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
Texas
Hospital Address Code Price Last Updated
Encompass Health Rehabilitation Hospital Of San Antonio 9119 Cinnamon Hl, San Antonio L0622 $162 [source] 4 years ago
Encompass Health Rehabilitation Hospital Of Round Rock 1400 Hesters Crossing Rd, Round Rock L0622 $462 [source] 4 years ago
Encompass Health Rehabilitation Hospital The Vintage 20180 Chasewood Park Drive, Houston L0622 $462 [source] 4 years ago
Encompass Health Rehabilitation Hospital Vision Park 117 Vision Park Blvd, Conroe L0622 $462 [source] 4 years ago
Encompass Health Rehabilitation Hospital Of Austin 330 W. Ben White Blvd., Austin L0622 $462 [source] 4 years ago
Encompass Health Rehabilitation Hospital Of Abilene 6401 Directors Pkwy, Abilene L0622 $462 [source] 4 years ago
Encompass Health Rehabilitation Hospital Of Richardson 3351 Waterview Parkway, Richardson L0622 $462 [source] 4 years ago
Encompass Health Rehabilitation Hospital Of Midland Odessa 1800 Heritage Blvd, Midland L0622 $462 [source] 4 years ago
Encompass Health Rehabilitation Hospital Of Dallas 7930 Northaven Rd, Dallas L0622 $462 [source] 4 years ago
Encompass Health Rehabilitation Hospital Of Pearland 2121 Business Center Drive, Pearland L0622 $487 [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.