L0450
Prosthetics & Orthotics
53 States
Tlso, flexible, provides trunk support, upper thoracic region, produces intracavitary pressure to reduce load on the intervertebral disks with rigid stays or panel(s), includes shoulder straps and closures, prefabricated, off-the-shelf
Short Desc
Tlso flex trunk/thor pre ots
Coverage determined by local carrier discretion.
Added Date
2003-01-01
Effective From
2014-01-01
Fee Schedule Rates
Effective Jan 2026Official Medicare DMEPOS pricing for 2026.
| State | Modifier | Non-Rural | Rural |
|---|---|---|---|
|
AK
|
Base Rate |
$242.76
|
Same |
|
AL
|
Base Rate |
$145.10
|
$188.72
|
|
AR
|
Base Rate |
$145.10
|
$172.41
|
|
AZ
|
Base Rate |
$136.83
|
$205.69
|
|
CA
|
Base Rate |
$63.92
|
$205.69
|
|
CO
|
Base Rate |
$95.25
|
$172.41
|
|
CT
|
Base Rate |
$145.10
|
$205.69
|
|
DC
|
Base Rate |
$127.31
|
$174.29
|
|
DE
|
Base Rate |
$127.31
|
$174.29
|
|
FL
|
Base Rate |
$145.10
|
$188.72
|
|
GA
|
Base Rate |
$145.10
|
$188.72
|
|
HI
|
Base Rate |
$252.57
|
Same |
|
IA
|
Base Rate |
$142.26
|
$184.97
|
|
ID
|
Base Rate |
$95.25
|
$204.43
|
|
IL
|
Base Rate |
$123.17
|
$172.41
|
|
IN
|
Base Rate |
$123.17
|
$172.41
|
|
KS
|
Base Rate |
$142.26
|
$184.97
|
|
KY
|
Base Rate |
$145.10
|
$188.72
|
|
LA
|
Base Rate |
$145.10
|
$172.41
|
|
MA
|
Base Rate |
$145.10
|
$205.69
|
|
MD
|
Base Rate |
$127.31
|
$174.29
|
|
ME
|
Base Rate |
$145.10
|
$205.69
|
|
MI
|
Base Rate |
$123.17
|
$172.41
|
|
MN
|
Base Rate |
$142.26
|
$172.41
|
|
MO
|
Base Rate |
$142.26
|
$184.97
|
|
MS
|
Base Rate |
$145.10
|
$188.72
|
|
MT
|
Base Rate |
$95.25
|
$172.41
|
|
NC
|
Base Rate |
$145.10
|
$188.72
|
|
ND
|
Base Rate |
$142.26
|
$172.41
|
|
NE
|
Base Rate |
$142.26
|
$184.97
|
|
NH
|
Base Rate |
$145.10
|
$205.69
|
|
NJ
|
Base Rate |
$127.31
|
$189.51
|
|
NM
|
Base Rate |
$136.83
|
$172.41
|
|
NV
|
Base Rate |
$63.92
|
$205.69
|
|
NY
|
Base Rate |
$127.31
|
$189.51
|
|
OH
|
Base Rate |
$123.17
|
$172.41
|
|
OK
|
Base Rate |
$136.83
|
$172.41
|
|
OR
|
Base Rate |
$63.92
|
$204.43
|
|
PA
|
Base Rate |
$127.31
|
$174.29
|
|
PR
|
Base Rate |
$231.44
|
Same |
|
RI
|
Base Rate |
$145.10
|
$205.69
|
|
SC
|
Base Rate |
$145.10
|
$188.72
|
|
SD
|
Base Rate |
$142.26
|
$172.41
|
|
TN
|
Base Rate |
$145.10
|
$188.72
|
|
TX
|
Base Rate |
$136.83
|
$172.41
|
|
UT
|
Base Rate |
$95.25
|
$172.41
|
|
VA
|
Base Rate |
$145.10
|
$174.29
|
|
VI
|
Base Rate |
$218.46
|
Same |
|
VT
|
Base Rate |
$145.10
|
$205.69
|
|
WA
|
Base Rate |
$63.92
|
$204.43
|
|
WI
|
Base Rate |
$123.17
|
$172.41
|
|
WV
|
Base Rate |
$145.10
|
$174.29
|
|
WY
|
Base Rate |
$95.25
|
$172.41
|