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
Texas
Hospital Address Code Price Last Updated
Texoma Medical Center 5016 South Us Highway 75, Denison L0621 $62 [source] 4 years ago
Northwest Texas Healthcare System 1501 S. Coulter, Amarillo L0621 $62 [source] 4 years ago
Encompass Health Rehabilitation Hospital Of Pearland 2121 Business Center Drive, Pearland L0621 $75 [source] 4 years ago
Encompass Health Rehabilitation Hospital Of City View 6701 Oakmont Blvd, Fort Worth L0621 $75 [source] 4 years ago
Encompass Health Rehabilitation Hospital Of Dallas 7930 Northaven Rd, Dallas L0621 $86 [source] 4 years ago
Encompass Health Rehabilitation Hospital Of Plano 2800 W 15Th St, Plano L0621 $86 [source] 4 years ago
Encompass Health Rehabilitation Hospital Of Arlington 3200 Matlock Rd, Arlington L0621 $86 [source] 4 years ago
Encompass Health Rehabilitation Hospital Of Midland Odessa 1800 Heritage Blvd, Midland L0621 $86 [source] 4 years ago
Encompass Health Rehabilitation Hospital Of Richardson 3351 Waterview Parkway, Richardson L0621 $86 [source] 4 years ago
Encompass Health Rehabilitation Hospital Of Wichita Falls 3901 Armory Rd, Wichita Falls L0621 $86 [source] 4 years ago
Encompass Health Rehabilitation Hospital Of Abilene 6401 Directors Pkwy, Abilene L0621 $86 [source] 4 years ago
Encompass Health Rehabilitation Hospital Of Texarkana 515 W 12Th St, Texarkana L0621 $86 [source] 4 years ago
Encompass Health Rehabilitation Hospital Of Austin 330 W. Ben White Blvd., Austin L0621 $86 [source] 4 years ago
Encompass Health Rehabilitation Hospital Of San Antonio 9119 Cinnamon Hl, San Antonio L0621 $86 [source] 4 years ago
Encompass Health Rehabilitation Hospital Of Sugar Land 1325 Highway 6, Sugar Land L0621 $86 [source] 4 years ago
Encompass Health Rehabilitation Hospital Vision Park 117 Vision Park Blvd, Conroe L0621 $86 [source] 4 years ago
Encompass Health Rehabilitation Hospital The Vintage 20180 Chasewood Park Drive, Houston L0621 $86 [source] 4 years ago
Encompass Health Rehabilitation Hospital Of Humble 19002 Mckay Dr, Humble L0621 $86 [source] 4 years ago
Encompass Health Rehabilitation Hospital Of Cypress 13031 Wortham Center Dr, Houston L0621 $86 [source] 4 years ago
Encompass Health Rehabilitation Hospital Of Round Rock 1400 Hesters Crossing Rd, Round Rock L0621 $86 [source] 4 years ago
Encompass Health Rehabilitation Hospital Of The Woodlands 18550 I H 45 S, Conroe L0621 $86 [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.