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HCPCS L1300 Fee Schedule

Last Verified: September 2026

Healthcare providers use this code to document and receive reimbursement for visits that address high-level medical decision-making, often including multiple diagnoses or prescription management.

Other scoliosis procedure, body jacket molded to patient model
Key FactDetail
Service Type

Orthotic Procedures and services

Other Scoliosis and Spinal Orthotics and Procedures

Complexity LevelHigh
Medicaid Fee ScheduleView Medicaid rates for L1300

National average reimbursement for HCPCS L1300 by major payers:

bcbs

$1,711.25

uhc

$1,139.51

aetna

$1,223.49

cigna

$2,445.41

Compare published rates across providers.

Choose a payer to see a sample of rates for HCPCS L1300.

HCPCS L1300
5 of 25 sample ratesHigher to lower in this preview
  1. Chu Chen

    MAPediatrics PhysicianNPI 1073502985Tax ID 42-484572

    $3,661.92Published rate
  2. Augusta Vamc

    GAGeneral Acute Care HospitalNPI 1801844469Tax ID 58-2089405

    $1,436.69Published rate
  3. Hca Health Services Of Tennessee, Inc., Tristar Centennial Medical Center

    Quest Diagnostics Clinical Laboratories, Inc.

    TNGeneral Acute Care HospitalNPI 1023055126Tax ID 38-2084239

    $1,254.11Published rate
  4. Michael Guillette

    Aztec Urgent Care LLC

    COPhysician AssistantNPI 1174512115Tax ID 27-1495988

    $868.04Published rate
  5. Clinch County Hospital Authority

    GACritical Access HospitalNPI 1861478851Tax ID 58-6011853

    $817.33Published rate

National sample. Rates vary by location, specialty, and contract.

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HCPCS L1300 vs. Other Other Scoliosis and Spinal Orthotics and Procedures Codes

The HCPCS L1300 code is part of the Orthotic Procedures and services services used for Other Scoliosis and Spinal Orthotics and Procedures. 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 L1300 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
L1290-HCPCSLowAddition to Thoracic-lumbar-sacral orthosis (TLSO), (low profile), lateral trochanteric pad
L1300-HCPCSHighOther scoliosis procedure, body jacket molded to patient model
L1310-HCPCSHighOther scoliosis procedure, post-operative body jacket

What is a fee schedule?

A fee schedule is a list of fixed prices that healthcare providers charge for specific services, including HCPCS L1300. These prices vary depending on payer type (Medicare, Medicaid, private insurance), geographic location, and provider contracts.

Understanding the L1300 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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