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See a sample rate comparisonHCPCS L1020 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.
Addition to Cervical-thoracic-lumbar-sacral orthosis (CTLSO) or scoliosis orthosis, kyphosis pad
| Key Fact | Detail |
|---|---|
| Service Type | Orthotic Procedures and services Scoliosis Orthotic Devices |
| Complexity Level | Low |
| Medicaid Fee Schedule | View Medicaid rates for L1020 |
National average reimbursement for HCPCS L1020 by major payers:
$103.63
$60.18
$68.81
$152.23
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HCPCS L1020
5 of 25 sample ratesHigher to lower in this preview
Emory Healthcare
Emory University
$212.47Published rateChu Chen
$95.09Published rateUnilab Corporation, Quest Diagnostics Clinical Lab
$64.90Published ratePalmyra Park Hospital, Inc., Palmyra Medical Centers
$57.00Published rateChristopher Raio
St Francis Hospital
$29.15Published rate
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Payer Contract Negotiation
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See a sample payer proposalHCPCS L1020 vs. Other Scoliosis Orthotic Devices Codes
The HCPCS L1020 code is part of the Orthotic Procedures and services services used for Scoliosis Orthotic Devices. 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 L1020 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 |
|---|---|---|
| L1010-HCPCS | Low | Addition to Cervical-thoracic-lumbar-sacral orthosis (CTLSO) or scoliosis orthosis, axilla sling |
| L1020-HCPCS | Low | Addition to Cervical-thoracic-lumbar-sacral orthosis (CTLSO) or scoliosis orthosis, kyphosis pad |
| L1025-HCPCS | Low | Addition to Cervical-thoracic-lumbar-sacral orthosis (CTLSO) or scoliosis orthosis, kyphosis pad, floating |
What is a fee schedule?
A fee schedule is a list of fixed prices that healthcare providers charge for specific services, including HCPCS L1020. These prices vary depending on payer type (Medicare, Medicaid, private insurance), geographic location, and provider contracts.
Understanding the L1020 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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