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See a sample rate comparisonHCPCS L0641 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 orthosis (LO), sagittal control, with rigid posterior panel(s), posterior extends from L-1 to below L-5 vertebra, produces intracavitary pressure to reduce load on the intervertebral discs, includes straps, closures, may include padding, stays, shoulder straps, pendulous abdomen design, prefabricated, off-the-shelf
| Key Fact | Detail |
|---|---|
| Service Type | Orthotic Procedures and services Lumbar Orthotics Sagittal Control |
| Complexity Level | Low |
| Medicaid Fee Schedule | View Medicaid rates for L0641 |
National average reimbursement for HCPCS L0641 by major payers:
$45.54
$50.83
$45.51
$71.00
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HCPCS L0641
5 of 25 sample ratesHigher to lower in this preview
Southern Regional Medical Corporation, Leonard J. Chabert Medical Center
$91.65Published rateTatyana Antonevich
Slocum Dickson Medical Group PLLC
$46.95Published rateAshley Fahy
Slocum Dickson Medical Group PLLC
$46.95Published rateKaren Flick
Slocum Dickson Medical Group PLLC
$30.47Published rateManzurul Sikder
Slocum Dickson Medical Group PLLC
$30.47Published rate
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See a sample payer proposalHCPCS L0641 vs. Other Lumbar Orthotics Sagittal Control Codes
The HCPCS L0641 code is part of the Orthotic Procedures and services services used for Lumbar Orthotics Sagittal Control. 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 L0641 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 |
|---|---|---|
| L0640-HCPCS | High | Lumbar-sacral orthosis (LSO), sagittal-coronal control, rigid shell(s)/panel(s), posterior extends from sacrococcygeal junction to T-9 vertebra, anterior extends from symphysis pubis to xiphoid, produces intracavitary pressure to reduce load on the intervertebral discs, overall strength is provided by overlapping rigid material and stabilizing closures, includes straps, closures, may include soft interface, pendulous abdomen design, custom fabricated |
| L0641-HCPCS | Low | Lumbar orthosis (LO), sagittal control, with rigid posterior panel(s), posterior extends from L-1 to below L-5 vertebra, produces intracavitary pressure to reduce load on the intervertebral discs, includes straps, closures, may include padding, stays, shoulder straps, pendulous abdomen design, prefabricated, off-the-shelf |
| L0642-HCPCS | Moderate | Lumbar orthosis (LO), sagittal control, with rigid anterior and posterior panels, posterior extends from L-1 to below L-5 vertebra, produces intracavitary pressure to reduce load on the intervertebral discs, includes straps, closures, may include padding, shoulder straps, pendulous abdomen design, prefabricated, off-the-shelf |
What is a fee schedule?
A fee schedule is a list of fixed prices that healthcare providers charge for specific services, including HCPCS L0641. These prices vary depending on payer type (Medicare, Medicaid, private insurance), geographic location, and provider contracts.
Understanding the L0641 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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