L0220 HCPCS code: Thoracic, rib belt, custom fabricated
L0220 is the HCPCS Level II code for thoracic, rib belt, custom fabricated. The 2026 Medicare DMEPOS fee schedule pays $94.68 to $187.65 depending on the state. Its Medicare coverage code is C (Carrier judgment): Coverage is decided by the Medicare contractor (MAC) case by case. The NCCI unit limit is 1 per day on DME suppliers. Medicare volume fell 28% from 2022 to 2024 (103 to 74 services). In 2024, 35 suppliers billed Medicare for L0220 (purchases), serving 73 beneficiaries.
Code details
| Field | Value |
|---|---|
| Section | L codes — Orthotic and prosthetic procedures and devices |
| Coverage code | C — Carrier judgment |
| Pricing indicator | 38 — DMEPOS: orthotics, prosthetics, prosthetic devices and vision services |
| BETOS category | D1F — Prosthetic and orthotic devices |
| Added | 1982-01-01 |
| Last action effective | 1996-01-01 |
2026 Medicare DMEPOS fee schedule for L0220
| Modifier | Meaning | Lowest state fee | Highest state fee | Ceiling | Floor |
|---|---|---|---|---|---|
| — | base fee | $94.68 | $187.65 | $187.65 | $140.73 |
| State | Modifier | Fee | Rural fee |
|---|---|---|---|
| AK | — | $94.68 | — |
| AL | — | $140.73 | — |
| AR | — | $187.65 | — |
| AZ | — | $140.73 | — |
| CA | — | $140.73 | — |
| CO | — | $140.73 | — |
| CT | — | $152.86 | — |
| DC | — | $162.05 | — |
| DE | — | $162.05 | — |
| FL | — | $140.73 | — |
| GA | — | $140.73 | — |
| HI | — | $101.28 | — |
| IA | — | $156.80 | — |
| ID | — | $151.39 | — |
| IL | — | $158.76 | — |
| IN | — | $158.76 | — |
| KS | — | $156.80 | — |
| KY | — | $140.73 | — |
| LA | — | $187.65 | — |
| MA | — | $152.86 | — |
| MD | — | $162.05 | — |
| ME | — | $152.86 | — |
| MI | — | $158.76 | — |
| MN | — | $158.76 | — |
| MO | — | $156.80 | — |
| MS | — | $140.73 | — |
| MT | — | $140.73 | — |
| NC | — | $140.73 | — |
| ND | — | $140.73 | — |
| NE | — | $156.80 | — |
| NH | — | $152.86 | — |
| NJ | — | $177.38 | — |
| NM | — | $187.65 | — |
| NV | — | $140.73 | — |
| NY | — | $177.38 | — |
| OH | — | $158.76 | — |
| OK | — | $187.65 | — |
| OR | — | $151.39 | — |
| PA | — | $162.05 | — |
| PR | — | $180.88 | — |
| RI | — | $152.86 | — |
| SC | — | $140.73 | — |
| SD | — | $140.73 | — |
| TN | — | $140.73 | — |
| TX | — | $187.65 | — |
| UT | — | $140.73 | — |
| VA | — | $162.05 | — |
| VI | — | $177.38 | — |
| VT | — | $152.86 | — |
| WA | — | $151.39 | — |
| WI | — | $158.76 | — |
| WV | — | $162.05 | — |
| WY | — | $140.73 | — |
How the L0220 fee compares
| Measure | Value |
|---|---|
| Rank among 2 L02 codes (lowest = 1) | 1 |
| Family fee range (average of state fees) | $154.02–$679.25 |
| Rural fee uplift | — |
Who bills L0220 (2024)
| Measure | Value |
|---|---|
| Suppliers billing rentals | — |
| Suppliers billing purchases | 35 |
| Referring clinicians | 56 |
| Medicare beneficiaries | 73 |
| States with claims | 2 |
| Year | Suppliers | Beneficiaries |
|---|---|---|
| 2022 | 44 | 103 |
| 2023 | 50 | 101 |
| 2024 | 35 | 73 |
Counts only. Supplier and clinician names, contact lists and state-by-state detail are in Caduvo.
Medicare utilization for L0220, 2022–2024
| Year | Services | Beneficiaries | Avg. allowed | Avg. paid |
|---|---|---|---|---|
| 2022 | 103 | 103 | $66.79 | $49.75 |
| 2023 | 101 | 101 | $76.06 | $58.31 |
| 2024 | 74 | 73 | $79.75 | $58.77 |
States with the most L0220 services (2024)
| State | Services | Avg. paid |
|---|---|---|
| Washington | 19 | $9.21 |
| California | 15 | $91.43 |
NCCI unit limits (MUE)
| Claim type | Max units per day | Rationale |
|---|---|---|
| DME suppliers | 1 | Anatomic Consideration |
| outpatient hospital claims | 1 | Anatomic Consideration |
What changed for L0220
- 2026-01-01: Average state fee rose 2.0%: $151.00 to $154.02
- 1982-01-01: L0220 added to HCPCS Level II
- Next scheduled CMS quarterly update (HCPCS and DMEPOS fee schedule): 2027-01-01
Frequently asked questions
What is HCPCS code L0220?
L0220 is the HCPCS Level II code for thoracic, rib belt, custom fabricated. Short descriptor: "Thor rib belt custom fabrica".
How much does Medicare pay for L0220?
Under the 2026 DMEPOS fee schedule, non-rural state fees are base (base fee): $94.68–$187.65. Rural fees can be higher.
Does Medicare cover L0220?
Coverage code C — Carrier judgment. Coverage is decided by the Medicare contractor (MAC) case by case.
Did the Medicare fee for L0220 change in 2026?
The average non-rural state fee moved from $151.00 in 2025 to $154.02 in 2026 (+2.0%). CMS's next quarterly HCPCS and DMEPOS update takes effect January 1, 2027.
How many units of L0220 can be billed per day?
1 on DME suppliers; 1 on outpatient hospital claims (NCCI medically unlikely edits).
Related L02 codes
- L0200 — Cervical, multiple post collar, occipital/mandibular supports, adjustable cervical bars, and thoracic extension ($593.42–$1,026.32)
Building a device that would bill under a code like this? Caduvo matches a device description to HCPCS/CPT codes, Medicare coverage and payment, and the FDA pathway in one report.
Next steps
- Run a reimbursement report for a device billed under L0220
- Watch L0220 for fee, coverage and descriptor changes
- Build a full Medicare revenue model for L0220
Sources: CMS HCPCS Level II release October 2025; CMS DMEPOS fee schedule 2026; CMS NCCI MUE tables; CMS Medicare utilization (physician and DME supplier files); CMS Medicare Coverage Database articles. Fees are Medicare allowables, not commercial rates. Not billing or legal advice.