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See a sample rate comparisonHCPCS L1220 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 Thoracic-lumbar-sacral orthosis (TLSO), (low profile), anterior thoracic extension
| Key Fact | Detail |
|---|---|
| Service Type | Orthotic Procedures and services Low-profile Additions, Thoracic-lumbar-sacral Orthotics |
| Complexity Level | Moderate |
| Medicaid Fee Schedule | View Medicaid rates for L1220 |
National average reimbursement for HCPCS L1220 by major payers:
$243.23
$151.41
$165.11
$338.06
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HCPCS L1220
5 of 25 sample ratesHigher to lower in this preview
Grady Memorial Hospital Corporation, Grady Health Systems
Emory University
$421.38Published rateStephens County Anesthesia Services,LLC
Stephens County Anesthesia Servicesllc
$168.80Published ratePhoebe Worth Medical Center, Inc, Phoebe Worth Medical Center, Inc
Phoebe Worth Medical Center Inc
$163.17Published rateMichael Guillette
Aztec Urgent Care LLC
$115.12Published rateJenkins County Hospital LLC, Optim Medical Center - Jenkins
Hospital Authority Of Jenkins County Dba Jenkins County Medical Center
$108.40Published rate
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Payer Contract Negotiation
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See a sample payer proposalHCPCS L1220 vs. Other Low-profile Additions, Thoracic-lumbar-sacral Orthotics Codes
The HCPCS L1220 code is part of the Orthotic Procedures and services services used for Low-profile Additions, Thoracic-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 L1220 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 |
|---|---|---|
| L1210-HCPCS | Moderate | Addition to Thoracic-lumbar-sacral-orthosis (TLSO), (low profile), lateral thoracic extension |
| L1220-HCPCS | Moderate | Addition to Thoracic-lumbar-sacral orthosis (TLSO), (low profile), anterior thoracic extension |
| L1230-HCPCS | Moderate | Addition to Thoracic-lumbar-sacral orthosis (TLSO), (low profile), Milwaukee type superstructure |
What is a fee schedule?
A fee schedule is a list of fixed prices that healthcare providers charge for specific services, including HCPCS L1220. These prices vary depending on payer type (Medicare, Medicaid, private insurance), geographic location, and provider contracts.
Understanding the L1220 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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