, prefabricated, includes fitting and adjustment
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L1005
Tension based scoliosis orthosis and accessory pads, includes fitting and adjustment
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L1006
Scoliosis orthosis, sagittal-coronal control provided by a rigid lateral frame, extends from axilla to trochanter, includes all accessory pads, straps and interface, prefabricated item that has been trimmed, bent, molded, assembled, or otherwise customized to fit a specific patient by an individual with expertise
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L1007
Scoliosis orthosis, sagittal-coronal control provided by a rigid lateral frame, extends from axilla, to trochanter, includes all accessory pads, straps, and interface, custom fabricated
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L1010
Addition to cervical-thoracic-lumbar-sacral orthosis (ctlso) or scoliosis orthosis, axilla sling
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L1020
Addition to ctlso or scoliosis orthosis, kyphosis pad
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L1025
Addition to ctlso or scoliosis orthosis, kyphosis pad, floating
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L1030
Addition to ctlso or scoliosis orthosis, lumbar bolster pad
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L1040
Addition to ctlso or scoliosis orthosis, lumbar or lumbar rib pad
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L1050
Addition to ctlso or scoliosis orthosis, sternal pad
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L1060
Addition to ctlso or scoliosis orthosis, thoracic pad
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L1070
Addition to ctlso or scoliosis orthosis, trapezius sling
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L1080
Addition to ctlso or scoliosis orthosis, outrigger
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L1085
Addition to ctlso or scoliosis orthosis, outrigger, bilateral with vertical extensions
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L1090
Addition to ctlso or scoliosis orthosis, lumbar sling
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L1100
Addition to ctlso or scoliosis orthosis, ring flange, plastic or leather
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L1110
Addition to ctlso or scoliosis orthosis, ring flange, plastic or leather, molded to patient model
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L1120
Addition to ctlso, scoliosis orthosis, cover for upright, each
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L1200
Thoracic-lumbar-sacral-orthosis (tlso), inclusive of furnishing initial orthosis only
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L1210
Addition to tlso, (low profile), lateral thoracic extension
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L1220
Addition to tlso, (low profile), anterior thoracic extension
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L1230
Addition to tlso, (low profile), milwaukee type superstructure
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L1240
Addition to tlso, (low profile), lumbar derotation pad
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L1250
Addition to tlso, (low profile), anterior asis pad
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L1260
Addition to tlso, (low profile), anterior thoracic derotation pad
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L1270
Addition to tlso, (low profile), abdominal pad
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L1280
Addition to tlso, (low profile), rib gusset (elastic), each
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L1290
Addition to tlso, (low profile), lateral trochanteric pad
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L1300
Other scoliosis procedure, body jacket molded to patient model
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L1310
Other scoliosis procedure, post-operative body jacket
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L1320
Thoracic, pectus carinatum orthosis, sternal compression, rigid circumferential frame with anterior and posterior rigid pads, custom fabricated
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L1330
Thoracic orthosis, sternal and/or sternocostal compression, may include anterior and/or posterior pads, panels, with or without frame, prefabricated, includes fitting and adjustment
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L1499
Spinal orthosis, not otherwise specified
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L1600
Hip orthosis, abduction control of hip joints, flexible, frejka type with cover, prefabricated item that has been trimmed, bent, molded, assembled, or otherwise customized to fit a specific patient by an inidividual with expertise
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L1610
Hip orthosis, abduction control of hip joints, flexible, (frejka cover only), prefabricated item that has been trimmed, bent, molded, assembled, or otherwise customized to fit a specific patient by an individual with expertise
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L1620
Hip orthosis, abduction control of hip joints, flexible, (pavlik harness), prefabricated item that has been trimmed, bent, molded, assembled, or otherwise customized to fit a specific patient by an individual with expertise
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L1630
Hip orthosis, abduction control of hip joints, semi-flexible (von rosen type), custom fabricated
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L1640
Hip orthosis, abduction control of hip joints, static, pelvic band or spreader bar, thigh cuffs, custom fabricated
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L1650
Hip orthosis, abduction control of hip joints, static, adjustable, (ilfled type), prefabricated, includes fitting and adjustment
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L1652
Hip orthosis, bilateral thigh cuffs with adjustable abductor spreader bar, adult size, prefabricated, includes fitting and adjustment, prefabricated item that has been trimmed, bent, molded, assembled, or otherwise customized to fit a specific patient by an individual with expertise
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L1653
Hip orthosis, bilateral thigh cuffs with adjustable abductor spreader bar, adult size, prefabricated, off the shelf
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L1660
Hip orthosis, abduction control of hip joints, static, plastic, prefabricated, includes fitting and adjustment
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L1680
Hip orthosis, abduction control of hip joints, dynamic, pelvic control, adjustable hip motion control, thigh cuffs (rancho hip action type), custom fabricated
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L1681
Hip orthosis, bilateral hip joints and thigh cuffs, adjustable flexion, extension, abduction control of hip joint, postoperative hip abduction type, prefabricated item that has been trimmed, bent, molded, assembled, or otherwise customized to fit a specific patient by an individual with expertise
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L1685
Hip orthosis, abduction control of hip joint, postoperative hip abduction type, custom fabricated
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L1686
Hip orthosis, abduction control of hip joint, postoperative hip abduction type, prefabricated, includes fitting and adjustment
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L1690
Combination, bilateral, lumbo-sacral, hip, femur orthosis providing adduction and internal rotation control, prefabricated, includes fitting and adjustment
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L1700
Legg perthes orthosis, (toronto type), custom fabricated
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L1710
Legg perthes orthosis, (newington type), custom fabricated
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L1720
Legg perthes orthosis, trilateral, (tachdijan type), custom fabricated
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L1730
Legg perthes orthosis, (scottish rite type), custom fabricated
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L1755
Legg perthes orthosis, (patten bottom type), custom fabricated
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L1810
Knee orthosis, elastic with joints, prefabricated item that has been trimmed, bent, molded, assembled, or otherwise customized to fit a specific patient by an individual with expertise
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L1812
Knee orthosis, elastic with joints, prefabricated, off-the-shelf
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L1820
Knee orthosis, elastic with condylar pads and joints, with or without patellar control, prefabricated item that has been trimmed, bent, molded, assembled, or otherwise customized to fit a specific patient by an individual with expertise
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L1821
Knee orthosis, elastic with condylar pads and joints, with or without patellar control, prefabricated, off the shelf
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L1830
Knee orthosis, immobilizer, canvas longitudinal, prefabricated, off-the-shelf
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L1831
Knee orthosis, locking knee joint(s), positional orthosis, prefabricated, includes fitting and adjustment
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L1832
Knee orthosis, adjustable knee joints (unicentric or polycentric), positional orthosis, rigid support, prefabricated item that has been trimmed, bent, molded, assembled, or otherwise customized to fit a specific patient by an individual with expertise
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L1833
Knee orthosis, adjustable knee joints (unicentric or polycentric), positional orthosis, rigid support, prefabricated, off-the shelf
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L1834
Knee orthosis, without knee joint, rigid, custom fabricated
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L1836
Knee orthosis, rigid, without joint(s), includes soft interface material, prefabricated, off-the-shelf
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L1840
Knee orthosis, derotation, medial-lateral, anterior cruciate ligament, custom fabricated
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L1843
Knee orthosis, single upright, thigh and calf, with adjustable flexion and extension joint (unicentric or polycentric), medial-lateral and rotation control, with or without varus/valgus adjustment, prefabricated item that has been trimmed, bent, molded, assembled, or otherwise customized to fit a specific patient by an individual with expertise
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L1844
Knee orthosis, single upright, thigh and calf, with adjustable flexion and extension joint (unicentric or polycentric), medial-lateral and rotation control, with or without varus/valgus adjustment, custom fabricated
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L1845
Knee orthosis, double upright, thigh and calf, with adjustable flexion and extension joint (unicentric or polycentric), medial-lateral and rotation control, with or without varus/valgus adjustment, prefabricated item that has been trimmed, bent, molded, assembled, or otherwise customized to fit a specific patient by an individual with expertise
→
L1846
Knee orthosis, double upright, thigh and calf, with adjustable flexion and extension joint (unicentric or polycentric), medial-lateral and rotation control, with or without varus/valgus adjustment, custom fabricated
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L1847
Knee orthosis, double upright with adjustable joint, with inflatable air support chamber(s), prefabricated item that has been trimmed, bent, molded, assembled, or otherwise customized to fit a specific patient by an individual with expertise
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L1848
Knee orthosis, double upright with adjustable joint, with inflatable air support chamber(s), prefabricated, off-the-shelf
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L1850
Knee orthosis, swedish type, prefabricated, off-the-shelf
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L1851
Knee orthosis (ko), single upright, thigh and calf, with adjustable flexion and extension joint (unicentric or polycentric), medial-lateral and rotation control, with or without varus/valgus adjustment, prefabricated, off-the-shelf
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L1852
Knee orthosis (ko), double upright, thigh and calf, with adjustable flexion and extension joint (unicentric or polycentric), medial-lateral and rotation control, with or without varus/valgus adjustment, prefabricated, off-the-shelf
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L1860
Knee orthosis, modification of supracondylar prosthetic socket, custom fabricated (sk)
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L1900
Ankle foot orthosis, spring wire, dorsiflexion assist calf band, custom fabricated
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L1902
Ankle orthosis, ankle gauntlet or similar, with or without joints, prefabricated, off-the-shelf
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L1904
Ankle orthosis, ankle gauntlet or similar, with or without joints, custom fabricated
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L1906
Ankle foot orthosis, multiligamentous ankle support, prefabricated, off-the-shelf
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L1907
Ankle orthosis, supramalleolar with straps, with or without interface/pads, custom fabricated
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L1910
Ankle foot orthosis, posterior, single bar, clasp attachment to shoe counter, prefabricated, includes fitting and adjustment
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L1920
Ankle foot orthosis, single upright with static or adjustable stop (phelps or perlstein type), custom fabricated
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L1930
Ankle foot orthosis, plastic or other material, prefabricated, includes fitting and adjustment
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L1932
Ankle foot orthosis, rigid anterior tibial section, total carbon fiber or equal material, prefabricated item that has been trimmed, bent, molded, assembled, or otherwise customized to fit a specific patient by an individual with expertise
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L1933
Ankle foot orthosis, rigid anterior tibial section, total carbon fiber or equal material, prefabricated, off-the-shelf
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L1940
Ankle foot orthosis, plastic or other material, custom fabricated
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L1945
Ankle foot orthosis, plastic, rigid anterior tibial section (floor reaction), custom fabricated
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L1950
Ankle foot orthosis, spiral, (institute of rehabilitative medicine type), plastic, custom fabricated
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L1951
Ankle foot orthosis, spiral, (institute of rehabilitative medicine type), plastic or other material, prefabricated item that has been trimmed, bent, molded, assembled, or otherwise customized to fit a specific patient by an individual with expertise
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L1952
Ankle foot orthosis, spiral, (institute of rehabilitative medicine type), plastic or other material, prefabricated, off-the-shelf
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L1960
Ankle foot orthosis, posterior solid ankle, plastic, custom fabricated
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L1970
Ankle foot orthosis, plastic with ankle joint, custom fabricated
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L1971
Ankle foot orthosis, plastic or other material with ankle joint, with or without dorsiflexion assist, prefabricated, item that has been trimmed, bent, molded, assembled, or otherwise customized to fit a specific patient by an individual with expertise
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L1972
Ankle foot orthosis, plastic or other material with ankle joint, with or without dorsiflexion assist, prefabricated, off-the shelf
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L1980
Ankle foot orthosis, single upright free plantar dorsiflexion, solid stirrup, calf band/cuff (single bar 'bk' orthosis), custom fabricated
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L1990
Ankle foot orthosis, double upright free plantar dorsiflexion, solid stirrup, calf band/cuff (double bar 'bk' orthosis), custom fabricated
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Procedure code
CODABLE
L1050
Addition to ctlso or scoliosis orthosis, sternal pad
Part
HCPCS Level II
L
Orthotic and Prosthetic Procedures and Devices
L1
L1000–L1990
Source
CMS — ICD-10-PCS FY2026, HCPCS Level II october 2026, Procedure Codes 2026.
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