L0720 HCPCS code: Cervical-thoracic-lumbar-sacral-orthoses (ctlso), anterior-posterior-lateral control, prefabricated item that has been trimmed, bent, molded, assembled, or otherwise customized to fit a specific patient by an individual with expertise
L0720 is the HCPCS Level II code for cervical-thoracic-lumbar-sacral-orthoses (ctlso), anterior-posterior-lateral control, prefabricated item that has been trimmed, bent, molded, assembled, or otherwise customized to fit a specific patient by an individual with expertise. The 2026 Medicare DMEPOS fee schedule pays $2,220.69 to $2,437.98 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. Its average fee ranks 1 of 3 L07 codes (family range $2,299.33–$2,700.12).
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 | 2025-04-01 |
| Last action effective | 2025-04-01 |
2026 Medicare DMEPOS fee schedule for L0720
| Modifier | Meaning | Lowest state fee | Highest state fee | Ceiling | Floor |
|---|---|---|---|---|---|
| — | base fee | $2,220.69 | $2,437.98 | — | — |
| State | Modifier | Fee | Rural fee |
|---|---|---|---|
| AK | — | $2,332.36 | — |
| AL | — | $2,265.94 | — |
| AR | — | $2,309.48 | — |
| AZ | — | $2,328.63 | — |
| CA | — | $2,328.63 | — |
| CO | — | $2,272.58 | — |
| CT | — | $2,350.67 | — |
| DC | — | $2,220.69 | — |
| DE | — | $2,220.69 | — |
| FL | — | $2,265.94 | — |
| GA | — | $2,265.94 | — |
| HI | — | $2,370.44 | — |
| IA | — | $2,246.69 | — |
| ID | — | $2,266.63 | — |
| IL | — | $2,381.24 | — |
| IN | — | $2,381.24 | — |
| KS | — | $2,246.69 | — |
| KY | — | $2,265.94 | — |
| LA | — | $2,309.48 | — |
| MA | — | $2,350.67 | — |
| MD | — | $2,220.69 | — |
| ME | — | $2,350.67 | — |
| MI | — | $2,381.24 | — |
| MN | — | $2,381.24 | — |
| MO | — | $2,246.69 | — |
| MS | — | $2,265.94 | — |
| MT | — | $2,272.58 | — |
| NC | — | $2,265.94 | — |
| ND | — | $2,272.58 | — |
| NE | — | $2,246.69 | — |
| NH | — | $2,350.67 | — |
| NJ | — | $2,249.02 | — |
| NM | — | $2,309.48 | — |
| NV | — | $2,328.63 | — |
| NY | — | $2,249.02 | — |
| OH | — | $2,381.24 | — |
| OK | — | $2,309.48 | — |
| OR | — | $2,266.63 | — |
| PA | — | $2,220.69 | — |
| PR | — | $2,437.98 | — |
| RI | — | $2,350.67 | — |
| SC | — | $2,265.94 | — |
| SD | — | $2,272.58 | — |
| TN | — | $2,265.94 | — |
| TX | — | $2,309.48 | — |
| UT | — | $2,272.58 | — |
| VA | — | $2,220.69 | — |
| VI | — | $2,427.33 | — |
| VT | — | $2,350.67 | — |
| WA | — | $2,266.63 | — |
| WI | — | $2,381.24 | — |
| WV | — | $2,220.69 | — |
| WY | — | $2,272.58 | — |
How the L0720 fee compares
| Measure | Value |
|---|---|
| Rank among 3 L07 codes (lowest = 1) | 1 |
| Family fee range (average of state fees) | $2,299.33–$2,700.12 |
| Rural fee uplift | — |
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 L0720
- April 2025: Code appears in this HCPCS release
- 2025-04-01: L0720 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 L0720?
L0720 is the HCPCS Level II code for cervical-thoracic-lumbar-sacral-orthoses (ctlso), anterior-posterior-lateral control, prefabricated item that has been trimmed, bent, molded, assembled, or otherwise customized to fit a specific patient by an individual with expertise. Short descriptor: "Ctlso a-p-l control custom".
How much does Medicare pay for L0720?
Under the 2026 DMEPOS fee schedule, non-rural state fees are base (base fee): $2,220.69–$2,437.98. Rural fees can be higher.
Does Medicare cover L0720?
Coverage code C — Carrier judgment. Coverage is decided by the Medicare contractor (MAC) case by case.
How many units of L0720 can be billed per day?
1 on DME suppliers; 1 on outpatient hospital claims (NCCI medically unlikely edits).
Related L07 codes
- L0700 — Cervical-thoracic-lumbar-sacral-orthoses (ctlso), anterior-posterior-lateral control, molded to patient model, (minerva type) ($1,615.53–$3,418.84)
- L0710 — Ctlso, anterior-posterior-lateral-control, molded to patient model, with interface material, (minerva type) ($1,717.75–$3,497.73)
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 L0720
- Watch L0720 for fee, coverage and descriptor changes
- Build a full Medicare revenue model for L0720
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.