How Much Does a TLSO Back Brace Cost ?

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A TLSO (Thoracic Lumbar Sacral Orthosis) can range in price. They can range from approximately $180.00 to $2708.00 depending on a few key variables.

We realize you might have been looking for one single price. We get that and we would rather just give you one price, but as you will soon see it doesn’t work like that exactly.

As you will soon see, there are many braces, considered to be TLSOs. Its a generic title for many people who use the term. Therefore there is not a singular price for all of them. After reading through this article you will see why.

In other words, if we gave you one price then we would be misleading you (not the goal).

There is a lot of difference in style and quality found in between this price range ($180 – $2708) which we have just given to you.  We will be discussing these differences with you.

We will also be giving you pictures with prices (below) so you can have a general idea too. So, if you want to scroll down and find a quick answer then great, but please realize there is some detail involved here and the picture won’t always tell you everything.

Having said all of that, if you only wanted a range and you got the range of pricing you were looking for already, then great!  Mission accomplished.

The Initial Price & Second Price Listed

To start, the first price above was an internet price ($180, before shipping and tax). The second price given was a custom made TLSO made by a specialist called an orthotist to treat scoliosis.  Both are TLSOs.

However, the TLSOs we just talked about are two totally different things in terms of what diagnosis they treat.  (The prices we are giving to you in this article are independent of the price you might receive as an inpatient as well.)

There are 2 general styles of TLSOs.  To keep it as simple as possible, we will define it as follows:

  • TLSOs for back injuries
  • TLSOs for the treatment of scoliosis

For clarity, we also need to touch upon how some braces are called TLSOs but some of them could definitely have a more exact name.  For example, the brace may fit into a broad category of an orthosis (brace) called a thoracolumbar sacral orthosis. In very basic terms this means a brace that typically goes from under your clavical down to your lap (which may or may not have shoulder straps). Also, for future reference,
Orthosis is a fancy word for brace, just an FYI.

We will be talking about TLSOs in a way that is shared medical terminology between spine surgeons and orthotists. If you wish to learn the names of the other back braces that exist, such as the dorsal lumbar sacral corset for example, then we are happy to share that information with you.  However, that explanation will need to occur in other articles.

To help make it easy you can look at the pictures we have below to help you decide if the brace price you are looking for matches up with the picture you had in mind.

Typically, traditional TLSOs are used for an injury such as a fracture to the spine.  Two common fracture types are a compression fracture or a burst fracture.  But, a TLSO can also be for a person who has other serious issues, such as cancer.  Either way, the person could benefit from some support.

Within this style of TLSO for injuries, there are two general types that you should be aware of when it comes to price.

  • Custom TLSOs
  • Prefabricated TLSOs.

Custom TLSO (For The Treatment Of An Injury)

Base code : L0486, Price for this code without additions = $ 1572.00

A custom TLSO for a serious injury has a base code of L0486.  It is considered to be the gold standard for treating many injuries to the thoracic lumbar sacral spine. This is the code that is used to bill insurance or Medicare as well by an orthotist.  This code has a price attached and that price is typically created independently from the medical professional who gives you the brace.

The only difference is if the orthotist (brace specialist) is billing you for a cash payment.  If they did this, the orthotist is not bound by any rules of engagement with your insurance.  Then the price can go up, but if the orthotist is ethical they will not quadruple the price.  It should stay the same.  The price we are giving is you is a current reimbursement for the L0486 from one from one of the coverages we work with that is considered to be “average”.

TLSOs can also have add on codes, when needed.  As you will see, this can change the price when it comes to scoliosis TLSOs, for example.  See our scoliosis blog post for very detailed information on this…

Different insurances, for example, will cover a TLSO at different levels of reimbursement so this is just one reason why we have to give you a range.  With one of the most common types of coverage out there today, the L0486 has a price of : $ 1572.00

Prefabricated TLSOs (For The Treatment Of An Injury)

L0462 and L0464 are the two base codes used for prefabricated TLSOs.  $1240 – $ 1476.00 respectively.

Another very common set of base codes that is part of the hcpc system (Health Care Procedure Coding System) are L0462 and L0464.  These base codes are used for many (not all) prefabricated TLSOs.  These prices range from approximately: $ 1240 to $ 1476.00.

If the custom TLSO is considered to be the “Gold Standard” for many back injuries, you might be wondering why would anyone want a prefabricated brace?  These are provided because sometimes you do not need the full support of a custom back support due to the injury type.  Also, when time is of the essence a prefabricated brace can be very helpful because they are already made and just need to be customized to the patient.  This can help a patient that is being transferred immediately to another level one trauma center but they still need support, while a custom brace takes usually a minimum of one day to measure, fabricate and then deliver the following day.

The codes L0462, L0464, and L0486 are typically provided to a patient by a medical professional. As stated earlier this is typically an orthotist. An orthotist is a person who has to go through years of school and a residency program just to be allowed to carry the license that lets them treat you (or your loved one) as a patient. This is the route we highly recommend going if you can choose it.

Internet TLSOs

If you do not choose to work with an orthotist, then you can go online and find a prefabricated TLSO for $180.00 approximately, for example. These braces may or may not have a PDAC letter. This is basically a letter that says the brace can be billed to insurance.

While internet TLSOs may have some value, there is a lot to be said for instruction and quality of construction. The online TLSO could have instructions that are provided but certain details are better shown to you by a licensed brace specialist. Such as, how the body changes in each different position and how that affects your spine and the fit of a brace. That’s a very big deal. We have never seen a prefabricated TLSO cover all of this with written information and this is crucial.

Or, what do you do if you have a problem? Who do you turn to when the internet TLSO doesn’t fit quite right? The best-case scenario is that you would be able to return the brace but we can not speak for these companies’ policies. Some of them might tell you that if it came out of the bag, or touched your skin, then you are stuck with the brace.

We think of the scenario in this way. It is like being handed a couple of pipes and someone says to you you’re going to need to fix your own plumbing issue and “oh, here are some written instructions”. While everything could work out fine, would you feel more comfortable if a licensed plumber was there to do the work? Again, we are not saying all TLSOs online are bad, but when it comes to your spine we believe working with a licensed individual is the best option.

Scoliosis TLSOs

Price can range, but these are typically more expensive and can go up to approximately $2700.  See our link to the scoliosis brace blog for more details. 

We go into great detail in another blog post on braces for scoliosis. (The link to that article is below.) However, we are happy to touch on it again here.  Basically, a scoliosis TLSO is a custom made brace which has a base code of L1200. There are also add on codes that can raise the price due to the severity of the curve and the decompensation of the spine. These add on codes can take the approximate cost from $ $1324 – $2108.00. The price could potentially rise up another $600 but that is rare.

In Summary

While all of these TLSOs are related, you can now see there are different kinds. The price can also vary depending on the insurance plan you may or may not have. The brace when billed to your insurance can cost you zero dollars out of pocket because your deductible might have been met, or you may have to pay full price if your deductible has not been used all year.  This is simply the range of possibility when it comes to price.

If you have to pay cash (no insurance related) then at least you have a range of prices and more knowledge. If the orthotist is charging you cash for the brace you can even ask for a slight discount as they are not bound to an insurance contract they have signed up for. It’s worth trying, but just remember a lot goes into making these braces, especially if they are custom.

*Disclaimer : Please be advised that Rinella Prosthetics & Orthotics can not be liable for any charges you have regarding a TLSO you purchase.  We can only tell you prices our company typically sees and can not be linked to any costs you get outside of being treated by our team.

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    2020-08-02T11:13:34+00:00By |Categories: Uncategorized|