HCPCS Level II L0629: Lumbar-Sacral Orthosis, Flexible, Custom Fabricated

HCPCS Level II code L0629 describes a custom fabricated, flexible lumbar-sacral orthosis that provides lumbo-sacral support with a posterior panel extending from the sacrococcygeal junction to the T9 vertebra, designed to produce intracavitary pressure to reduce load on intervertebral discs and may include straps, closures, stays, shoulder straps, or a pendulous abdomen design; service type is provision of a custom-fabricated durable medical device for spinal support, typically supplied in outpatient orthotics clinics, durable medical equipment providers, or hospital orthopedic departments.

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HCPCS Level II L0629: Lumbar-Sacral Orthosis, Flexible, Custom Fabricated

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Clinical & Coding Specifications

Clinical Context

A patient presents with mechanical low back pain and documented lumbar degenerative disc disease following conservative therapy. Typical patient: a 55-year-old construction worker with chronic low-back pain radiating to the sacral region after a work-related strain; symptoms include axial lumbar pain exacerbated by bending and lifting, reduced functional capacity, and intermittent paraspinal muscle spasm. Imaging (lumbar MRI or radiographs) demonstrates multilevel degenerative disc changes without acute fracture. A lumbar-sacral orthosis described by L0629 is custom fabricated and fitted in an outpatient orthotics clinic or durable medical equipment (DME) vendor setting, after prescription by an authorized clinician (e.g., physiatrist, orthopedic spine surgeon, neurosurgeon, or primary care physician). The clinical workflow: evaluation and documentation of diagnosis and functional limitation, trial of conservative care (medication, physical therapy), prescription for a custom-fabricated lumbar-sacral orthosis with specification of desired features, measurement and ordering from the orthotist, fabrication and patient fitting with education on wear schedule and skin checks, and follow-up to assess symptom relief and fit. Typical site of service: outpatient orthotics/prosthetics clinic, hospital outpatient department, ambulatory surgery center pre/post-op consultations, or the patient’s home for DME delivery and fitting when needed. Payers commonly involved include Aetna, Blue Cross Blue Shield, Cigna Health, UnitedHealthcare, BUCA, and Medicare.

Related CPT Codes

CPT Code	Description	Relationship to This Procedure
`99203`	Office or other outpatient visit for the evaluation and management of a new patient, moderate complexity	Used for the initial clinical evaluation and medical necessity documentation leading to a prescription for `L0629`.
`99213`	Office or other outpatient visit for the evaluation and management of an established patient, low to moderate complexity	Used for routine follow-up visits to assess fit, function, and ongoing need for the lumbar-sacral orthosis.
`97760`	Orthotic management and training, upper extremity, lower extremity and/or trunk, initial orthotic fit and training (includes assessment and fitting)	Used when billing professional services for initial fitting, patient education, and training in use of the custom lumbar-sacral orthosis.
`20550`	Injection, tendon sheath, or ligament; single or multiple trigger point injections (if performed)	May be performed in the same episode of care for pain management prior to or concurrent with orthotic prescription.
`63030`	Laminectomy, facetectomy and foraminotomy, 1 vertebral segment; lumbar	Represents a surgical procedure after which `L0629` may be prescribed postoperatively for support and immobilization.

Related Modifiers

6 rows

Modifier	Description	When to Use
22	Modifier –22 (Increased Procedural Services) is used when a reported procedure is substantially more extensive than normally required. The CPT Manual and CMS state it may be appended only when the…	- When to use: Append modifier -22 to a procedural CPT code when the service performed is substantially more extensive than the usual service described by that code — i.e., the procedure required…
52	Modifier ‑52 (Reduced Services) indicates that a service or procedure was partially reduced or omitted at the provider’s discretion, allowing reporting of the basic procedure number with a qualifier…	- Use modifier -52 when a physician or qualified health professional electively reduces or omits part of a procedure or service (for example, performing fewer required views or omitting a portion of…
59	Modifier 59 indicates a distinct procedural service when two procedures that are not normally billed together are clinically and procedurally separate. The CPT definition (as reiterated by CMS)…	- Use modifier -59 to report a distinct procedural service when documentation supports that the procedure reported is not normally billed together with another service on the same day because of a…
62	Modifier 62 indicates that two surgeons function as co‑surgeons, each performing distinct parts of the same primary surgical procedure. It is appended to the primary procedure code (and any…	- Use modifier -62 when two surgeons act as co‑surgeons (both primary surgeons) on a single definitive primary procedure, each performing distinct parts of the same surgical procedure (append -62 to…
80	CPT® Modifier 80 (Assistant Surgeon) is appended to a surgical CPT code when a physician (MD or DO) provides full, continuous assistance throughout the operative procedure. It is intended only for…	- Use CPT Modifier -80 when a physician (MD or DO) serves as an assistant surgeon and provides full, continuous assistance throughout the entire operative procedure; append -80 to the surgical CPT…
82	Modifier 82 is appended to a surgical CPT code to indicate that an attending physician acted as an assistant because a qualified resident surgeon was unavailable. In teaching hospitals it documents…	- When to use: Append modifier 82 in teaching-hospital settings to indicate a physician served as an assistant surgeon because a qualified resident surgeon was unavailable (includes situations where…

Related Provider Taxonomies

8 rows

Taxonomy Code	Specialty	Notes
207RH0000X	Hematology (Internal Medicine) Physician	An internist with additional training who specializes in diseases of the blood, spleen and lymph. This specialist treats conditions such as anemia, cl…
207T00000X	Neurological Surgery Physician	A neurological surgeon provides the operative and non-operative management (i.e., prevention, diagnosis, evaluation, treatment, critical care, and reh…
2084P0800X	Psychiatry Physician	A Psychiatrist specializes in the prevention, diagnosis, and treatment of mental disorders, emotional disorders, psychotic disorders, mood disorders, …
208D00000X	General Practice Physician	A physician who specializes in the general practice of diagnosing, treating, and managing patients with a variety of illnesses and conditions.
163WG0100X	Gastroenterology Registered Nurse	Nursing Service Providers · Registered Nurse
175T00000X	Peer Specialist	Individuals certified to perform peer support services through a training process defined by a government agency, such as the Department of Veterans A…
261QD1600X	Developmental Disabilities Clinic/Center	An entity, facility, or distinct part of a facility providing comprehensive, multidiscipline diagnostic, treatment, therapy, training, and counseling …
207WX0109X	Neuro-ophthalmology Physician	A neuro-ophthalmologist is a subspecialist of ophthalmology. This physician evaluates, treats, and studies disorders of the eye, orbit and nervous sy…

Related ICD-10-CM Codes

21 rows

ICD-10-CM Code	Description
G96.11	Dural tear
M43.16	Spondylolisthesis, lumbar region
M43.17	Spondylolisthesis, lumbosacral region
M47.26	Other spondylosis with radiculopathy, lumbar region
M47.27	Other spondylosis with radiculopathy, lumbosacral region
M48.07	Spinal stenosis, lumbosacral region
M51.26	Other intervertebral disc displacement, lumbar region
M51.27	Other intervertebral disc displacement, lumbosacral region
M53.2X6	Spinal instabilities, lumbar region
M54.16	Radiculopathy, lumbar region

Showing 1–10 of 21

HCPCS L0112: Cranial Cervical Orthosis, Congenital Torticollis Type

HCPCS-L0113-CRANIAL-CERVICAL-ORTHOSIS-TORTICOLLIS

HCPCS Level II L0113: Prefabricated Cranial Cervical Orthosis for Torticollis

HCPCS-L0130-CERVICAL-FLEXIBLE-THERMOPLASTIC-COLLAR-MOLDED-TO-PATIENT

HCPCS Level II L0130: Cervical Flexible Thermoplastic Collar, Molded to Patient

HCPCS-L0140-CERVICAL-SEMI-RIGID-ADJUSTABLE-PLASTIC-COLLAR

HCPCS Level II L0140: Cervical Semi-Rigid Adjustable Plastic Collar

HCPCS-L0150-CERVICAL-SEMI-RIGID-ADJUSTABLE-CHIN-CUP

HCPCS Level II L0150: Cervical Semi-Rigid Adjustable Chin Cup

HCPCS-L0160-CERVICAL-SEMI-RIGID-OCCIPITAL-MANDIBULAR-SUPPORT

HCPCS Level II L0160: Cervical Semi-Rigid Occipital/Mandibular Support

HCPCS-L0170-CERVICAL-COLLAR-MOLDED-TO-PATIENT-MODEL

HCPCS Level II L0170: Cervical Collar, Custom-Molded

HCPCS-L0172-CERVICAL-COLLAR-SEMI-RIGID-THERMOPLASTIC-FOAM

HCPCS L0172: Cervical Collar, Semi-Rigid Prefabricated

HCPCS-L0174-CERVICAL-COLLAR-SEMI-RIGID-THORACIC-EXTENSION

HCPCS L0174: Cervical Collar, Semi-Rigid Thermoplastic with Thoracic Extension

HCPCS-L0180-CERVICAL-MULTIPLE-POST-COLLAR-OCCIPITAL-MANDIBULAR-ADJUSTABLE

HCPCS Level II L0180: Cervical Orthosis with Occipital/Mandibular Supports

Showing 1–10 of 466

Frequently Asked Questions

References

1.CPT® Codes and Descriptions. AAPC. Retrieved Aug 11, 2026.Maintains the CPT code set's official descriptions and guidelines, licensed from the American Medical Association, used as the definitional source for CPT codes on this page.
2.HCPCS Quarterly Update. Centers for Medicare & Medicaid Services (CMS). Retrieved Aug 11, 2026.CMS's quarterly release of HCPCS Level II codes and short/long descriptors, the source for HCPCS code definitions and update history.
3.ICD-10-CM Full Code List. Centers for Medicare & Medicaid Services (CMS). Retrieved Aug 11, 2026.CMS's complete ICD-10-CM diagnosis code list, used to cross-reference diagnosis codes associated with this procedure or service.

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Clinical & Coding Specifications

Clinical Context

Related CPT Codes

CPT Code	Description	Relationship to This Procedure
`99203`	Office or other outpatient visit for the evaluation and management of a new patient, moderate complexity	Used for the initial clinical evaluation and medical necessity documentation leading to a prescription for `L0629`.
`99213`	Office or other outpatient visit for the evaluation and management of an established patient, low to moderate complexity	Used for routine follow-up visits to assess fit, function, and ongoing need for the lumbar-sacral orthosis.
`97760`	Orthotic management and training, upper extremity, lower extremity and/or trunk, initial orthotic fit and training (includes assessment and fitting)	Used when billing professional services for initial fitting, patient education, and training in use of the custom lumbar-sacral orthosis.
`20550`	Injection, tendon sheath, or ligament; single or multiple trigger point injections (if performed)	May be performed in the same episode of care for pain management prior to or concurrent with orthotic prescription.
`63030`	Laminectomy, facetectomy and foraminotomy, 1 vertebral segment; lumbar	Represents a surgical procedure after which `L0629` may be prescribed postoperatively for support and immobilization.

Related Modifiers

6 rows

Modifier	Description	When to Use
22	Modifier –22 (Increased Procedural Services) is used when a reported procedure is substantially more extensive than normally required. The CPT Manual and CMS state it may be appended only when the…	- When to use: Append modifier -22 to a procedural CPT code when the service performed is substantially more extensive than the usual service described by that code — i.e., the procedure required…
52	Modifier ‑52 (Reduced Services) indicates that a service or procedure was partially reduced or omitted at the provider’s discretion, allowing reporting of the basic procedure number with a qualifier…	- Use modifier -52 when a physician or qualified health professional electively reduces or omits part of a procedure or service (for example, performing fewer required views or omitting a portion of…
59	Modifier 59 indicates a distinct procedural service when two procedures that are not normally billed together are clinically and procedurally separate. The CPT definition (as reiterated by CMS)…	- Use modifier -59 to report a distinct procedural service when documentation supports that the procedure reported is not normally billed together with another service on the same day because of a…
62	Modifier 62 indicates that two surgeons function as co‑surgeons, each performing distinct parts of the same primary surgical procedure. It is appended to the primary procedure code (and any…	- Use modifier -62 when two surgeons act as co‑surgeons (both primary surgeons) on a single definitive primary procedure, each performing distinct parts of the same surgical procedure (append -62 to…
80	CPT® Modifier 80 (Assistant Surgeon) is appended to a surgical CPT code when a physician (MD or DO) provides full, continuous assistance throughout the operative procedure. It is intended only for…	- Use CPT Modifier -80 when a physician (MD or DO) serves as an assistant surgeon and provides full, continuous assistance throughout the entire operative procedure; append -80 to the surgical CPT…
82	Modifier 82 is appended to a surgical CPT code to indicate that an attending physician acted as an assistant because a qualified resident surgeon was unavailable. In teaching hospitals it documents…	- When to use: Append modifier 82 in teaching-hospital settings to indicate a physician served as an assistant surgeon because a qualified resident surgeon was unavailable (includes situations where…

Related Provider Taxonomies

8 rows

Taxonomy Code	Specialty	Notes
207RH0000X	Hematology (Internal Medicine) Physician	An internist with additional training who specializes in diseases of the blood, spleen and lymph. This specialist treats conditions such as anemia, cl…
207T00000X	Neurological Surgery Physician	A neurological surgeon provides the operative and non-operative management (i.e., prevention, diagnosis, evaluation, treatment, critical care, and reh…
2084P0800X	Psychiatry Physician	A Psychiatrist specializes in the prevention, diagnosis, and treatment of mental disorders, emotional disorders, psychotic disorders, mood disorders, …
208D00000X	General Practice Physician	A physician who specializes in the general practice of diagnosing, treating, and managing patients with a variety of illnesses and conditions.
163WG0100X	Gastroenterology Registered Nurse	Nursing Service Providers · Registered Nurse
175T00000X	Peer Specialist	Individuals certified to perform peer support services through a training process defined by a government agency, such as the Department of Veterans A…
261QD1600X	Developmental Disabilities Clinic/Center	An entity, facility, or distinct part of a facility providing comprehensive, multidiscipline diagnostic, treatment, therapy, training, and counseling …
207WX0109X	Neuro-ophthalmology Physician	A neuro-ophthalmologist is a subspecialist of ophthalmology. This physician evaluates, treats, and studies disorders of the eye, orbit and nervous sy…

Related ICD-10-CM Codes

21 rows

ICD-10-CM Code	Description
G96.11	Dural tear
M43.16	Spondylolisthesis, lumbar region
M43.17	Spondylolisthesis, lumbosacral region
M47.26	Other spondylosis with radiculopathy, lumbar region
M47.27	Other spondylosis with radiculopathy, lumbosacral region
M48.07	Spinal stenosis, lumbosacral region
M51.26	Other intervertebral disc displacement, lumbar region
M51.27	Other intervertebral disc displacement, lumbosacral region
M53.2X6	Spinal instabilities, lumbar region
M54.16	Radiculopathy, lumbar region

Showing 1–10 of 21

HCPCS L0112: Cranial Cervical Orthosis, Congenital Torticollis Type

HCPCS-L0113-CRANIAL-CERVICAL-ORTHOSIS-TORTICOLLIS

HCPCS Level II L0113: Prefabricated Cranial Cervical Orthosis for Torticollis

HCPCS-L0130-CERVICAL-FLEXIBLE-THERMOPLASTIC-COLLAR-MOLDED-TO-PATIENT

HCPCS Level II L0130: Cervical Flexible Thermoplastic Collar, Molded to Patient

HCPCS-L0140-CERVICAL-SEMI-RIGID-ADJUSTABLE-PLASTIC-COLLAR

HCPCS Level II L0140: Cervical Semi-Rigid Adjustable Plastic Collar

HCPCS-L0150-CERVICAL-SEMI-RIGID-ADJUSTABLE-CHIN-CUP

HCPCS Level II L0150: Cervical Semi-Rigid Adjustable Chin Cup

HCPCS-L0160-CERVICAL-SEMI-RIGID-OCCIPITAL-MANDIBULAR-SUPPORT

HCPCS Level II L0160: Cervical Semi-Rigid Occipital/Mandibular Support

HCPCS-L0170-CERVICAL-COLLAR-MOLDED-TO-PATIENT-MODEL

HCPCS Level II L0170: Cervical Collar, Custom-Molded

HCPCS-L0172-CERVICAL-COLLAR-SEMI-RIGID-THERMOPLASTIC-FOAM

HCPCS L0172: Cervical Collar, Semi-Rigid Prefabricated

HCPCS-L0174-CERVICAL-COLLAR-SEMI-RIGID-THORACIC-EXTENSION

HCPCS L0174: Cervical Collar, Semi-Rigid Thermoplastic with Thoracic Extension

HCPCS-L0180-CERVICAL-MULTIPLE-POST-COLLAR-OCCIPITAL-MANDIBULAR-ADJUSTABLE

HCPCS Level II L0180: Cervical Orthosis with Occipital/Mandibular Supports

Showing 1–10 of 466

Frequently Asked Questions

References

1.CPT® Codes and Descriptions. AAPC. Retrieved Aug 11, 2026.Maintains the CPT code set's official descriptions and guidelines, licensed from the American Medical Association, used as the definitional source for CPT codes on this page.
2.HCPCS Quarterly Update. Centers for Medicare & Medicaid Services (CMS). Retrieved Aug 11, 2026.CMS's quarterly release of HCPCS Level II codes and short/long descriptors, the source for HCPCS code definitions and update history.
3.ICD-10-CM Full Code List. Centers for Medicare & Medicaid Services (CMS). Retrieved Aug 11, 2026.CMS's complete ICD-10-CM diagnosis code list, used to cross-reference diagnosis codes associated with this procedure or service.

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OpenPayer

HCPCS Level II L0629: Lumbar-Sacral Orthosis, Flexible, Custom Fabricated

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HCPCS Level II L0629: Lumbar-Sacral Orthosis, Flexible, Custom Fabricated

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Clinical & Coding Specifications

Clinical Context

Related CPT Codes

Related Modifiers

Related Provider Taxonomies

Related ICD-10-CM Codes

Related Codes

References

Clinical & Coding Specifications

Clinical Context

Related CPT Codes

Related Modifiers

Related Provider Taxonomies

Related ICD-10-CM Codes

Related Codes

References

HCPCS Level II L0629: Lumbar-Sacral Orthosis, Flexible, Custom Fabricated

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HCPCS Level II L0629: Lumbar-Sacral Orthosis, Flexible, Custom Fabricated

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Clinical & Coding Specifications

Clinical Context

Related CPT Codes

Related Modifiers

Related Provider Taxonomies

Related ICD-10-CM Codes

Related Codes

What device and clinical purpose does HCPCS code L0629 describe?

What clinical and documentation elements are expected when ordering and supplying a custom LSO billed with L0629?

Which billing modifiers are commonly associated with claims for L0629 and when are they used?

What CPT codes are commonly billed in the same episode of care as L0629?

Which payers are referenced for coverage considerations, and does the content provide payer-specific coverage rules or reimbursement rates?

References

Clinical & Coding Specifications

Clinical Context

Related CPT Codes

Related Modifiers

Related Provider Taxonomies

Related ICD-10-CM Codes

Related Codes

What device and clinical purpose does HCPCS code L0629 describe?

What clinical and documentation elements are expected when ordering and supplying a custom LSO billed with L0629?

Which billing modifiers are commonly associated with claims for L0629 and when are they used?

What CPT codes are commonly billed in the same episode of care as L0629?

Which payers are referenced for coverage considerations, and does the content provide payer-specific coverage rules or reimbursement rates?

References