L1120 HCPCS code: Addition to ctlso, scoliosis orthosis, cover for upright, each
L1120 is the HCPCS Level II code for addition to ctlso, scoliosis orthosis, cover for upright, each. The 2026 Medicare DMEPOS fee schedule pays $28.75 to $114.51 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 3 per day on DME suppliers. Its average fee ranks 1 of 3 L11 codes (family range $51.69–$334.14).
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 | 1986-01-01 |
| Last action effective | 1996-01-01 |
2026 Medicare DMEPOS fee schedule for L1120
| Modifier | Meaning | Lowest state fee | Highest state fee | Ceiling | Floor |
|---|---|---|---|---|---|
| — | base fee | $28.75 | $114.51 | $60.85 | $45.64 |
| State | Modifier | Fee | Rural fee |
|---|---|---|---|
| AK | — | $107.10 | — |
| AL | — | $50.16 | — |
| AR | — | $53.66 | — |
| AZ | — | $60.85 | — |
| CA | — | $60.85 | — |
| CO | — | $49.35 | — |
| CT | — | $45.64 | — |
| DC | — | $49.63 | — |
| DE | — | $49.63 | — |
| FL | — | $50.16 | — |
| GA | — | $50.16 | — |
| HI | — | $114.51 | — |
| IA | — | $45.64 | — |
| ID | — | $56.49 | — |
| IL | — | $46.74 | — |
| IN | — | $46.74 | — |
| KS | — | $45.64 | — |
| KY | — | $50.16 | — |
| LA | — | $53.66 | — |
| MA | — | $45.64 | — |
| MD | — | $49.63 | — |
| ME | — | $45.64 | — |
| MI | — | $46.74 | — |
| MN | — | $46.74 | — |
| MO | — | $45.64 | — |
| MS | — | $50.16 | — |
| MT | — | $49.35 | — |
| NC | — | $50.16 | — |
| ND | — | $49.35 | — |
| NE | — | $45.64 | — |
| NH | — | $45.64 | — |
| NJ | — | $45.64 | — |
| NM | — | $53.66 | — |
| NV | — | $60.85 | — |
| NY | — | $45.64 | — |
| OH | — | $46.74 | — |
| OK | — | $53.66 | — |
| OR | — | $56.49 | — |
| PA | — | $49.63 | — |
| PR | — | $28.75 | — |
| RI | — | $45.64 | — |
| SC | — | $50.16 | — |
| SD | — | $49.35 | — |
| TN | — | $50.16 | — |
| TX | — | $53.66 | — |
| UT | — | $49.35 | — |
| VA | — | $49.63 | — |
| VI | — | $45.64 | — |
| VT | — | $45.64 | — |
| WA | — | $56.49 | — |
| WI | — | $46.74 | — |
| WV | — | $49.63 | — |
| WY | — | $49.35 | — |
How the L1120 fee compares
| Measure | Value |
|---|---|
| Rank among 3 L11 codes (lowest = 1) | 1 |
| Family fee range (average of state fees) | $51.69–$334.14 |
| Rural fee uplift | — |
NCCI unit limits (MUE)
| Claim type | Max units per day | Rationale |
|---|---|---|
| DME suppliers | 3 | Nature of Equipment |
| outpatient hospital claims | 3 | Nature of Equipment |
What changed for L1120
- 2026-01-01: Average state fee rose 2.0%: $50.68 to $51.69
- 1986-01-01: L1120 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 L1120?
L1120 is the HCPCS Level II code for addition to ctlso, scoliosis orthosis, cover for upright, each. Short descriptor: "Covers for upright each".
How much does Medicare pay for L1120?
Under the 2026 DMEPOS fee schedule, non-rural state fees are base (base fee): $28.75–$114.51. Rural fees can be higher.
Does Medicare cover L1120?
Coverage code C — Carrier judgment. Coverage is decided by the Medicare contractor (MAC) case by case.
Did the Medicare fee for L1120 change in 2026?
The average non-rural state fee moved from $50.68 in 2025 to $51.69 in 2026 (+2.0%). CMS's next quarterly HCPCS and DMEPOS update takes effect January 1, 2027.
How many units of L1120 can be billed per day?
3 on DME suppliers; 3 on outpatient hospital claims (NCCI medically unlikely edits).
Related L11 codes
- L1100 — Addition to ctlso or scoliosis orthosis, ring flange, plastic or leather ($91.93–$267.47)
- L1110 — Addition to ctlso or scoliosis orthosis, ring flange, plastic or leather, molded to patient model ($184.07–$523.88)
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Next steps
- Run a reimbursement report for a device billed under L1120
- Watch L1120 for fee, coverage and descriptor changes
- Build a full Medicare revenue model for L1120
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.