Hip orthosis, abduction control of hip joints, flexible, frejka type with cover, prefabricated item that has been trimmed, bent, molded, assembled, or otherwise customized to fit a specific patient by an inidividual with expertise
Medicare coverage: Carrier judgment
Status: active (October 2026 file)
Medically Unlikely Edits (effective October 1, 2026)
Practitioner: max 0 units per day (clinical), rationale: CMS Policy
Outpatient hospital: max 1 units per day (policy), rationale: Code Descriptor / CPT Instruction
DME supplier: max 1 units per day (policy), rationale: Code Descriptor / CPT Instruction
Medicare pricing for L1600
DMEPOS fee schedule, July 2026 (DME26-C)
no modifier, prosthetics and orthotics (PO): non-rural $148.08 to $197.44 in the contiguous states; $148.08 to $329.89 in AK, HI, PR and VI; ceiling $197.44, floor $148.08
From payers' published prior-auth lists, coverage policies and state Medicaid fee schedules, updated Oct 16, 2026. The role is what the policy's own code table or text says about the code. Not a guarantee of coverage or payment; verify with the payer. CPT® is a registered trademark of the American Medical Association.