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    v1.0.31
    OpenPayerBilling CodesOrthotic Procedures and servicesHCPCS hcpcs-l1640-hip-abduction-orthosis-custom-fabricated
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    HCPCS L1640: Hip Orthosis, Abduction Control, Custom Fabricated

    HCPCS Level II code L1640 describes a custom-fabricated hip orthosis with abduction control of the hip joints, consisting of a pelvic band or spreader bar and thigh cuffs; service type: custom orthotic fabrication and fitting; typical site of service: orthotics/prosthetics clinic, outpatient physical medicine clinic, or specialty orthotics lab.

    For related coverage guidance, see recent payer policy updates: Patient-Controlled End Range of Motion Stretching Devices, Sleep Position Trainer, Hospital Beds Corporate Medical Policy.

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    Table of contents

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    Clinical & Coding Specifications

    Clinical Context

    A 56-year-old patient with chronic hip instability and abductor muscle weakness following a complex acetabular fracture repair is fitted for a custom-fabricated hip orthosis. The device is a static hip orthosis with abduction control, incorporating a pelvic band or spreader bar and thigh cuffs to maintain controlled hip abduction and limit adduction and internal rotation. The orthotist performs a comprehensive evaluation, takes measurements and casts or digital scans, fabricates the custom device, and performs an initial fitting and adjustment. Typical workflow steps include: referral from orthopedic surgery or physical medicine, pre-fit evaluation and documentation of functional limitations and prior treatments, measurement/scanning visit, fabrication (laboratory work), delivery and fitting visit with in-clinic adjustments, patient education on donning/doffing and skin checks, and follow-up visits for adjustment and reimbursement documentation. Typical sites of service are outpatient orthotics clinics, hospital-based orthotics/prosthetics departments, and specialized durable medical equipment providers associated with orthopedic practices.

    Related CPT Codes

    CPT CodeDescriptionRelationship to This Procedure
    97760Orthotic management and training, initial encounter, fitting and training for use of orthosisPerformed at delivery to instruct patient in use, donning/doffing, and gait training when applicable
    97763Orthotic/prosthetic management and training, subsequent encounterUsed for follow-up visits to adjust training and document functional progress
    99070Supplies and materials (except spectacles) provided by the physician over and above those usually included with office visitUsed if additional non-covered supplies or custom materials are provided at fitting
    99080Reporting of quality data or other reporting (use depends on payer)Administrative documentation codes potentially used with durable medical equipment processes
    99456Work-related or medical disability examination services (impairment rating)Used when a formal impairment evaluation is requested in relation to functional limitations addressed by the orthosis

    Related Modifiers

    9 rows

    ModifierDescriptionWhen to Use
    22Modifier –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…
    23Modifier -23 (Unusual Anesthesia) is used on anesthesia service CPT codes when a procedure that normally requires no anesthesia or only local anesthesia must be performed under general anesthesia…- Use modifier -23 only on anesthesia CPT codes (00100–01999) when a procedure that normally requires no anesthesia or only local anesthesia must be performed under general anesthesia because of…
    50Modifier –50 (Bilateral Procedure) is appended to a CPT code when an identical procedure is performed on paired anatomical structures during the same operative session. The AMA states to add…- Use modifier -50 when the same CPT surgical, diagnostic, or radiology procedure is performed on paired anatomical structures (both sides of the body) during the same operative/session by the same…
    52Modifier ‑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…
    53Modifier 53 (Discontinued Procedure) signals that a surgical or diagnostic service was begun by the physician but terminated because of extenuating circumstances that threatened the patient’s…- Use modifier -53 when a physician/qualified healthcare professional has started a surgical or diagnostic procedure (e.g., anesthesia administered, incision or scope insertion) and then discontinues…
    62Modifier 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…
    78CPT modifier -78 indicates an unplanned, related return to the operating or procedure room by the same provider during the global postoperative period. It is appended when treatment for a…- Use modifier -78 when an unplanned, related complication during the original procedure’s global postoperative period requires the patient to return to a formal operating or procedure room and the…
    80CPT® 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…
    82Modifier 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
    2080P0207X
    367A00000X
    163W00000X
    207QS1201X
    2471Q0001X
    222Z00000X
    1744G0900X
    1744R1103X

    Related ICD-10-CM Codes

    21 rows

    ICD-10-CM CodeDescription
    G80.9Cerebral palsy, unspecified
    M16.0Bilateral primary osteoarthritis of hip
    M16.11Unilateral primary osteoarthritis, right hip
    M16.12Unilateral primary osteoarthritis, left hip
    M16.9Osteoarthritis of hip, unspecified
    M21.069Valgus deformity, not elsewhere classified, unspecified knee
    M21.169Varus deformity, not elsewhere classified, unspecified knee
    M24.151Other articular cartilage disorders, right hip
    M24.152Other articular cartilage disorders, left hip
    M25.551Pain in right hip

    Showing 1–10 of 21

    Related Payer Policy Updates

    Specialty: Durable Medical Equipment (DME)1 / 3

    10 rows

    PolicyPayerEffective Date
    Patient-Controlled End Range of Motion Stretching DevicesBluecross Idaho2027-01-01
    Sleep Position Trainerregence2027-01-01
    Hospital Beds Corporate Medical Policybcbsvermont2027-01-01
    Continuous Passive Motion Devices with Remote Monitoring or Adaptive CapabilitiesBlue Cross Blue Shield - Rhode Island2026-12-01
    Bone Growth StimulatorsMass General Brigham Health Plan2026-12-01
    Prior Authorization for Durable Medical Equipment (DME)Blue Cross Blue Shield - Rhode Island2026-12-01
    Patient Liftsuniverahealthcare2026-11-16
    Durable Medical Equipment RepairsCareSource Georgia2026-11-01
    Custom Compression GarmentsModa Health2026-11-01
    Tonic Motor Activation (TOMAC) for Restless Legs Syndromeregence2026-11-01

    Related Codes

    HCPCS-L0112-CRANIAL-CERVICAL-ORTHOSIS-CONGENITAL-TORTICOLLIS-CUSTOM

    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

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    Frequently Asked Questions

    References

    1. 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. 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. 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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