Code: L0622

Description:

Description: Sacroiliac orthosis, flexible, provides pelvic-sacral support, reduces motion about the sacroiliac joint, includes straps, closures, may include pendulous abdomen design, custom fabricated
HCPCS Category: Orthotic/prosthetic procedures

Other Descriptions:

HC SIO FLEX PELVISACRL CUST

SACROILIAC ORTHOTIC FLEXIBLE CUSTOM FABRICATED

Sio flex pelvisacral custom

Related codes:

Code: L0621

SUPPORT ORTH SCROILIAC

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

Illinois

Hospital	Address	Code	Price	Last Updated
Adventist Bolingbrook Hospital	500 Remington Blvd, Bolingbrook	L0622	$472 [source]	4 years ago
Presence St. Mary's Hospital	500 W Court St, Kankakee	L0622	$628 [source]	4 years ago
Alexian Brothers Medical Center	935 Beisner Rd, Elk Grove Village	L0622	$824 [source]	4 years ago
Adventist Hinsdale Hospital	120 N Oak St, Hinsdale	L0622	$846 [source]	4 years ago
Adventist Lagrange Memorial Hospital	5101 Willow Springs Rd, La Grange	L0622	$853 [source]	4 years ago
Adventist Glenoaks Hospital	701 Winthrop Ave, Glendale Heights	L0622	$853 [source]	4 years ago
St. Alexius Medical Center	1555 Barrington Road,	L0622	$857 [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 §180.