| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| L2275 |
Addition to lower extremity, varus/valgus correction, plastic modification, padded/lined |
413 |
261 |
$21K |
| L5671 |
Addition to lower extremity, below knee / above knee suspension locking mechanism (shuttle, lanyard or equal), excludes socket insert |
98 |
74 |
$7K |
| L5673 |
Addition to lower extremity, below knee/above knee, custom fabricated from existing mold or prefabricated, socket insert, silicone gel, elastomeric, or equal, with or without perforations, with or without breathable material, for use with locking mechanism |
81 |
62 |
$6K |
| L1970 |
Ankle foot orthosis, plastic with ankle joint, custom fabricated |
14 |
12 |
$5K |
| L1940 |
Ankle foot orthosis, plastic or other material, custom fabricated |
28 |
14 |
$5K |
| L2820 |
Addition to lower extremity orthosis, soft interface for molded plastic, below knee section |
390 |
259 |
$4K |
| L8470 |
Prosthetic sock, single ply, fitting, below knee, each |
20 |
17 |
$4K |
| L5637 |
Addition to lower extremity, below knee, total contact |
50 |
41 |
$4K |
| L2280 |
Addition to lower extremity, molded inner boot |
121 |
77 |
$3K |
| L8420 |
Prosthetic sock, multiple ply, below knee, each |
35 |
30 |
$3K |
| L5645 |
Addition to lower extremity, below knee, flexible inner socket, external frame |
34 |
28 |
$797.34 |
| L5940 |
Addition, endoskeletal system, below knee, ultra-light material (titanium, carbon fiber or equal) |
30 |
26 |
$680.94 |
| L5620 |
Addition to lower extremity, test socket, below knee |
32 |
28 |
$436.50 |
| L5629 |
Addition to lower extremity, below knee, acrylic socket |
32 |
28 |
$363.75 |
| L5910 |
Addition, endoskeletal system, below knee, alignable system |
16 |
15 |
$176.54 |
| L8440 |
Prosthetic shrinker, below knee, each |
13 |
12 |
$116.40 |