L0972 HCPCS code: Lso, corset front
L0972 is the HCPCS Level II code for lso, corset front. The 2026 Medicare DMEPOS fee schedule pays $81.66 to $198.16 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. In 2024, 11 suppliers billed Medicare for L0972 (purchases), serving 259 beneficiaries. Its average fee ranks 4 of 8 L09 codes (family range $20.91–$251.90).
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 L0972
| Modifier | Meaning | Lowest state fee | Highest state fee | Ceiling | Floor |
|---|---|---|---|---|---|
| — | base fee | $81.66 | $198.16 | $157.68 | $118.26 |
| State | Modifier | Fee | Rural fee |
|---|---|---|---|
| AK | — | $185.33 | — |
| AL | — | $134.25 | — |
| AR | — | $152.77 | — |
| AZ | — | $157.68 | — |
| CA | — | $157.68 | — |
| CO | — | $127.20 | — |
| CT | — | $118.26 | — |
| DC | — | $138.79 | — |
| DE | — | $138.79 | — |
| FL | — | $134.25 | — |
| GA | — | $134.25 | — |
| HI | — | $198.16 | — |
| IA | — | $120.25 | — |
| ID | — | $118.26 | — |
| IL | — | $119.54 | — |
| IN | — | $119.54 | — |
| KS | — | $120.25 | — |
| KY | — | $134.25 | — |
| LA | — | $152.77 | — |
| MA | — | $118.26 | — |
| MD | — | $138.79 | — |
| ME | — | $118.26 | — |
| MI | — | $119.54 | — |
| MN | — | $119.54 | — |
| MO | — | $120.25 | — |
| MS | — | $134.25 | — |
| MT | — | $127.20 | — |
| NC | — | $134.25 | — |
| ND | — | $127.20 | — |
| NE | — | $120.25 | — |
| NH | — | $118.26 | — |
| NJ | — | $131.03 | — |
| NM | — | $152.77 | — |
| NV | — | $157.68 | — |
| NY | — | $131.03 | — |
| OH | — | $119.54 | — |
| OK | — | $152.77 | — |
| OR | — | $118.26 | — |
| PA | — | $138.79 | — |
| PR | — | $81.66 | — |
| RI | — | $118.26 | — |
| SC | — | $134.25 | — |
| SD | — | $127.20 | — |
| TN | — | $134.25 | — |
| TX | — | $152.77 | — |
| UT | — | $127.20 | — |
| VA | — | $138.79 | — |
| VI | — | $131.03 | — |
| VT | — | $118.26 | — |
| WA | — | $118.26 | — |
| WI | — | $119.54 | — |
| WV | — | $138.79 | — |
| WY | — | $127.20 | — |
How the L0972 fee compares
| Measure | Value |
|---|---|
| Rank among 8 L09 codes (lowest = 1) | 4 |
| Family fee range (average of state fees) | $20.91–$251.90 |
| Rural fee uplift | — |
Who bills L0972 (2024)
| Measure | Value |
|---|---|
| Suppliers billing rentals | — |
| Suppliers billing purchases | 11 |
| Referring clinicians | 107 |
| Medicare beneficiaries | 259 |
| States with claims | 1 |
Counts only. Supplier and clinician names, contact lists and state-by-state detail are in Caduvo.
Medicare utilization for L0972, 2024–2024
| Year | Services | Beneficiaries | Avg. allowed | Avg. paid |
|---|---|---|---|---|
| 2024 | 259 | 259 | $103.68 | $77.06 |
States with the most L0972 services (2024)
| State | Services | Avg. paid |
|---|---|---|
| California | 247 | $76.65 |
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 L0972
- 2026-01-01: Average state fee rose 2.0%: $130.00 to $132.60
- 1982-01-01: L0972 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 L0972?
L0972 is the HCPCS Level II code for lso, corset front. Short descriptor: "Lso corset front".
How much does Medicare pay for L0972?
Under the 2026 DMEPOS fee schedule, non-rural state fees are base (base fee): $81.66–$198.16. Rural fees can be higher.
Does Medicare cover L0972?
Coverage code C — Carrier judgment. Coverage is decided by the Medicare contractor (MAC) case by case.
Did the Medicare fee for L0972 change in 2026?
The average non-rural state fee moved from $130.00 in 2025 to $132.60 in 2026 (+2.0%). CMS's next quarterly HCPCS and DMEPOS update takes effect January 1, 2027.
How many units of L0972 can be billed per day?
1 on DME suppliers; 1 on outpatient hospital claims (NCCI medically unlikely edits).
Related L09 codes
- L0970 — Tlso, corset front ($81.66–$221.47)
- L0974 — Tlso, full corset ($133.09–$285.59)
- L0976 — Lso, full corset ($133.09–$244.99)
- L0978 — Axillary crutch extension ($81.66–$692.78)
- L0980 — Peroneal straps, prefabricated, off-the-shelf, pair ($16.07–$26.75)
- L0982 — Stocking supporter grips, prefabricated, off-the-shelf, set of four (4) ($17.45–$24.95)
- L0984 — Protective body sock, prefabricated, off-the-shelf, each ($69.77–$90.32)
- L0999 — Addition to spinal orthosis, not otherwise specified
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 L0972
- Watch L0972 for fee, coverage and descriptor changes
- Build a full Medicare revenue model for L0972
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.