L0470
Prosthetics & Orthotics
53 States
Tlso, triplanar control, rigid posterior frame and flexible soft anterior apron with straps, closures and padding, extends from sacrococcygeal junction to scapula, lateral strength provided by pelvic, thoracic, and lateral frame pieces, rotational strength provided by subclavicular extensions, restricts gross trunk motion in sagittal, coronal, and transverse planes, provides intracavitary pressure to reduce load on the intervertebral disks, includes fitting and shaping the frame, prefabricated, includes fitting and adjustment
Short Desc
Tlso rigid frame pre subclav
Coverage determined by local carrier discretion.
Added Date
2003-01-01
Effective From
2003-01-01
National Floor
$732.62
National Ceiling
$976.83
Fee Schedule Rates
Effective Jan 2026Official Medicare DMEPOS pricing for 2026.
| State | Modifier | Non-Rural | Rural |
|---|---|---|---|
|
AK
|
Base Rate |
$1,256.50
|
Same |
|
AL
|
Base Rate |
$843.00
|
Same |
|
AR
|
Base Rate |
$732.62
|
Same |
|
AZ
|
Base Rate |
$976.83
|
Same |
|
CA
|
Base Rate |
$976.83
|
Same |
|
CO
|
Base Rate |
$732.62
|
Same |
|
CT
|
Base Rate |
$908.96
|
Same |
|
DC
|
Base Rate |
$732.62
|
Same |
|
DE
|
Base Rate |
$732.62
|
Same |
|
FL
|
Base Rate |
$843.00
|
Same |
|
GA
|
Base Rate |
$843.00
|
Same |
|
HI
|
Base Rate |
$1,343.57
|
Same |
|
IA
|
Base Rate |
$785.56
|
Same |
|
ID
|
Base Rate |
$781.08
|
Same |
|
IL
|
Base Rate |
$808.59
|
Same |
|
IN
|
Base Rate |
$808.59
|
Same |
|
KS
|
Base Rate |
$785.56
|
Same |
|
KY
|
Base Rate |
$843.00
|
Same |
|
LA
|
Base Rate |
$732.62
|
Same |
|
MA
|
Base Rate |
$908.96
|
Same |
|
MD
|
Base Rate |
$732.62
|
Same |
|
ME
|
Base Rate |
$908.96
|
Same |
|
MI
|
Base Rate |
$808.59
|
Same |
|
MN
|
Base Rate |
$808.59
|
Same |
|
MO
|
Base Rate |
$785.56
|
Same |
|
MS
|
Base Rate |
$843.00
|
Same |
|
MT
|
Base Rate |
$732.62
|
Same |
|
NC
|
Base Rate |
$843.00
|
Same |
|
ND
|
Base Rate |
$732.62
|
Same |
|
NE
|
Base Rate |
$785.56
|
Same |
|
NH
|
Base Rate |
$908.96
|
Same |
|
NJ
|
Base Rate |
$854.19
|
Same |
|
NM
|
Base Rate |
$732.62
|
Same |
|
NV
|
Base Rate |
$976.83
|
Same |
|
NY
|
Base Rate |
$854.19
|
Same |
|
OH
|
Base Rate |
$808.59
|
Same |
|
OK
|
Base Rate |
$732.62
|
Same |
|
OR
|
Base Rate |
$781.08
|
Same |
|
PA
|
Base Rate |
$732.62
|
Same |
|
PR
|
Base Rate |
$584.47
|
Same |
|
RI
|
Base Rate |
$908.96
|
Same |
|
SC
|
Base Rate |
$843.00
|
Same |
|
SD
|
Base Rate |
$732.62
|
Same |
|
TN
|
Base Rate |
$843.00
|
Same |
|
TX
|
Base Rate |
$732.62
|
Same |
|
UT
|
Base Rate |
$732.62
|
Same |
|
VA
|
Base Rate |
$732.62
|
Same |
|
VI
|
Base Rate |
$732.62
|
Same |
|
VT
|
Base Rate |
$908.96
|
Same |
|
WA
|
Base Rate |
$781.08
|
Same |
|
WI
|
Base Rate |
$808.59
|
Same |
|
WV
|
Base Rate |
$732.62
|
Same |
|
WY
|
Base Rate |
$732.62
|
Same |