Rate Benchmarking
Compare your rates with similar providers.
Select a published rate, define comparable providers, and see where that rate falls in your market.
See a sample rate comparisonHCPCS L1240 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), lumbar derotation pad
| Key Fact | Detail |
|---|---|
| Service Type | Orthotic Procedures and services Low-profile Additions, Thoracic-lumbar-sacral Orthotics |
| Complexity Level | Low |
| Medicaid Fee Schedule | View Medicaid rates for L1240 |
National average reimbursement for HCPCS L1240 by major payers:
$86.06
$53.93
$61.44
$128.06
Compare published rates across providers.
Choose a payer to see a sample of rates for HCPCS L1240.
HCPCS L1240
5 of 25 sample ratesHigher to lower in this preview
Chu Chen
$166.05Published rateQuest Diagnostics Incorporated
$58.29Published rateHca Health Services Of Tennessee, Inc., Tristar Centennial Medical Center
Quest Diagnostics Clinical Laboratories, Inc.
$56.00Published ratePaulding Medical Center, Inc., Wellstar Paulding Hospital
Paulding Medical Center Inc
$47.86Published rateAlicia Encinas
Miguel A Arenas Md PC
$43.63Published rate
Get a free rate benchmark for your specialty.
Choose your state and specialty to build a report from payer-published rates.
Use market rates to prepare your payer proposal.
Payer Contract Negotiation
Draft a fee schedule renegotiation letter.
Use your fee schedule and market benchmarks to set target rates and draft a letter for your payer.
See a sample payer proposalHCPCS L1240 vs. Other Low-profile Additions, Thoracic-lumbar-sacral Orthotics Codes
The HCPCS L1240 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 L1240 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 |
|---|---|---|
| L1230-HCPCS | Moderate | Addition to Thoracic-lumbar-sacral orthosis (TLSO), (low profile), Milwaukee type superstructure |
| L1240-HCPCS | Low | Addition to Thoracic-lumbar-sacral orthosis (TLSO), (low profile), lumbar derotation pad |
| L1250-HCPCS | Low | Addition to Thoracic-lumbar-sacral orthosis (TLSO), (low profile), anterior asis pad |
What is a fee schedule?
A fee schedule is a list of fixed prices that healthcare providers charge for specific services, including HCPCS L1240. These prices vary depending on payer type (Medicare, Medicaid, private insurance), geographic location, and provider contracts.
Understanding the L1240 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.
FREE SAMPLE MARKET COMPARISON
Let's review your payer contracts side-by-side with the market.
Bring your top codes (like HCPCS L1240) and we'll show you how you compare in 15 minutes or less.