L1320 HCPCS code: Thoracic, pectus carinatum orthosis, sternal compression, rigid circumferential frame with anterior and posterior rigid pads, custom fabricated
L1320 is the HCPCS Level II code for thoracic, pectus carinatum orthosis, sternal compression, rigid circumferential frame with anterior and posterior rigid pads, custom fabricated. 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.
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 | 2024-04-01 |
| Last action effective | 2024-04-01 |
NCCI unit limits (MUE)
| Claim type | Max units per day | Rationale |
|---|---|---|
| DME suppliers | 1 | Anatomic Consideration |
What changed for L1320
- 2024-04-01: L1320 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 L1320?
L1320 is the HCPCS Level II code for thoracic, pectus carinatum orthosis, sternal compression, rigid circumferential frame with anterior and posterior rigid pads, custom fabricated. Short descriptor: "Pectus carinatum ortho cust".
Does Medicare cover L1320?
Coverage code C — Carrier judgment. Coverage is decided by the Medicare contractor (MAC) case by case.
How many units of L1320 can be billed per day?
1 on DME suppliers (NCCI medically unlikely edits).
Related L13 codes
- L1300 — Other scoliosis procedure, body jacket molded to patient model ($1,919.53–$3,013.95)
- L1310 — Other scoliosis procedure, post-operative body jacket ($1,975.19–$2,631.87)
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Next steps
- Run a reimbursement report for a device billed under L1320
- Watch L1320 for fee, coverage and descriptor changes
- Build a full Medicare revenue model for L1320
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.