L0455 – 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, off-the-shelf

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

Active code Carrier judgment

HCPCS codeL0455
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, off-the-shelf
Short description
Tlso flex trnk sj-t9 pre ots
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, 2014
Last change
January 1, 2014 – No change

Frequently asked questions

What is HCPCS code L0455?

L0455 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, off-the-shelf.

Does Medicare cover L0455?

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.