L1006 HCPCS code: Scoliosis orthosis, sagittal-coronal control provided by a rigid lateral frame, extends from axilla to trochanter, includes all accessory pads, straps and interface, prefabricated item that has been trimmed, bent, molded, assembled, or otherwise customized to fit a specific patient by an individual with expertise
L1006 is the HCPCS Level II code for scoliosis orthosis, sagittal-coronal control provided by a rigid lateral frame, extends from axilla to trochanter, includes all accessory pads, straps and interface, 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 $1,309.09 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, 38 suppliers billed Medicare for L1006 (purchases), serving 72 beneficiaries. Its average fee ranks 12 of 14 L10 codes (family range $71.30–$3,913.88).
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 | 2024-10-01 |
| Last action effective | 2024-10-01 |
2026 Medicare DMEPOS fee schedule for L1006
| Modifier | Meaning | Lowest state fee | Highest state fee | Ceiling | Floor |
|---|---|---|---|---|---|
| — | base fee | $1,309.09 | $1,309.09 | $1,570.91 | $1,178.18 |
| State | Modifier | Fee | Rural fee |
|---|---|---|---|
| AK | — | $1,309.09 | — |
| AL | — | $1,309.09 | — |
| AR | — | $1,309.09 | — |
| AZ | — | $1,309.09 | — |
| CA | — | $1,309.09 | — |
| CO | — | $1,309.09 | — |
| CT | — | $1,309.09 | — |
| DC | — | $1,309.09 | — |
| DE | — | $1,309.09 | — |
| FL | — | $1,309.09 | — |
| GA | — | $1,309.09 | — |
| HI | — | $1,309.09 | — |
| IA | — | $1,309.09 | — |
| ID | — | $1,309.09 | — |
| IL | — | $1,309.09 | — |
| IN | — | $1,309.09 | — |
| KS | — | $1,309.09 | — |
| KY | — | $1,309.09 | — |
| LA | — | $1,309.09 | — |
| MA | — | $1,309.09 | — |
| MD | — | $1,309.09 | — |
| ME | — | $1,309.09 | — |
| MI | — | $1,309.09 | — |
| MN | — | $1,309.09 | — |
| MO | — | $1,309.09 | — |
| MS | — | $1,309.09 | — |
| MT | — | $1,309.09 | — |
| NC | — | $1,309.09 | — |
| ND | — | $1,309.09 | — |
| NE | — | $1,309.09 | — |
| NH | — | $1,309.09 | — |
| NJ | — | $1,309.09 | — |
| NM | — | $1,309.09 | — |
| NV | — | $1,309.09 | — |
| NY | — | $1,309.09 | — |
| OH | — | $1,309.09 | — |
| OK | — | $1,309.09 | — |
| OR | — | $1,309.09 | — |
| PA | — | $1,309.09 | — |
| PR | — | $1,309.09 | — |
| RI | — | $1,309.09 | — |
| SC | — | $1,309.09 | — |
| SD | — | $1,309.09 | — |
| TN | — | $1,309.09 | — |
| TX | — | $1,309.09 | — |
| UT | — | $1,309.09 | — |
| VA | — | $1,309.09 | — |
| VI | — | $1,309.09 | — |
| VT | — | $1,309.09 | — |
| WA | — | $1,309.09 | — |
| WI | — | $1,309.09 | — |
| WV | — | $1,309.09 | — |
| WY | — | $1,309.09 | — |
How the L1006 fee compares
| Measure | Value |
|---|---|
| Rank among 14 L10 codes (lowest = 1) | 12 |
| Family fee range (average of state fees) | $71.30–$3,913.88 |
| Rural fee uplift | — |
Who bills L1006 (2024)
| Measure | Value |
|---|---|
| Suppliers billing rentals | — |
| Suppliers billing purchases | 38 |
| Referring clinicians | 56 |
| Medicare beneficiaries | 72 |
| States with claims | 1 |
Counts only. Supplier and clinician names, contact lists and state-by-state detail are in Caduvo.
Medicare utilization for L1006, 2024–2024
| Year | Services | Beneficiaries | Avg. allowed | Avg. paid |
|---|---|---|---|---|
| 2024 | 72 | 72 | $1,253.34 | $971.02 |
States with the most L1006 services (2024)
| State | Services | Avg. paid |
|---|---|---|
| New York | 15 | $982.62 |
NCCI unit limits (MUE)
| Claim type | Max units per day | Rationale |
|---|---|---|
| DME suppliers | 1 | Anatomic Consideration |
What changed for L1006
- 2026-01-01: Average state fee rose 2.0%: $1,283.42 to $1,309.09
- 2024-10-01: L1006 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 L1006?
L1006 is the HCPCS Level II code for scoliosis orthosis, sagittal-coronal control provided by a rigid lateral frame, extends from axilla to trochanter, includes all accessory pads, straps and interface, prefabricated item that has been trimmed, bent, molded, assembled, or otherwise customized to fit a specific patient by an individual with expertise. Short descriptor: "Scoliosis orth sag/ cor".
How much does Medicare pay for L1006?
Under the 2026 DMEPOS fee schedule, non-rural state fees are base (base fee): $1,309.09. Rural fees can be higher.
Does Medicare cover L1006?
Coverage code C — Carrier judgment. Coverage is decided by the Medicare contractor (MAC) case by case.
Did the Medicare fee for L1006 change in 2026?
The average non-rural state fee moved from $1,283.42 in 2025 to $1,309.09 in 2026 (+2.0%). CMS's next quarterly HCPCS and DMEPOS update takes effect January 1, 2027.
How many units of L1006 can be billed per day?
1 on DME suppliers (NCCI medically unlikely edits).
Related L10 codes
- L1000 — Cervical-thoracic-lumbar-sacral orthosis (ctlso) (milwaukee), inclusive of furnishing initial orthosis, including model ($2,332.97–$4,062.52)
- L1001 — Cervical thoracic lumbar sacral orthosis, immobilizer, infant size, prefabricated, includes fitting and adjustment
- L1005 — Tension based scoliosis orthosis and accessory pads, includes fitting and adjustment ($3,839.20–$4,223.13)
- L1007 — Scoliosis orthosis, sagittal-coronal control provided by a rigid lateral frame, extends from axilla, to trochanter, includes all accessory pads, straps, and interface, custom fabricated
- L1010 — Addition to cervical-thoracic-lumbar-sacral orthosis (ctlso) or scoliosis orthosis, axilla sling ($51.03–$102.83)
- L1020 — Addition to ctlso or scoliosis orthosis, kyphosis pad ($66.65–$184.59)
- L1025 — Addition to ctlso or scoliosis orthosis, kyphosis pad, floating ($143.30–$323.62)
- L1030 — Addition to ctlso or scoliosis orthosis, lumbar bolster pad ($71.58–$97.47)
- L1040 — Addition to ctlso or scoliosis orthosis, lumbar or lumbar rib pad ($51.17–$166.02)
- L1050 — Addition to ctlso or scoliosis orthosis, sternal pad ($51.17–$141.90)
- L1060 — Addition to ctlso or scoliosis orthosis, thoracic pad ($81.66–$170.96)
- L1070 — Addition to ctlso or scoliosis orthosis, trapezius sling ($68.51–$144.98)
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 L1006
- Watch L1006 for fee, coverage and descriptor changes
- Build a full Medicare revenue model for L1006
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.