L0634 Medicare Reimbursement Rate (2026)
Current CMS pricing and breakdown for ~Lso flexion control custom.
National Average Payment
A national base rate is not currently published.
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Code Description
Lumbar-sacral orthosis, sagittal-coronal control, with rigid posterior frame/panel(s), posterior extends from sacrococcygeal junction to t-9 vertebra, lateral strength provided by rigid lateral frame/panel(s), produces intracavitary pressure to reduce load on intervertebral discs, includes straps, closures, may include padding, stays, shoulder straps, pendulous abdomen design, custom fabricated
Reimbursement Summary
CPT code L0634 (Lumbar-sacral orthosis, sagittal-coronal control, with rigid posterior frame/panel(s), posterior extends from sacrococcygeal junction to t-9 vertebra, lateral strength provided by rigid lateral frame/panel(s), produces intracavitary pressure to reduce load on intervertebral discs, includes straps, closures, may include padding, stays, shoulder straps, pendulous abdomen design, custom fabricated) does not currently have a published national facility or non-facility reimbursement rate in 2026.
L0634 is a HCPCS Level II code in the category “DMEPOS Equipment.” Medicare does not publish a single national payment amount for this code in 2026 (No National Rate). A national base rate is not currently published.
To estimate a local payment amount when available, use MedFeeSchedule's Medicare Physician Fee Schedule Lookup Tool on the homepage and confirm final pricing guidance through CMS or your local Medicare Administrative Contractor (MAC).
Q3 2026 Breakdown
| Component | Office (Non-Fac) | Facility (Hosp) |
|---|---|---|
| Work RVU | ||
| Practice Expense (PE) | ||
| Malpractice (MP) | ||
| Total RVUs | 0.00 | 0.00 |
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Medicare rates are used as a benchmark only. Actual payer contracts, modifiers, place of service, units, and billing rules may affect reimbursement. This tool is for educational and operational review purposes, not legal or billing advice.
Facility vs. Non-Facility (Office) Payment
Facility vs. non-facility pricing most commonly applies to physician services paid under the RVU-based Physician Fee Schedule. For L0634 (DMEPOS Equipment), the payment methodology may not include both facility and non-facility rates.
Learn How This Reimbursement Is Calculated
Medicare reimbursement is determined by RVUs, geographic adjustments, and the annual conversion factor.
Frequently Asked Questions
What is the 2026 Medicare rate for L0634?
Medicare does not publish a single national reimbursement rate for L0634 in 2026 (No National Rate). Use MedFeeSchedule's Medicare Physician Fee Schedule Lookup Tool to explore locality-adjusted estimates when applicable.
What is the description for code L0634?
Lumbar-sacral orthosis, sagittal-coronal control, with rigid posterior frame/panel(s), posterior extends from sacrococcygeal junction to t-9 vertebra, lateral strength provided by rigid lateral frame/panel(s), produces intracavitary pressure to reduce load on intervertebral discs, includes straps, closures, may include padding, stays, shoulder straps, pendulous abdomen design, custom fabricated
Why do facility and non-facility payments differ for L0634?
Facility vs. non-facility differences usually apply to RVU-based physician services. L0634 may not use both facility and non-facility pricing depending on its payment methodology.
How can I find my local Medicare rate for L0634?
Use MedFeeSchedule's Medicare Physician Fee Schedule Lookup Tool on the homepage to estimate your locality-adjusted reimbursement. Medicare payment can vary based on geographic adjustments (GPCI), place of service, and claim specifics.
Is L0634 covered by Medicare?
Coverage depends on medical necessity, setting, and Medicare policy. Some codes may be bundled, contractor-priced, or restricted. Verify final coverage guidance through CMS or your local MAC when applicable.
