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 | $534.05 | 1306540380 - KARLIE RYAN | 451471722 - (AL) BAMA HEART DOC, PC DBA ALABAMA HEART & VASCULAR MEDICINE | AL | Family Nurse Practitioner (363LF0000X) |
United | L0457 | $574.28 | 1225340151 - MATTHEW FIELDS | 471157530 - UT REGIONAL ONE PHYSICIANS INC | TN | Anesthesiology Physician (207L00000X) |
United | L0457 | $890.34 | 1437397247 - MICHAEL JOSEPH | 832249459 - MOSAIC MEDICAL CENTER - MARYVILLE | TN | Anesthesiology Physician (207L00000X) |
United | L0457 | $601.07 | 1629290689 - JOHN BLAKE | 626000101 - ERLANGER MEDICAL CENTER | TN | Pain Medicine (Anesthesiology) Physician (207LP2900X) |
United | L0457 | $1001.79 | 1740254580 - CHARLES POOLE | 850735608 - (GA) NORTH GEORGIA ANESTHESIA SERVICES, PC | TN | Anesthesiology Physician (207L00000X) |
United | L0457 | $565.79 | 1528565835 - CLEO CARTER | 471157530 - UT REGIONAL ONE PHYSICIANS INC | TN | Anesthesiology Physician (207L00000X) |
United | L0457 | $601.07 | 1386961076 - AARON BROMAN | 620931432 - (TN) ANESTHESIA MEDICAL GROUP PC | TN | Anesthesiology Physician (207L00000X) |
United | L0457 | $601.07 | 1245250240 - DAVID ROBINSON | 921045506 - (FL) RASC ANESTHESIA LLC | TN | Anesthesiology Physician (207L00000X) |
United | L0457 | $601.07 | 1891951570 - MARY DIMICELI-ZSIGMOND | 620931432 - (TN) ANESTHESIA MEDICAL GROUP PC | TN | Anesthesiology Physician (207L00000X) |
United | L0457 | $618.58 | 1649295452 - NAHEL SAIED | 462354804 - FLORIDA HOSPITAL HEALTHCARE PARTNERS INC | TN | Critical Care Medicine (Anesthesiology) Physician (207LC0200X) |
United | L0457 | $601.07 | 1982601290 - TODD USSERY | 621142980 - (TN) JAMES R NUNLEY DOPC | TN | Pain Medicine (Anesthesiology) Physician (207LP2900X) |
United | L0457 | $445.05 | 1811988108 - DONALD JONES | 822233265 - (TN) PAIN MEDICINE OF THE SOUTH PLLC | TN | Interventional Pain Medicine Physician (208VP0014X) |
United | L0457 | $565.79 | 1922595198 - WALTER CAVALCANTE GIRAO | 471157530 - UT REGIONAL ONE PHYSICIANS INC | TN | Anesthesiology Physician (207L00000X) |
United | L0457 | $575.97 | 1316086606 - TIMOTHY BUNKER | 814859416 - (TN) NOBLE TRUTH HOLDINGS LLC | TN | Pain Medicine (Physical Medicine & Rehabilitation) Physician (2081P2900X) |
United | L0457 | $612.94 | 1689244220 - CHRISTOPHER HALL | 451183242 - (TN) KEN HOMOLYA MD LLC | 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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