| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| L2280 |
Addition to lower extremity, molded inner boot |
584 |
322 |
$133K |
| L1960 |
Ankle foot orthosis, posterior solid ankle, plastic, custom fabricated |
385 |
216 |
$113K |
| L2820 |
Addition to lower extremity orthosis, soft interface for molded plastic, below knee section |
1,727 |
1,051 |
$97K |
| L2270 |
Addition to lower extremity, varus/valgus correction ('t') strap, padded/lined or malleolus pad |
1,321 |
773 |
$93K |
| L2275 |
Addition to lower extremity, varus/valgus correction, plastic modification, padded/lined |
1,281 |
743 |
$78K |
| A5500 |
For diabetics only, fitting (including follow-up), custom preparation and supply of off-the-shelf depth-inlay shoe manufactured to accommodate multi-density insert(s), per shoe |
1,494 |
762 |
$66K |
| L1970 |
Ankle foot orthosis, plastic with ankle joint, custom fabricated |
141 |
96 |
$54K |
| L3000 |
Foot, insert, removable, molded to patient model, 'ucb' type, berkeley shell, each |
253 |
128 |
$42K |
| A5513 |
For diabetics only, multiple density insert, custom molded from model of patient's foot, total contact with patient's foot, including arch, base layer minimum of 3/16 inch material of shore a 35 durometer (or higher), includes arch filler and other shaping material, custom fabricated, each |
766 |
402 |
$23K |
| L2220 |
Addition to lower extremity, dorsiflexion and plantar flexion assist/resist, each joint |
106 |
74 |
$8K |
| L1940 |
Ankle foot orthosis, plastic or other material, custom fabricated |
19 |
12 |
$6K |
| L4360 |
Walking boot, pneumatic and/or vacuum, with or without joints, with or without interface material, prefabricated item that has been trimmed, bent, molded, assembled, or otherwise customized to fit a specific patient by an individual with expertise |
43 |
42 |
$5K |
| L3906 |
Wrist hand orthosis, without joints, may include soft interface, straps, custom fabricated, includes fitting and adjustment |
17 |
12 |
$5K |
| L8000 |
Breast prosthesis, mastectomy bra, without integrated breast prosthesis form, any size, any type |
52 |
52 |
$4K |
| L1820 |
Knee orthosis, elastic with condylar pads and joints, with or without patellar control, prefabricated item that has been trimmed, bent, molded, assembled, or otherwise customized to fit a specific patient by an individual with expertise |
29 |
25 |
$2K |