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See a sample rate comparisonHCPCS L0452 Fee Schedule
Last Verified: September 2026
Healthcare providers use this code to document and receive reimbursement for visits that address moderate-level medical decision-making, often including multiple diagnoses or prescription management.
Thoracic-lumbar-sacral orthosis (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, custom fabricated
| Key Fact | Detail |
|---|---|
| Service Type | Orthotic Procedures and services Thoracic-lumbar-sacral (TLSO) Orthotics |
| Complexity Level | Moderate |
| Medicaid Fee Schedule | View Medicaid rates for L0452 |
National average reimbursement for HCPCS L0452 by major payers:
$253.31
$201.39
$151.41
$240.21
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HCPCS L0452
5 of 25 sample ratesHigher to lower in this preview
Chu Chen
Merrimack Valley Pediatric Associates, Inc.
$721.95Published ratePhoebe Worth Medical Center, Inc, Phoebe Worth Medical Center, Inc
Phoebe Worth Medical Center Inc
$247.44Published rateThe Medical Center Inc, Piedmont Columbus Regional Midtown
The Medical Center Inc
$184.86Published rateMeriwether Healthcare, L.L.C., Warm Springs Medical Center
Meriwether Healthcare, LLC D/B/A Warm Springs Medical Center
$170.64Published rateWildwood Sanitarium, Incorporated, Wildwood Lifestyle Center And Hospital
Wildwood Sanitarium Incorporated
$113.76Published rate
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See a sample payer proposalHCPCS L0452 vs. Other Thoracic-lumbar-sacral (TLSO) Orthotics Codes
The HCPCS L0452 code is part of the Orthotic Procedures and services services used for Thoracic-lumbar-sacral (TLSO) Orthotics. It represents a moderate-complexity encounter and is one of several codes that vary based on time spent, level of medical decision-making, and documentation requirements.
The HCPCS L0452 code involves more provider time and moderate medical decision-making, unlike lower-level codes that require less time and simpler assessments. It typically includes multiple diagnoses, medication management, or test interpretation, leading to higher reimbursement and more detailed documentation requirements.
| Code | Complexity | Description |
|---|---|---|
| L0450-HCPCS | Low | Thoracic-lumbar-sacral orthosis (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 |
| L0452-HCPCS | Moderate | Thoracic-lumbar-sacral orthosis (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, custom fabricated |
| L0454-HCPCS | Moderate | Thoracic-lumbar-sacral orthosis (TLSO) flexible, provides trunk support, extends from sacrococcygeal junction to above T-9 vertebra, restricts gross trunk motion in the sagittal plane, produces intracavitary pressure to reduce load on the intervertebral disks with rigid stays or panel(s), includes shoulder straps and closures, prefabricated item that has been trimmed, bent, molded, assembled, or otherwise customized to fit a specific patient by an individual with expertise |
What is a fee schedule?
A fee schedule is a list of fixed prices that healthcare providers charge for specific services, including HCPCS L0452. These prices vary depending on payer type (Medicare, Medicaid, private insurance), geographic location, and provider contracts.
Understanding the L0452 fee schedule helps patients estimate costs and providers optimize billing for accurate reimbursements.
Factors that affect fee schedules
Medicare & Medicaid Rates
Government-set reimbursement amounts
Private Insurance Rates
Negotiated rates between providers and insurance companies
Geographic Location
Costs may be higher in urban areas.
Provider Type
Hospital providers may have different rates than private practice.
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