| 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 |
125 |
96 |
$66K |
| L5685 |
Addition to lower extremity prosthesis, below knee, suspension/sealing sleeve, with or without valve, any material, each |
68 |
55 |
$7K |
| L5645 |
Addition to lower extremity, below knee, flexible inner socket, external frame |
13 |
13 |
$3K |
| L5620 |
Addition to lower extremity, test socket, below knee |
23 |
13 |
$2K |
| L5940 |
Addition, endoskeletal system, below knee, ultra-light material (titanium, carbon fiber or equal) |
13 |
13 |
$2K |
| L5910 |
Addition, endoskeletal system, below knee, alignable system |
13 |
13 |
$1K |
| L5629 |
Addition to lower extremity, below knee, acrylic socket |
13 |
13 |
$1K |
| L5637 |
Addition to lower extremity, below knee, total contact |
13 |
13 |
$1K |
| L8420 |
Prosthetic sock, multiple ply, below knee, each |
15 |
15 |
$532.12 |
| L8470 |
Prosthetic sock, single ply, fitting, below knee, each |
17 |
17 |
$297.38 |