HCPCS L0457 Fee Schedule
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.
| Key Fact | Detail |
|---|---|
| Service Type | • Orthotic Procedures and services • Thoracic-lumbar-sacral (TLSO) Orthotics |
| Complexity Level | Moderate |
National average reimbursement for HCPCS L0457 by major payers:
$578.48
$648.47
$600.78
$914.99
| Payer | Code | Rate | NPI | Tax ID | State | Specialty |
|---|---|---|---|---|---|---|
Select a payer to view fee schedule data Choose a payer from the options above to see rates for HCPCS L0457 | ||||||
United | L0457 | $562.74 | 1750534913 - TREVOR ROBISON | 363305449 - MOUNT SINAI COMMUNITY FOUNDATION | TN | Anesthesiology Physician (207L00000X) |
United | L0457 | $574.28 | 1619266814 - KEN HOMOLYA MD LLC | 451183242 - (TN) KEN HOMOLYA MD LLC | TN | Pain Medicine Physician (208VP0000X) |
United | L0457 | $1535.94 | 1295081065 - FORREST ALLEN | 621619606 - (TN) PREMIER ORTHOPAEDICS SPORTS MEDICINE PLC | TN | Interventional Pain Medicine Physician (208VP0014X) |
United | L0457 | $601.07 | 1639497506 - BENJAMIN ELLIS | 620931432 - (TN) ANESTHESIA MEDICAL GROUP PC | TN | Anesthesiology Physician (207L00000X) |
United | L0457 | $582.32 | 1801021464 - LIFELINC ANESTHESIA, PLLC | 621709852 | TN | Anesthesiology Physician (207L00000X) |
United | L0457 | $601.07 | 1629290689 - JOHN BLAKE | 626000101 - ERLANGER MEDICAL CENTER | TN | Pain Medicine (Anesthesiology) Physician (207LP2900X) |
United | L0457 | $601.07 | 1982601290 - TODD USSERY | 621142980 - (TN) JAMES R NUNLEY DOPC | TN | Pain Medicine (Anesthesiology) Physician (207LP2900X) |
United | L0457 | $565.79 | 1609163880 - WILLIAM SEELY | 474372269 - SPECIALTY ORTHOPEDIC GROUP OF MS, LLC | TN | Interventional Pain Medicine Physician (208VP0014X) |
United | L0457 | $510.25 | 1477016657 - ALEXANDRA CESARE | 431960221 - (OR) SALEM HEALTH WEST VALLEY | TN | Anesthesiology Physician (207L00000X) |
United | L0457 | $601.07 | 1679570162 - ROBERT RIEDEL | 620931432 - (TN) ANESTHESIA MEDICAL GROUP PC | TN | Anesthesiology Physician (207L00000X) |
United | L0457 | $837.85 | 1710198882 - SEAN BENTON | 261556197 - (OK) ANESTHESIA MEDICAL PROFESSIONALS PLLC | TN | Anesthesiology Physician (207L00000X) |
United | L0457 | $582.32 | 1821397233 - LIFELINC ANESTHESIA II, PLLC | 450959268 - LIFELINC ANESTHESIA II PLLC | TN | Anesthesiology Physician (207L00000X) |
United | L0457 | $565.79 | 1861531899 - KEVIN GILES | 621871909 - (TN) ANESTHESIA CARE OF TULLAHOMA PC | TN | Anesthesiology Physician (207L00000X) |
United | L0457 | $574.28 | 1649229014 - ATHENS ANESTHESIA ASSOCIATES, INC. | 352268971 - (TN) ATHENS ANESTHESIA ASSOCIATES INC | TN | Anesthesiology Physician (207L00000X) |
United | L0457 | $445.05 | 1205019940 - SANDRA KAPLAN | 621863415 - (TN) STEPHEN V DRESKIN MD PC | TN | Pain Medicine Physician (208VP0000X) |
United | 99202 | $100.00 | 1234567890 | 1234567890 | CA | Cardiologist |
United | 99202 | $100.00 | 1234567890 | 1234567890 | CA | Cardiologist |
United | 99202 | $100.00 | 1234567890 | 1234567890 | CA | Cardiologist |
United | 99202 | $100.00 | 1234567890 | 1234567890 | CA | Cardiologist |
United | 99202 | $100.00 | 1234567890 | 1234567890 | CA | Cardiologist |
United | 99202 | $100.00 | 1234567890 | 1234567890 | CA | Cardiologist |
United | 99202 | $100.00 | 1234567890 | 1234567890 | CA | Cardiologist |
United | 99202 | $100.00 | 1234567890 | 1234567890 | CA | Cardiologist |
United | 99202 | $100.00 | 1234567890 | 1234567890 | CA | Cardiologist |
United | 99202 | $100.00 | 1234567890 | 1234567890 | CA | Cardiologist |
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HCPCS L0457 vs. Other Thoracic-lumbar-sacral (TLSO) Orthotics Codes
The HCPCS L0457 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 L0457 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 |
|---|---|---|
| L0456-HCPCS | Moderate | Thoracic-lumbar-sacral orthosis (TLSO), flexible, provides trunk support, thoracic region, rigid posterior panel and soft anterior apron, extends from the sacrococcygeal junction and terminates just inferior to the scapular spine, restricts gross trunk motion in the sagittal plane, produces intracavitary pressure to reduce load on the intervertebral disks, includes 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 |
| L0457-HCPCS | Moderate | Thoracic-lumbar-sacral orthosis (TLSO), flexible, provides trunk support, thoracic region, rigid posterior panel and soft anterior apron, extends from the sacrococcygeal junction and terminates just inferior to the scapular spine, restricts gross trunk motion in the sagittal plane, produces intracavitary pressure to reduce load on the intervertebral disks, includes straps and closures, prefabricated, off-the-shelf |
| L0458-HCPCS | Moderate | Thoracic-lumbar-sacral orthosis (TLSO), triplanar control, modular segmented spinal system, two rigid plastic shells, posterior extends from the sacrococcygeal junction and terminates just inferior to the scapular spine, anterior extends from the symphysis pubis to the xiphoid, soft liner, restricts gross trunk motion in the sagittal, coronal, and transverse planes, lateral strength is provided by overlapping plastic and stabilizing closures, includes straps and closures, prefabricated, includes fitting and adjustment |
What is a fee schedule?
A fee schedule is a list of fixed prices that healthcare providers charge for specific services, including HCPCS L0457. These prices vary depending on payer type (Medicare, Medicaid, private insurance), geographic location, and provider contracts.
Understanding the L0457 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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