| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| L5679 |
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, not for use with locking mechanism |
23 |
16 |
$8K |
| L5620 |
Addition to lower extremity, test socket, below knee |
20 |
13 |
$2K |
| L5910 |
Addition, endoskeletal system, below knee, alignable system |
20 |
13 |
$2K |
| L5637 |
Addition to lower extremity, below knee, total contact |
20 |
13 |
$1K |
| L8420 |
Prosthetic sock, multiple ply, below knee, each |
22 |
15 |
$683.74 |
| L8440 |
Prosthetic shrinker, below knee, each |
19 |
13 |
$434.45 |
| L2820 |
Addition to lower extremity orthosis, soft interface for molded plastic, below knee section |
15 |
13 |
$385.33 |
| L8470 |
Prosthetic sock, single ply, fitting, below knee, each |
18 |
12 |
$160.97 |