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HCPCS L0633 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.

Lumbar-sacral orthosis (LSO), sagittal-coronal control, with rigid posterior frame/panel(s), posterior extends from sacrococcygeal junction to T-9 vertebra, lateral strength provided by rigid lateral frame/panels, produces intracavitary pressure to reduce load on intervertebral discs, includes straps, closures, may include padding, stays, shoulder straps, pendulous abdomen design, prefabricated item that has been trimmed, bent, molded, assembled, or otherwise customized to fit a specific patient by an individual with expertise
Key FactDetail
Service Type

Orthotic Procedures and services

Lumbar-sacral Orthotics

Complexity LevelModerate
Medicaid Fee ScheduleView Medicaid rates for L0633

National average reimbursement for HCPCS L0633 by major payers:

bcbs

$282.13

uhc

$184.68

aetna

$202.95

cigna

$267.84

Compare published rates across providers.

Choose a payer to see a sample of rates for HCPCS L0633.

HCPCS L0633
5 of 25 sample ratesHigher to lower in this preview
  1. Grady Memorial Hospital Corporation, Grady Health Systems

    Emory University

    GAGeneral Acute Care HospitalNPI 1992799050Tax ID 58-1537752

    $498.52Published rate
  2. Irwin County Hospital

    GAGeneral Acute Care HospitalNPI 1720098791Tax ID 58-6003765

    $234.94Published rate
  3. Jefferson Kilpatrick

    NCFacial Plastic Surgery PhysicianNPI 1417979501Tax ID 45-5568773

    $174.02Published rate
  4. Lower Oconee Community Hospital Inc

    GACritical Access HospitalNPI 1184771586Tax ID 20-8897263

    $157.35Published rate
  5. Michael Guillette

    Aztec Urgent Care LLC

    COPhysician AssistantNPI 1174512115Tax ID 27-1495988

    $142.39Published rate

National sample. Rates vary by location, specialty, and contract.

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HCPCS L0633 vs. Other Lumbar-sacral Orthotics Codes

The HCPCS L0633 code is part of the Orthotic Procedures and services services used for Lumbar-sacral 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 L0633 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.

CodeComplexityDescription
L0632-HCPCSModerateLumbar-sacral orthosis (LSO), sagittal control, with rigid anterior and posterior panels, posterior extends from sacrococcygeal junction to T-9 vertebra, produces intracavitary pressure to reduce load on the intervertebral discs, includes straps, closures, may include padding, shoulder straps, pendulous abdomen design, custom fabricated
L0633-HCPCSModerateLumbar-sacral orthosis (LSO), sagittal-coronal control, with rigid posterior frame/panel(s), posterior extends from sacrococcygeal junction to T-9 vertebra, lateral strength provided by rigid lateral frame/panels, produces intracavitary pressure to reduce load on intervertebral discs, includes straps, closures, may include padding, stays, shoulder straps, pendulous abdomen design, prefabricated item that has been trimmed, bent, molded, assembled, or otherwise customized to fit a specific patient by an individual with expertise
L0634-HCPCSModerateLumbar-sacral orthosis (LSO), sagittal-coronal control, with rigid posterior frame/panel(s), posterior extends from sacrococcygeal junction to T-9 vertebra, lateral strength provided by rigid lateral frame/panel(s), produces intracavitary pressure to reduce load on intervertebral discs, includes straps, closures, may include padding, stays, shoulder straps, pendulous abdomen design, custom fabricated

What is a fee schedule?

A fee schedule is a list of fixed prices that healthcare providers charge for specific services, including HCPCS L0633. These prices vary depending on payer type (Medicare, Medicaid, private insurance), geographic location, and provider contracts.

Understanding the L0633 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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