| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| L2280 |
Addition to lower extremity, molded inner boot |
3,479 |
1,751 |
$745K |
| L2275 |
Addition to lower extremity, varus/valgus correction, plastic modification, padded/lined |
6,095 |
3,178 |
$246K |
| L1904 |
Ankle orthosis, ankle gauntlet or similar, with or without joints, custom fabricated |
824 |
400 |
$182K |
| L2270 |
Addition to lower extremity, varus/valgus correction ('t') strap, padded/lined or malleolus pad |
4,729 |
2,476 |
$87K |
| L1970 |
Ankle foot orthosis, plastic with ankle joint, custom fabricated |
149 |
83 |
$79K |
| L1200 |
Thoracic-lumbar-sacral-orthosis (tlso), inclusive of furnishing initial orthosis only |
74 |
70 |
$58K |
| L1960 |
Ankle foot orthosis, posterior solid ankle, plastic, custom fabricated |
141 |
74 |
$48K |
| L2820 |
Addition to lower extremity orthosis, soft interface for molded plastic, below knee section |
2,034 |
1,100 |
$40K |
| L4205 |
Repair of orthotic device, labor component, per 15 minutes |
529 |
447 |
$20K |
| L3202 |
Orthopedic shoe, oxford with supinator or pronator, child |
775 |
422 |
$15K |
| L3906 |
Wrist hand orthosis, without joints, may include soft interface, straps, custom fabricated, includes fitting and adjustment |
55 |
41 |
$14K |
| L2840 |
Addition to lower extremity orthosis, tibial length sock, fracture or equal, each |
911 |
526 |
$14K |
| L2340 |
Addition to lower extremity, pre-tibial shell, molded to patient model |
28 |
17 |
$4K |
| L1260 |
Addition to tlso, (low profile), anterior thoracic derotation pad |
80 |
77 |
$2K |
| L1210 |
Addition to tlso, (low profile), lateral thoracic extension |
80 |
77 |
$2K |
| L1270 |
Addition to tlso, (low profile), abdominal pad |
73 |
70 |
$2K |
| L1240 |
Addition to tlso, (low profile), lumbar derotation pad |
73 |
70 |
$2K |
| L1280 |
Addition to tlso, (low profile), rib gusset (elastic), each |
71 |
69 |
$2K |
| L1290 |
Addition to tlso, (low profile), lateral trochanteric pad |
73 |
70 |
$2K |
| L1250 |
Addition to tlso, (low profile), anterior asis pad |
73 |
70 |
$1K |
| L2200 |
Addition to lower extremity, limited ankle motion, each joint |
63 |
37 |
$975.84 |