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See a sample rate comparisonHCPCS L0490 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), sagittal-coronal control, one piece rigid plastic shell, with overlapping reinforced anterior, with multiple straps and closures, posterior extends from sacrococcygeal junction and terminates at or before the T-9 vertebra, anterior extends from symphysis pubis to xiphoid, anterior opening, restricts gross trunk motion in sagittal and coronal planes, prefabricated, includes fitting and adjustment
| Key Fact | Detail |
|---|---|
| Service Type | Orthotic Procedures and services Thoracic-lumbar-sacral (TLSO) Orthotics |
| Complexity Level | Moderate |
| Medicaid Fee Schedule | View Medicaid rates for L0490 |
National average reimbursement for HCPCS L0490 by major payers:
$293.00
$182.52
$201.85
$405.01
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HCPCS L0490
5 of 25 sample ratesHigher to lower in this preview
Emory University, Emory University Hospital
Emory University
$637.34Published rateAztec Urgent Care, LLC
Aztec Urgent Care LLC
$228.80Published rateHospital Authority Of Jefferson County And The City Of Louisville, Jefferson Hospital
Hospital Authority Of Jefferson County And The City Of Louisville
$172.83Published rateNgmc Barrow LLC, Ngmc Barrow
Gainesville Radiology Group
$151.89Published rateKristina Jimenez
Miguel A Arenas Md PC
$101.26Published rate
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See a sample payer proposalHCPCS L0490 vs. Other Thoracic-lumbar-sacral (TLSO) Orthotics Codes
The HCPCS L0490 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 L0490 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 |
|---|---|---|
| L0488-HCPCS | High | Thoracic-lumbar-sacral orthosis (TLSO), triplanar control, one piece rigid plastic shell with interface liner, multiple straps and closures, posterior extends from sacrococcygeal junction and terminates just inferior to scapular spine, anterior extends from symphysis pubis to sternal notch, anterior or posterior opening, restricts gross trunk motion in sagittal, coronal, and transverse planes, prefabricated, includes fitting and adjustment |
| L0490-HCPCS | Moderate | Thoracic-lumbar-sacral orthosis (TLSO), sagittal-coronal control, one piece rigid plastic shell, with overlapping reinforced anterior, with multiple straps and closures, posterior extends from sacrococcygeal junction and terminates at or before the T-9 vertebra, anterior extends from symphysis pubis to xiphoid, anterior opening, restricts gross trunk motion in sagittal and coronal planes, prefabricated, includes fitting and adjustment |
| L0491-HCPCS | Moderate | Thoracic-lumbar-sacral orthosis (TLSO), sagittal-coronal 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 and coronal 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 L0490. These prices vary depending on payer type (Medicare, Medicaid, private insurance), geographic location, and provider contracts.
Understanding the L0490 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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