HCPCS 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

Current code23 hospitals with prices

Description from CMS's HCPCS Level II code file.

What Washington hospitals publish for this code

Medicare Advantage: Rate for a private Medicare Advantage plan. Applies only to members of that plan.

Prices for HCPCS L0454 by hospital
HospitalMedicare Advantage rates (lowest – highest)Cash priceList price (before discounts)
Capital Medical CenterOlympiaFile dated 2026-08-27—$207$518
Deaconess Medical CenterSpokaneFile dated 2026-08-27—$207$518
Harborview Medical CenterSeattleFile dated 2026-04-01—$510$728
Mary Bridge Children's HospitalTacomaFile dated 2026-08-27—$207$518
MultiCare Auburn Medical CenterAuburnFile dated 2026-08-27—$207$518
MultiCare Covington Medical CenterCovingtonFile dated 2026-08-27—$207$518
MultiCare Good Samaritan HospitalPuyallupFile dated 2026-08-27—$207$518
MultiCare Valley HospitalSpokane ValleyFile dated 2026-08-27—$207$518
Tacoma General Allenmore HospitalTacomaFile dated 2026-08-27—$207$518
University of Washington Medical CtrSeattleFile dated 2026-04-01—$676$966

Lowest and highest amounts each hospital lists for this code during a hospital stay, including lines it lists for both settings or without saying which. A doctor’s fee is shown separately when the hospital lists one with the code. “At least” means plans were counted in more than one group and some may be the same plan. This is one line of a bill; most care brings several.

Medicare (traditional) reference

Only for people on original Medicare. These are CMS’s 2026 amounts. They aren’t what private insurance or cash patients pay.

Equipment fee, Washington
$416 (fee)