| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 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 |
309 |
270 |
$90K |
| L5671 |
Addition to lower extremity, below knee / above knee suspension locking mechanism (shuttle, lanyard or equal), excludes socket insert |
247 |
215 |
$59K |
| L5645 |
Addition to lower extremity, below knee, flexible inner socket, external frame |
106 |
94 |
$22K |
| L5637 |
Addition to lower extremity, below knee, total contact |
135 |
118 |
$16K |
| L5910 |
Addition, endoskeletal system, below knee, alignable system |
120 |
107 |
$10K |
| L5620 |
Addition to lower extremity, test socket, below knee |
146 |
130 |
$9K |
| L5940 |
Addition, endoskeletal system, below knee, ultra-light material (titanium, carbon fiber or equal) |
30 |
29 |
$6K |
| L8420 |
Prosthetic sock, multiple ply, below knee, each |
66 |
62 |
$3K |
| L5685 |
Addition to lower extremity prosthesis, below knee, suspension/sealing sleeve, with or without valve, any material, each |
58 |
52 |
$3K |
| L5972 |
All lower extremity prostheses, foot, flexible keel |
17 |
13 |
$2K |
| L5704 |
Custom shaped protective cover, below knee |
12 |
12 |
$2K |
| L5629 |
Addition to lower extremity, below knee, acrylic socket |
26 |
25 |
$1K |