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HCPCS L1080 Fee Schedule

Last Verified: November 2025

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, outrigger
Key FactDetail
Service Type

Orthotic Procedures and services

Scoliosis Orthotic Devices

Complexity LevelLow

National average reimbursement for HCPCS L1080 by major payers:

bcbs

$60.11

uhc

$37.62

aetna

$41.75

cigna

$74.93

Preview provider-level rates for...
For billing codeHCPCS L1080
PayerCodeRateNPITax IDStateSpecialty

Select a payer to view fee schedule data

Choose a payer from the options above to see rates for HCPCS L1080

United
L1080$121.411073502985 - CHU CHEN42484572 - (MA) MERRIMACK VALLEY PEDIATRIC ASSOCIATES, INC.MAPediatrics Physician (208000000X)
United
L1080$31.101013553197 - AMY MOORE451471722 - (AL) BAMA HEART DOC, PC DBA ALABAMA HEART & VASCULAR MEDICINEALAcute Care Nurse Practitioner (363LA2100X)
United
L1080$31.101790057420 - BAMA HEART DOC, P.C., ALABAMA HEART AND VASCULAR MEDICINE451471722 - (AL) BAMA HEART DOC, PC DBA ALABAMA HEART & VASCULAR MEDICINEALInterventional Cardiology Physician (207RI0011X)
United
L1080$34.181194752840 - PATRICK REIDY202399514 - FLORIDA GULF COAST EAR, NOSE AND THROAT, LLCFLOtolaryngology Physician (207Y00000X)
United
L1080$29.811255478004 - CHRISTOPHER RAIO111635088 - MERCY MEDICAL CENTERNYEmergency Medicine Physician (207P00000X)
United
L1080$40.681881630614 - QUEST DIAGNOSTICS LLC IL364257926ILClinical Medical Laboratory (291U00000X)
United
L1080$83.121992779482 - ANNA JAQUES HOSPITAL42104338 - (MA) ANNA JAQUES HOSPITALMAGeneral Acute Care Hospital (282N00000X)
United
L1080$30.791588098172 - PROGRESSIVE EMERGENCY PHYSICIANS PLLC463316332 - PROGRESSIVE EMERGENCY PHYSICIANS PLLCNYMulti-Specialty Group (193200000X)
United
L1080$32.061588098172 - PROGRESSIVE EMERGENCY PHYSICIANS PLLC463316332 - PROGRESSIVE EMERGENCY PHYSICIANS PLLCNYEmergency Medicine Physician (207P00000X)
United
L1080$35.931023055126 - HCA HEALTH SERVICES OF TENNESSEE, INC., TRISTAR CENTENNIAL MEDICAL CENTER382084239 - QUEST DIAGNOSTICS CLINICAL LABORATORIES, INC.TNGeneral Acute Care Hospital (282N00000X)
United
L1080$64.811073502985 - CHU CHEN42484572MAPediatrics Physician (208000000X)
United
L1080$121.411073502985 - CHU CHEN42484572MAPediatrics Physician (208000000X)
United
L1080$115.901073502985 - CHU CHEN42484572MAPediatrics Physician (208000000X)
United
L1080$121.421073502985 - CHU CHEN42484572 - MERRIMACK VALLEY PEDIATRIC ASSOCIATES, INC.MAPediatrics Physician (208000000X)
United
L1080$46.661255478004 - CHRISTOPHER RAIO111888924 - GOOD SAMARITAN HOSPTIAL MEDICAL CENTERNYEmergency Medicine Physician (207P00000X)
United
99202$100.0012345678901234567890CACardiologist
United
99202$100.0012345678901234567890CACardiologist
United
99202$100.0012345678901234567890CACardiologist
United
99202$100.0012345678901234567890CACardiologist
United
99202$100.0012345678901234567890CACardiologist
United
99202$100.0012345678901234567890CACardiologist
United
99202$100.0012345678901234567890CACardiologist
United
99202$100.0012345678901234567890CACardiologist
United
99202$100.0012345678901234567890CACardiologist
United
99202$100.0012345678901234567890CACardiologist

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HCPCS L1080 vs. Other Scoliosis Orthotic Devices Codes

The HCPCS L1080 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 L1080 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
L1070-HCPCSLowAddition to Cervical-thoracic-lumbar-sacral orthosis (CTLSO) or scoliosis orthosis, trapezius sling
L1080-HCPCSLowAddition to Cervical-thoracic-lumbar-sacral orthosis (CTLSO) or scoliosis orthosis, outrigger
L1085-HCPCSLowAddition to Cervical-thoracic-lumbar-sacral orthosis (CTLSO) or scoliosis orthosis, outrigger, bilateral with vertical extensions

What is a fee schedule?

A fee schedule is a list of fixed prices that healthcare providers charge for specific services, including HCPCS L1080. These prices vary depending on payer type (Medicare, Medicaid, private insurance), geographic location, and provider contracts.

Understanding the L1080 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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