Code: L0628

Description:
Description: Lumbar-sacral orthosis, flexible, provides lumbo-sacral support, posterior extends from sacrococcygeal junction to t-9 vertebra, produces intracavitary pressure to reduce load on the intervertebral discs, includes straps, closures, may include stays, shoulder straps, pendulous abdomen design, prefabricated, off-the-shelf
HCPCS Category: Orthotic/prosthetic procedures
Other Descriptions:
HC LUMBAR-SCARAL ORTHOTIC FLEXIBLE PREFABRICATED
BRACE BACK CASH ORTHOSIS
SUPPORT LS XXXL13IN REVERE
BRACE LSO NECK L0633
SUPPORT LUMBOSAC LG 10INREVERE
SUPPORT LUMBOSAC XL 13INREVERE
SUPPORT LUMBOSAC XL 10INREVERE
SUPPORT LUMBOSAC XXL13INREVERE
SUPPORT LUMBOSAC LG 13INREVERE
Related codes:
Code: L0621
SUPPORT ORTH SCROILIAC
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: L0629
LSO FLX SURG SUPP
Indiana
Hospital Address Code Price Last Updated
Franciscan Health Indianapolis , Indianapolis L0628 $118 [source] 4 years ago
Ascension St. Vincent Warrick 1116 Millis Ave, Boonville L0628 $182 [source] 4 years ago
Ascension St. Vincent Hospital 2001 W 86Th St, Indianapolis L0628 $182 [source] 4 years ago
Ascension Medical Group St. Vincent 301 Henry St, North Vernon L0628 $182 [source] 4 years ago
Ascension St. Vincent Evansville 3700 Washington Ave, Evansville L0628 $182 [source] 4 years ago
Ascension St. Vincent Williamsport 412 N Monroe St, Williamsport L0628 $182 [source] 4 years ago
St Vincent Salem Hospital Inc 911 N Shelby St, Salem L0628 $182 [source] 4 years ago
St. Vincent Mercy Hospital 1331 S A St, Elwood L0628 $182 [source] 4 years ago
Ascension St. Vincent Dunn 1600 23Rd St, Bedford L0628 $182 [source] 4 years ago
Ascension St. Vincent Randolph 473 E Greenville Ave, Winchester L0628 $182 [source] 4 years ago
Ascension St. Vincent Carmel 13500 N Meridian St, Carmel L0628 $182 [source] 4 years ago
Ascension St. Vincent Anderson 2015 Jackson St, Anderson L0628 $182 [source] 4 years ago
Ascension St. Vincent Heart Center 10580 N Meridian St, Indianapolis L0628 $182 [source] 4 years ago
Encompass Health Deaconess Rehabilitation Hospital 9355 Warrick Trl, Newburgh L0628 $198 [source] 4 years ago
St. Vincent Clay Hospital, Inc 1206 E National Ave, Brazil L0628 $6,012 [source] 4 years ago
Ascension St Vincent Fishers 13861 Olio Road, L0628 $6,012 [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.