L1300 HCPCS code: Other scoliosis procedure, body jacket molded to patient model
L1300 is the HCPCS Level II code for other scoliosis procedure, body jacket molded to patient model. The 2026 Medicare DMEPOS fee schedule pays $1,919.53 to $3,013.95 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. Medicare volume rose 2% from 2022 to 2024 (41 to 42 services). In 2024, 31 suppliers billed Medicare for L1300 (purchases), serving 42 beneficiaries.
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 L1300
| Modifier | Meaning | Lowest state fee | Highest state fee | Ceiling | Floor |
|---|---|---|---|---|---|
| — | base fee | $1,919.53 | $3,013.95 | $2,559.37 | $1,919.53 |
| State | Modifier | Fee | Rural fee |
|---|---|---|---|
| AK | — | $2,818.56 | — |
| AL | — | $1,919.53 | — |
| AR | — | $2,212.58 | — |
| AZ | — | $2,559.37 | — |
| CA | — | $2,559.37 | — |
| CO | — | $2,385.46 | — |
| CT | — | $2,041.90 | — |
| DC | — | $2,116.61 | — |
| DE | — | $2,116.61 | — |
| FL | — | $1,919.53 | — |
| GA | — | $1,919.53 | — |
| HI | — | $3,013.95 | — |
| IA | — | $2,066.79 | — |
| ID | — | $1,941.17 | — |
| IL | — | $2,118.07 | — |
| IN | — | $2,118.07 | — |
| KS | — | $2,066.79 | — |
| KY | — | $1,919.53 | — |
| LA | — | $2,212.58 | — |
| MA | — | $2,041.90 | — |
| MD | — | $2,116.61 | — |
| ME | — | $2,041.90 | — |
| MI | — | $2,118.07 | — |
| MN | — | $2,118.07 | — |
| MO | — | $2,066.79 | — |
| MS | — | $1,919.53 | — |
| MT | — | $2,385.46 | — |
| NC | — | $1,919.53 | — |
| ND | — | $2,385.46 | — |
| NE | — | $2,066.79 | — |
| NH | — | $2,041.90 | — |
| NJ | — | $2,559.37 | — |
| NM | — | $2,212.58 | — |
| NV | — | $2,559.37 | — |
| NY | — | $2,559.37 | — |
| OH | — | $2,118.07 | — |
| OK | — | $2,212.58 | — |
| OR | — | $1,941.17 | — |
| PA | — | $2,116.61 | — |
| PR | — | $2,807.76 | — |
| RI | — | $2,041.90 | — |
| SC | — | $1,919.53 | — |
| SD | — | $2,385.46 | — |
| TN | — | $1,919.53 | — |
| TX | — | $2,212.58 | — |
| UT | — | $2,385.46 | — |
| VA | — | $2,116.61 | — |
| VI | — | $2,559.37 | — |
| VT | — | $2,041.90 | — |
| WA | — | $1,941.17 | — |
| WI | — | $2,118.07 | — |
| WV | — | $2,116.61 | — |
| WY | — | $2,385.46 | — |
How the L1300 fee compares
| Measure | Value |
|---|---|
| Rank among 2 L13 codes (lowest = 1) | 1 |
| Family fee range (average of state fees) | $2,197.71–$2,238.23 |
| Rural fee uplift | — |
Who bills L1300 (2024)
| Measure | Value |
|---|---|
| Suppliers billing rentals | — |
| Suppliers billing purchases | 31 |
| Referring clinicians | 40 |
| Medicare beneficiaries | 42 |
| States with claims | 0 |
| Year | Suppliers | Beneficiaries |
|---|---|---|
| 2022 | 34 | 41 |
| 2023 | 37 | 43 |
| 2024 | 31 | 42 |
Counts only. Supplier and clinician names, contact lists and state-by-state detail are in Caduvo.
Medicare utilization for L1300, 2022–2024
| Year | Services | Beneficiaries | Avg. allowed | Avg. paid |
|---|---|---|---|---|
| 2022 | 41 | 41 | $1,951.96 | $1,530.75 |
| 2023 | 44 | 43 | $2,096.12 | $1,605.05 |
| 2024 | 42 | 42 | $2,232.73 | $1,739.23 |
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 L1300
- 2026-01-01: Average state fee rose 2.0%: $2,154.62 to $2,197.71
- 1986-01-01: L1300 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 L1300?
L1300 is the HCPCS Level II code for other scoliosis procedure, body jacket molded to patient model. Short descriptor: "Body jacket mold to patient".
How much does Medicare pay for L1300?
Under the 2026 DMEPOS fee schedule, non-rural state fees are base (base fee): $1,919.53–$3,013.95. Rural fees can be higher.
Does Medicare cover L1300?
Coverage code C — Carrier judgment. Coverage is decided by the Medicare contractor (MAC) case by case.
Did the Medicare fee for L1300 change in 2026?
The average non-rural state fee moved from $2,154.62 in 2025 to $2,197.71 in 2026 (+2.0%). CMS's next quarterly HCPCS and DMEPOS update takes effect January 1, 2027.
How many units of L1300 can be billed per day?
1 on DME suppliers; 1 on outpatient hospital claims (NCCI medically unlikely edits).
Related L13 codes
- L1310 — Other scoliosis procedure, post-operative body jacket ($1,975.19–$2,631.87)
- L1320 — Thoracic, pectus carinatum orthosis, sternal compression, rigid circumferential frame with anterior and posterior rigid pads, custom fabricated
- L1330 — Thoracic orthosis, sternal and/or sternocostal compression, may include anterior and/or posterior pads, panels, with or without frame, prefabricated, off the shelf
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 L1300
- Watch L1300 for fee, coverage and descriptor changes
- Build a full Medicare revenue model for L1300
Sources: CMS HCPCS Level II release October 2026; 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.