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
California
Hospital Address Code Price Last Updated
Encompass Health Rehabilitation Hospital Of Bakersfield 5001 Commerce Dr, Bakersfield L0621 $90 [source] 4 years ago
Encompass Health Rehabilitation Hospital Of Tustin 14851 Yorba St, Tustin L0621 $102 [source] 4 years ago
Encompass Health Rehabilitation Hospital Of Modesto 1303 Mable Avenue, Modesto L0621 $102 [source] 4 years ago
South San Francisco Medical Center 1200 El Camino Real, South San Francisco L0621 $235 [source] 4 years ago
Oakland Medical Center 3600 Broadway, Woodland Hills L0621 $235 [source] 4 years ago
Sacramento Medical Center 2025 Morse Ave, Sacramento L0621 $235 [source] 4 years ago
Kaiser Foundation Hospitals 4501 Sand Creek Road, Antioch L0621 $235 [source] 4 years ago
Modesto Medical Center 4601 Dale Rd, Modesto L0621 $235 [source] 4 years ago
Vacaville Medical Center 1 Quality Dr, Vacaville L0621 $235 [source] 4 years ago
San Leandro Medical Center 2500 Merced St, San Leandro L0621 $235 [source] 4 years ago
Walnut Creek Medical Center 1425 S Main St, Walnut Creek L0621 $235 [source] 4 years ago
Santa Clara Medical Center 700 Lawrence Expy, Santa Clara L0621 $235 [source] 4 years ago
South Sacramento Medical Center 6600 Bruceville Rd, Sacramento L0621 $235 [source] 4 years ago
Richmond Medical Center 901 Nevin Ave, Richmond L0621 $235 [source] 4 years ago
Santa Rosa Medical Center 401 Bicentennial Way, American Canyon L0621 $235 [source] 4 years ago
Redwood City Medical Center 1100 Veterans Blvd, Redwood City L0621 $235 [source] 4 years ago
Vallejo Medical Center 975 Sereno Dr, Vallejo L0621 $235 [source] 4 years ago
San Rafael Medical Center 99 Montecillo Rd, San Rafael L0621 $235 [source] 4 years ago
San Francisco Medical Center 2525 Geary Blvd, San Francisco L0621 $235 [source] 4 years ago
Fresno Medical Center 39400 Paseo Padre Pkwy, Fresno L0621 $235 [source] 4 years ago
Roseville Medical Center 1600 Eureka Rd, Roseville L0621 $235 [source] 4 years ago
San Jose Medical Center 250 Hospital Pkwy, San Jose L0621 $235 [source] 4 years ago

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.