Code: L0621

Description:
Description: Sacroiliac orthosis, flexible, provides pelvic-sacral support, reduces motion about the sacroiliac joint, includes straps, closures, may include pendulous abdomen design, prefabricated, off-the-shelf
HCPCS Category: Orthotic/prosthetic procedures
Other Descriptions:
Sio Flex Pelvisacral Prefab
HC PF SIO FLEX PELVISACRAL
HC SACRO ILIAC SUPPORT
ELCROSS SACRAL SUPPORT SMALL
Related codes:
Code: L0622
ORTHOSIS SACROLILAC FLEX
Code: L0623
Description: Sacroiliac orthosis, provides pelvic-sacral support, with rigid or semi-rigid panels over the sacrum and abdomen, reduces motion about the sacroiliac joint, includes straps, closures, may include pendulous abdomen design, prefabricated, off-the-shelf
HCPCS Category: Orthotic/prosthetic procedures
Code: L0625
SUPPORT LUMBAR SACRO 10
Code: L0626
Description: Lumbar orthosis, sagittal control, with rigid posterior panel(s), posterior extends from l-1 to below l-5 vertebra, produces intracavitary pressure to reduce load on the intervertebral discs, includes straps, closures, may include padding, stays, shoulder straps, pendulous abdomen design, prefabricated item that has been trimmed, bent, molded, assembled, or otherwise customized to fit a specific patient by an individual with expertise
HCPCS Category: Orthotic/prosthetic procedures
Code: L0627
BRACE LO SAGTL RIGD LVL1
Code: L0628
BRACE FLEX SUPPORT L0628
Code: L0629
LSO FLX SURG SUPP
State Average # Hospitals In Database
Minnesota (MN) $23 14
Vermont (VT) $31 1
West Virginia (WV) $54 4
Arkansas (AR) $56 3
New Mexico (NM) $60 1
Kentucky (KY) $61 3
Oklahoma (OK) $63 2
Pennsylvania (PA) $63 9
Maryland (MD) $69 1
Colorado (CO) $71 2
Tennessee (TN) $75 2
South Carolina (SC) $77 5
Alabama (AL) $79 7
Texas (TX) $82 21
Kansas (KS) $83 4
Georgia (GA) $86 1
Louisiana (LA) $86 1
New Jersey (NJ) $86 2
Utah (UT) $86 1
New York (NY) $97 3
Hawaii (HI) $97 4
Virginia (VA) $101 6
Arizona (AZ) $102 5
Wisconsin (WI) $105 12
Delaware (DE) $117 2
Ohio (OH) $118 4
New Hampshire (NH) $123 2
Massachusetts (MA) $140 17
Idaho (ID) $155 2
Connecticut (CT) $167 2
California (CA) $217 23
Illinois (IL) $228 8
Washington (WA) $237 2
Florida (FL) $379 24
Indiana (IN) $817 18
Nevada (NV) $2,154 14
North Carolina (NC) $6,509 1

ChargemasterDB by Joseph Paul Cohen
A database of US hospital prices based on data made available by the Centers for Medicare & Medicaid Services (CMS), HHS price transparancy rule 45 CFR ยง180.