L0454 – Tlso flexible, provides trunk support, extends from sacrococcygeal junction to above t-9 vertebra, restricts gross trunk motion in the sagittal plane, produces intracavitary pressure to reduce load on the intervertebral disks with rigid stays or panel(s), includes shoulder straps and closures, prefabricated item that has been trimmed, bent, molded, assembled, or otherwise customized to fit a specific patient by an individual with expertise

HCPCS Level II code · L codes: Orthotic and Prosthetic Procedures and Devices

Active code Carrier judgment

HCPCS codeL0454
Long description
Tlso flexible, provides trunk support, extends from sacrococcygeal junction to above t-9 vertebra, restricts gross trunk motion in the sagittal plane, produces intracavitary pressure to reduce load on the intervertebral disks with rigid stays or panel(s), includes shoulder straps and closures, prefabricated item that has been trimmed, bent, molded, assembled, or otherwise customized to fit a specific patient by an individual with expertise
Short description
Tlso trnk sj-t9 pre cst
Pricing indicator
38 Orthotics, prosthetics, prosthetic devices & vision services
Medicare coverage
C Carrier judgment – coverage decided by the Medicare contractor
BETOS category
D1F Prosthetic/Orthotic devices
Added
January 1, 2003
Last change
January 1, 2014 – No change

Frequently asked questions

What is HCPCS code L0454?

L0454 is a HCPCS Level II code for tlso flexible, provides trunk support, extends from sacrococcygeal junction to above t-9 vertebra, restricts gross trunk motion in the sagittal plane, produces intracavitary pressure to reduce load on the intervertebral disks with rigid stays or panel(s), includes shoulder straps and closures, prefabricated item that has been trimmed, bent, molded, assembled, or otherwise customized to fit a specific patient by an individual with expertise.

Does Medicare cover L0454?

The HCPCS file lists coverage code C: Carrier judgment – coverage decided by the Medicare contractor. Coverage and payment also depend on local coverage determinations and the patient’s plan.

Nearby L codes

Source: CMS HCPCS Level II quarterly file, October 2026. Reference only – check payer policy before billing.