L1690 HCPCS code: Combination, bilateral, lumbo-sacral, hip, femur orthosis providing adduction and internal rotation control, prefabricated, includes fitting and adjustment
L1690 is the HCPCS Level II code for combination, bilateral, lumbo-sacral, hip, femur orthosis providing adduction and internal rotation control, prefabricated, includes fitting and adjustment. The 2026 Medicare DMEPOS fee schedule pays $2,319.54 to $2,783.46 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 fell 77% from 2022 to 2024 (6,037 to 1,370 services). In 2024, 51 suppliers billed Medicare for L1690 (purchases), serving 1,354 beneficiaries; California, Texas, New York accounted for 44% of services. Its average fee ranks 13 of 14 L16 codes (family range $57.38–$2,410.76).
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 | 1999-01-01 |
| Last action effective | 2001-01-01 |
2026 Medicare DMEPOS fee schedule for L1690
| Modifier | Meaning | Lowest state fee | Highest state fee | Ceiling | Floor |
|---|---|---|---|---|---|
| — | base fee | $2,319.54 | $2,783.46 | $2,830.66 | $2,122.99 |
| State | Modifier | Fee | Rural fee |
|---|---|---|---|
| AK | — | $2,319.54 | — |
| AL | — | $2,389.39 | — |
| AR | — | $2,389.17 | — |
| AZ | — | $2,319.54 | — |
| CA | — | $2,319.54 | — |
| CO | — | $2,402.54 | — |
| CT | — | $2,319.54 | — |
| DC | — | $2,319.54 | — |
| DE | — | $2,319.54 | — |
| FL | — | $2,389.39 | — |
| GA | — | $2,389.39 | — |
| HI | — | $2,319.54 | — |
| IA | — | $2,364.79 | — |
| ID | — | $2,319.54 | — |
| IL | — | $2,376.51 | — |
| IN | — | $2,376.51 | — |
| KS | — | $2,364.79 | — |
| KY | — | $2,389.39 | — |
| LA | — | $2,389.17 | — |
| MA | — | $2,319.54 | — |
| MD | — | $2,319.54 | — |
| ME | — | $2,319.54 | — |
| MI | — | $2,376.51 | — |
| MN | — | $2,376.51 | — |
| MO | — | $2,364.79 | — |
| MS | — | $2,389.39 | — |
| MT | — | $2,402.54 | — |
| NC | — | $2,389.39 | — |
| ND | — | $2,402.54 | — |
| NE | — | $2,364.79 | — |
| NH | — | $2,319.54 | — |
| NJ | — | $2,319.54 | — |
| NM | — | $2,389.17 | — |
| NV | — | $2,319.54 | — |
| NY | — | $2,319.54 | — |
| OH | — | $2,376.51 | — |
| OK | — | $2,389.17 | — |
| OR | — | $2,319.54 | — |
| PA | — | $2,319.54 | — |
| PR | — | $2,783.46 | — |
| RI | — | $2,319.54 | — |
| SC | — | $2,389.39 | — |
| SD | — | $2,402.54 | — |
| TN | — | $2,389.39 | — |
| TX | — | $2,389.17 | — |
| UT | — | $2,402.54 | — |
| VA | — | $2,319.54 | — |
| VI | — | $2,783.46 | — |
| VT | — | $2,319.54 | — |
| WA | — | $2,319.54 | — |
| WI | — | $2,376.51 | — |
| WV | — | $2,319.54 | — |
| WY | — | $2,402.54 | — |
How the L1690 fee compares
| Measure | Value |
|---|---|
| Rank among 14 L16 codes (lowest = 1) | 13 |
| Family fee range (average of state fees) | $57.38–$2,410.76 |
| Rural fee uplift | — |
Who bills L1690 (2024)
| Measure | Value |
|---|---|
| Suppliers billing rentals | — |
| Suppliers billing purchases | 51 |
| Referring clinicians | 1,113 |
| Medicare beneficiaries | 1,354 |
| States with claims | 32 |
| Share of services in top 3 states (California, Texas, New York) | 44% |
| Year | Suppliers | Beneficiaries |
|---|---|---|
| 2022 | 83 | 5,533 |
| 2023 | 69 | 2,218 |
| 2024 | 51 | 1,354 |
Counts only. Supplier and clinician names, contact lists and state-by-state detail are in Caduvo.
Medicare utilization for L1690, 2022–2024
| Year | Services | Beneficiaries | Avg. allowed | Avg. paid |
|---|---|---|---|---|
| 2022 | 6,037 | 5,533 | $1,984.26 | $1,554.11 |
| 2023 | 2,226 | 2,218 | $2,105.24 | $1,631.33 |
| 2024 | 1,370 | 1,354 | $2,232.45 | $1,745.56 |
States with the most L1690 services (2024)
| State | Services | Avg. paid |
|---|---|---|
| California | 321 | $1,735.54 |
| Texas | 134 | $1,786.17 |
| New York | 113 | $1,730.68 |
| Florida | 76 | $1,783.82 |
| Massachusetts | 62 | $1,735.97 |
NCCI unit limits (MUE)
| Claim type | Max units per day | Rationale |
|---|---|---|
| DME suppliers | 1 | Code Descriptor / CPT Instruction |
| outpatient hospital claims | 1 | Code Descriptor / CPT Instruction |
What changed for L1690
- 2026-01-01: Average state fee rose 2.0%: $2,326.88 to $2,373.42
- 1999-01-01: L1690 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 L1690?
L1690 is the HCPCS Level II code for combination, bilateral, lumbo-sacral, hip, femur orthosis providing adduction and internal rotation control, prefabricated, includes fitting and adjustment. Short descriptor: "Combination bilateral ho".
How much does Medicare pay for L1690?
Under the 2026 DMEPOS fee schedule, non-rural state fees are base (base fee): $2,319.54–$2,783.46. Rural fees can be higher.
Does Medicare cover L1690?
Coverage code C — Carrier judgment. Coverage is decided by the Medicare contractor (MAC) case by case.
Did the Medicare fee for L1690 change in 2026?
The average non-rural state fee moved from $2,326.88 in 2025 to $2,373.42 in 2026 (+2.0%). CMS's next quarterly HCPCS and DMEPOS update takes effect January 1, 2027.
How many units of L1690 can be billed per day?
1 on DME suppliers; 1 on outpatient hospital claims (NCCI medically unlikely edits).
Related L16 codes
- L1600 — Hip orthosis, abduction control of hip joints, flexible, frejka type with cover, prefabricated item that has been trimmed, bent, molded, assembled, or otherwise customized to fit a specific patient by an inidividual with expertise ($148.08–$329.89)
- L1610 — Hip orthosis, abduction control of hip joints, flexible, (frejka cover only), prefabricated item that has been trimmed, bent, molded, assembled, or otherwise customized to fit a specific patient by an individual with expertise ($48.44–$75.43)
- L1620 — Hip orthosis, abduction control of hip joints, flexible, (pavlik harness), prefabricated item that has been trimmed, bent, molded, assembled, or otherwise customized to fit a specific patient by an individual with expertise ($153.96–$205.58)
- L1630 — Hip orthosis, abduction control of hip joints, semi-flexible (von rosen type), custom fabricated ($170.36–$259.63)
- L1640 — Hip orthosis, abduction control of hip joints, static, pelvic band or spreader bar, thigh cuffs, custom fabricated ($458.97–$1,142.13)
- L1650 — Hip orthosis, abduction control of hip joints, static, adjustable, (ilfled type), prefabricated, includes fitting and adjustment ($189.69–$351.91)
- L1652 — Hip orthosis, bilateral thigh cuffs with adjustable abductor spreader bar, adult size, prefabricated, includes fitting and adjustment, prefabricated item that has been trimmed, bent, molded, assembled, or otherwise customized to fit a specific patient by an individual with expertise ($427.56–$470.32)
- L1653 — Hip orthosis, bilateral thigh cuffs with adjustable abductor spreader bar, adult size, prefabricated, off the shelf ($427.56–$470.32)
- L1660 — Hip orthosis, abduction control of hip joints, static, plastic, prefabricated, includes fitting and adjustment ($182.17–$262.21)
- L1680 — Hip orthosis, abduction control of hip joints, dynamic, pelvic control, adjustable hip motion control, thigh cuffs (rancho hip action type), custom fabricated ($1,400.11–$3,215.45)
- L1681 — Hip orthosis, bilateral hip joints and thigh cuffs, adjustable flexion, extension, abduction control of hip joint, postoperative hip abduction type, prefabricated item that has been trimmed, bent, molded, assembled, or otherwise customized to fit a specific patient by an individual with expertise ($2,096.44–$3,461.66)
- L1685 — Hip orthosis, abduction control of hip joint, postoperative hip abduction type, custom fabricated ($1,366.86–$2,740.53)
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 L1690
- Watch L1690 for fee, coverage and descriptor changes
- Build a full Medicare revenue model for L1690
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.