L1007 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, custom fabricated
L1007 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, custom fabricated. Its Medicare coverage code is C (Carrier judgment): Coverage is decided by the Medicare contractor (MAC) case by case.
Code details
| Field | Value |
|---|---|
| Section | L codes — Orthotic and prosthetic procedures and devices |
| Coverage code | C — Carrier judgment |
| Pricing indicator | 46 — Priced by the Medicare contractor (no national fee) |
| BETOS category | D1F — Prosthetic and orthotic devices |
| Added | 2025-10-01 |
| Last action effective | 2025-10-01 |
What changed for L1007
- October 2025: Code appears in this HCPCS release
- 2025-10-01: L1007 added to HCPCS Level II
- 2025-10-01: Last CMS action: code added
- Next scheduled CMS quarterly update (HCPCS and DMEPOS fee schedule): 2027-01-01
Frequently asked questions
What is HCPCS code L1007?
L1007 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, custom fabricated. Short descriptor: "Scoliosis orth s-c custom".
Does Medicare cover L1007?
Coverage code C — Carrier judgment. Coverage is decided by the Medicare contractor (MAC) case by case.
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)
- L1006 — 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 ($1,309.09–$1,309.09)
- 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)
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Next steps
- Run a reimbursement report for a device billed under L1007
- Watch L1007 for fee, coverage and descriptor changes
- Build a full Medicare revenue model for L1007
Sources: CMS HCPCS Level II release October 2025; CMS DMEPOS fee schedule; 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.