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

Wisconsin

Hospital	Address	Code	Price	Last Updated
River Falls Area Hospital	, River Falls	L0628	$31 [source]	4 years ago
Howard Young Medical Center Inc Of Woodruff Wisconsin	240 Maple Street, Woodruff	L0628	$68 [source]	4 years ago
Ascension Calumet Hospital	614 Memorial Dr, Chilton	L0628	$81 [source]	4 years ago
Aspirus Divine Savior Hospital	2817 New Pinery Rd, Portage	L0628	$95 [source]	4 years ago
Watertown Regional Medical Center	125 Hospital Drive, Watertown	L0628	$266 [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.