| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| L4361 |
Walking boot, pneumatic and/or vacuum, with or without joints, with or without interface material, prefabricated, off-the-shelf |
68,854 |
66,833 |
$12.89M |
| L3809 |
Wrist hand finger orthosis, without joint(s), prefabricated, off-the-shelf, any type |
45,432 |
42,915 |
$6.11M |
| L1833 |
Knee orthosis, adjustable knee joints (unicentric or polycentric), positional orthosis, rigid support, prefabricated, off-the shelf |
15,774 |
15,262 |
$5.96M |
| L3660 |
Shoulder orthosis, figure of eight design abduction restrainer, canvas and webbing, prefabricated, off-the-shelf |
110,810 |
107,845 |
$5.92M |
| S1040 |
Cranial remolding orthosis, pediatric, rigid, with soft interface material, custom fabricated, includes fitting and adjustment(s) |
2,338 |
2,293 |
$5.57M |
| E0114 |
Crutches underarm, other than wood, adjustable or fixed, pair, with pads, tips and handgrips |
132,408 |
129,919 |
$4.15M |
| L3908 |
Wrist hand orthosis, wrist extension control cock-up, non molded, prefabricated, off-the-shelf |
82,250 |
74,578 |
$3.23M |
| L1830 |
Knee orthosis, immobilizer, canvas longitudinal, prefabricated, off-the-shelf |
36,618 |
35,551 |
$2.11M |
| L4350 |
Ankle control orthosis, stirrup style, rigid, includes any type interface (e.g., pneumatic, gel), prefabricated, off-the-shelf |
28,498 |
27,864 |
$1.72M |
| L3670 |
Shoulder orthosis, acromio/clavicular (canvas and webbing type), prefabricated, off-the-shelf |
22,960 |
22,136 |
$1.59M |
| E0143 |
Walker, folding, wheeled, adjustable or fixed height |
32,252 |
30,659 |
$1.41M |
| L1820 |
Knee orthosis, elastic with condylar pads and joints, with or without patellar control, prefabricated item that has been trimmed, bent, molded, assembled, or otherwise customized to fit a specific patient by an individual with expertise |
17,392 |
16,561 |
$1.30M |
| L4387 |
Walking boot, non-pneumatic, with or without joints, with or without interface material, prefabricated, off-the-shelf |
9,325 |
9,073 |
$1.01M |
| L1852 |
Knee orthosis (ko), double upright, thigh and calf, with adjustable flexion and extension joint (unicentric or polycentric), medial-lateral and rotation control, with or without varus/valgus adjustment, prefabricated, off-the-shelf |
1,630 |
1,540 |
$824K |
| L1906 |
Ankle foot orthosis, multiligamentous ankle support, prefabricated, off-the-shelf |
10,162 |
9,803 |
$768K |
| L3260 |
Surgical boot/shoe, each |
26,823 |
25,154 |
$641K |
| L1902 |
Ankle orthosis, ankle gauntlet or similar, with or without joints, prefabricated, off-the-shelf |
8,944 |
8,518 |
$545K |
| L3000 |
Foot, insert, removable, molded to patient model, 'ucb' type, berkeley shell, each |
1,431 |
906 |
$398K |
| L1812 |
Knee orthosis, elastic with joints, prefabricated, off-the-shelf |
6,214 |
5,692 |
$396K |
| L0464 |
Tlso, triplanar control, modular segmented spinal system, four rigid plastic shells, posterior extends from sacrococcygeal junction and terminates just inferior to scapular spine, anterior extends from symphysis pubis to the sternal notch, soft liner, restricts gross trunk motion in sagittal, coronal, and transverse planes, lateral strength is provided by overlapping plastic and stabilizing closures, includes straps and closures, prefabricated, includes fitting and adjustment |
730 |
695 |
$392K |
| 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 |
609 |
550 |
$374K |
| L3982 |
Upper extremity fracture orthosis, radius/ulnar, prefabricated, includes fitting and adjustment |
1,300 |
1,231 |
$304K |
| L0174 |
Cervical, collar, semi-rigid, thermoplastic foam, two piece with thoracic extension, prefabricated, off-the-shelf |
1,971 |
1,845 |
$294K |
| L1851 |
Knee orthosis (ko), single upright, thigh and calf, with adjustable flexion and extension joint (unicentric or polycentric), medial-lateral and rotation control, with or without varus/valgus adjustment, prefabricated, off-the-shelf |
550 |
482 |
$268K |
| L1970 |
Ankle foot orthosis, plastic with ankle joint, custom fabricated |
829 |
650 |
$265K |
| L2112 |
Ankle foot orthosis, fracture orthosis, tibial fracture orthosis, soft, prefabricated, includes fitting and adjustment |
758 |
722 |
$254K |
| L2820 |
Addition to lower extremity orthosis, soft interface for molded plastic, below knee section |
4,743 |
3,849 |
$231K |
| L0172 |
Cervical, collar, semi-rigid thermoplastic foam, two-piece, prefabricated, off-the-shelf |
3,579 |
3,497 |
$229K |
| L2425 |
Addition to knee joint, disc or dial lock for adjustable knee flexion, each joint |
2,310 |
2,228 |
$219K |
| L2275 |
Addition to lower extremity, varus/valgus correction, plastic modification, padded/lined |
2,911 |
2,140 |
$196K |
| A5500 |
For diabetics only, fitting (including follow-up), custom preparation and supply of off-the-shelf depth-inlay shoe manufactured to accommodate multi-density insert(s), per shoe |
5,255 |
2,826 |
$189K |
| L4397 |
Static or dynamic ankle foot orthosis, including soft interface material, adjustable for fit, for positioning, may be used for minimal ambulation, prefabricated, off-the-shelf |
1,942 |
1,803 |
$188K |
| L3761 |
Elbow orthosis (eo), with adjustable position locking joint(s), prefabricated, off-the-shelf |
617 |
605 |
$140K |
| L3650 |
Shoulder orthosis, figure of eight design abduction restrainer, prefabricated, off-the-shelf |
4,547 |
4,399 |
$139K |
| A5513 |
For diabetics only, multiple density insert, custom molded from model of patient's foot, total contact with patient's foot, including arch, base layer minimum of 3/16 inch material of shore a 35 durometer (or higher), includes arch filler and other shaping material, custom fabricated, each |
4,565 |
2,591 |
$131K |
| L3984 |
Upper extremity fracture orthosis, wrist, prefabricated, includes fitting and adjustment |
437 |
431 |
$109K |
| L5301 |
Below knee, molded socket, shin, sach foot, endoskeletal system |
75 |
64 |
$100K |
| L3924 |
Hand finger orthosis, without joints, may include soft interface, straps, prefabricated, off-the-shelf |
1,994 |
1,670 |
$98K |
| L5940 |
Addition, endoskeletal system, below knee, ultra-light material (titanium, carbon fiber or equal) |
397 |
344 |
$95K |
| L5671 |
Addition to lower extremity, below knee / above knee suspension locking mechanism (shuttle, lanyard or equal), excludes socket insert |
321 |
287 |
$91K |
| L3760 |
Elbow orthosis (eo), with adjustable position locking joint(s), prefabricated, item that has been trimmed, bent, molded, assembled, or otherwise customized to fit a specific patient by an individual with expertise |
353 |
348 |
$84K |
| E0935 |
Continuous passive motion exercise device for use on knee only |
476 |
441 |
$81K |
| L1940 |
Ankle foot orthosis, plastic or other material, custom fabricated |
422 |
330 |
$80K |
| L5637 |
Addition to lower extremity, below knee, total contact |
546 |
484 |
$74K |
| L5620 |
Addition to lower extremity, test socket, below knee |
463 |
403 |
$69K |
| L2999 |
Lower extremity orthoses, not otherwise specified |
970 |
813 |
$61K |
| L3807 |
Wrist hand finger orthosis, without joint(s), prefabricated item that has been trimmed, bent, molded, assembled, or otherwise customized to fit a specific patient by an individual with expertise |
419 |
384 |
$56K |
| E0100 |
Cane, includes canes of all materials, adjustable or fixed, with tip |
4,733 |
4,580 |
$56K |
| L3980 |
Upper extremity fracture orthosis, humeral, prefabricated, includes fitting and adjustment |
342 |
329 |
$54K |
| L2830 |
Addition to lower extremity orthosis, soft interface for molded plastic, above knee section |
994 |
902 |
$52K |
| L1960 |
Ankle foot orthosis, posterior solid ankle, plastic, custom fabricated |
178 |
141 |
$52K |
| L5629 |
Addition to lower extremity, below knee, acrylic socket |
440 |
383 |
$51K |
| L0651 |
Lumbar-sacral orthosis, sagittal-coronal control, rigid shell(s)/panel(s), posterior extends from sacrococcygeal junction to t-9 vertebra, anterior extends from symphysis pubis to xyphoid, produces intracavitary pressure to reduce load on the intervertebral discs, overall strength is provided by overlapping rigid material and stabilizing closures, includes straps, closures, may include soft interface, pendulous abdomen design, prefabricated, off-the-shelf |
110 |
105 |
$49K |
| L0120 |
Cervical, flexible, non-adjustable, prefabricated, off-the-shelf (foam collar) |
2,856 |
2,710 |
$48K |
| L0140 |
Cervical, semi-rigid, adjustable (plastic collar) |
1,385 |
1,365 |
$47K |
| L2280 |
Addition to lower extremity, molded inner boot |
171 |
109 |
$46K |
| L5910 |
Addition, endoskeletal system, below knee, alignable system |
294 |
255 |
$41K |
| L0642 |
Lumbar orthosis, sagittal control, with rigid anterior and posterior panels, posterior extends from l-1 to below l-5 vertebra, produces intracavitary pressure to reduce load on the intervertebral discs, includes straps, closures, may include padding, shoulder straps, pendulous abdomen design, prefabricated, off-the-shelf |
199 |
192 |
$40K |
| L8420 |
Prosthetic sock, multiple ply, below knee, each |
968 |
709 |
$40K |
| L1845 |
Knee orthosis, double upright, thigh and calf, with adjustable flexion and extension joint (unicentric or polycentric), medial-lateral and rotation control, with or without varus/valgus adjustment, prefabricated item that has been trimmed, bent, molded, assembled, or otherwise customized to fit a specific patient by an individual with expertise |
73 |
72 |
$38K |
| A4467 |
Belt, strap, sleeve, garment, or covering, any type |
1,638 |
1,518 |
$36K |
| L2810 |
Addition to lower extremity orthosis, knee control, condylar pad |
635 |
589 |
$33K |
| L3999 |
Upper limb orthosis, not otherwise specified |
914 |
828 |
$30K |
| L2397 |
Addition to lower extremity orthosis, suspension sleeve |
350 |
336 |
$29K |
| L0180 |
Cervical, multiple post collar, occipital/mandibular supports, adjustable |
132 |
128 |
$27K |
| L0639 |
Lumbar-sacral orthosis, sagittal-coronal control, rigid shell(s)/panel(s), posterior extends from sacrococcygeal junction to t-9 vertebra, anterior extends from symphysis pubis to xyphoid, produces intracavitary pressure to reduce load on the intervertebral discs, overall strength is provided by overlapping rigid material and stabilizing closures, includes straps, closures, may include soft interface, pendulous abdomen design, prefabricated item that has been trimmed, bent, molded, assembled, or otherwise customized to fit a specific patient by an individual with expertise |
43 |
43 |
$27K |
| L5645 |
Addition to lower extremity, below knee, flexible inner socket, external frame |
71 |
55 |
$24K |
| L5000 |
Partial foot, shoe insert with longitudinal arch, toe filler |
100 |
92 |
$21K |
| E0149 |
Walker, heavy duty, wheeled, rigid or folding, any type |
200 |
188 |
$21K |
| L2330 |
Addition to lower extremity, lacer molded to patient model, for custom fabricated orthosis only |
81 |
76 |
$19K |
| A4565 |
Slings |
1,566 |
1,522 |
$13K |
| L4360 |
Walking boot, pneumatic and/or vacuum, with or without joints, with or without interface material, prefabricated item that has been trimmed, bent, molded, assembled, or otherwise customized to fit a specific patient by an individual with expertise |
55 |
50 |
$12K |
| 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 |
13 |
12 |
$11K |
| L2270 |
Addition to lower extremity, varus/valgus correction ('t') strap, padded/lined or malleolus pad |
363 |
223 |
$10K |
| L1810 |
Knee orthosis, elastic with joints, prefabricated item that has been trimmed, bent, molded, assembled, or otherwise customized to fit a specific patient by an individual with expertise |
83 |
77 |
$7K |
| L3202 |
Orthopedic shoe, oxford with supinator or pronator, child |
120 |
77 |
$7K |
| E0936 |
Continuous passive motion exercise device for use other than knee |
54 |
54 |
$6K |
| E1399 |
Durable medical equipment, miscellaneous |
610 |
521 |
$6K |
| L8470 |
Prosthetic sock, single ply, fitting, below knee, each |
359 |
314 |
$6K |
| A4570 |
Splint |
623 |
615 |
$5K |
| L2220 |
Addition to lower extremity, dorsiflexion and plantar flexion assist/resist, each joint |
88 |
70 |
$5K |
| L8400 |
Prosthetic sheath, below knee, each |
110 |
92 |
$5K |
| L4386 |
Walking boot, non-pneumatic, with or without joints, with or without interface material, prefabricated item that has been trimmed, bent, molded, assembled, or otherwise customized to fit a specific patient by an individual with expertise |
42 |
42 |
$4K |
| L0150 |
Cervical, semi-rigid, adjustable molded chin cup (plastic collar with mandibular/occipital piece) |
67 |
67 |
$4K |
| L4396 |
Static or dynamic ankle foot orthosis, including soft interface material, adjustable for fit, for positioning, may be used for minimal ambulation, prefabricated item that has been trimmed, bent, molded, assembled, or otherwise customized to fit a specific patient by an individual with expertise |
46 |
41 |
$4K |
| L3762 |
Elbow orthosis, rigid, without joints, includes soft interface material, prefabricated, off-the-shelf |
69 |
52 |
$4K |
| L1930 |
Ankle foot orthosis, plastic or other material, prefabricated, includes fitting and adjustment |
18 |
14 |
$4K |
| L8440 |
Prosthetic shrinker, below knee, each |
91 |
76 |
$3K |
| E0188 |
Synthetic sheepskin pad |
179 |
170 |
$3K |
| L3350 |
Heel wedge |
366 |
266 |
$3K |
| L2755 |
Addition to lower extremity orthosis, high strength, lightweight material, all hybrid lamination/prepreg composite, per segment, for custom fabricated orthosis only |
30 |
26 |
$3K |
| L3030 |
Foot, insert, removable, formed to patient foot, each |
33 |
29 |
$3K |
| L1832 |
Knee orthosis, adjustable knee joints (unicentric or polycentric), positional orthosis, rigid support, prefabricated item that has been trimmed, bent, molded, assembled, or otherwise customized to fit a specific patient by an individual with expertise |
15 |
15 |
$3K |
| L5972 |
All lower extremity prostheses, foot, flexible keel |
12 |
12 |
$2K |
| L3995 |
Addition to upper extremity orthosis, sock, fracture or equal, each |
98 |
97 |
$2K |
| L0621 |
Sacroiliac orthosis, flexible, provides pelvic-sacral support, reduces motion about the sacroiliac joint, includes straps, closures, may include pendulous abdomen design, prefabricated, off-the-shelf |
24 |
24 |
$2K |
| L5685 |
Addition to lower extremity prosthesis, below knee, suspension/sealing sleeve, with or without valve, any material, each |
14 |
12 |
$2K |
| L3060 |
Foot, arch support, removable, premolded, longitudinal/ metatarsal, each |
21 |
13 |
$1K |
| E0156 |
Seat attachment, walker |
85 |
72 |
$658.76 |
| A4566 |
Shoulder sling or vest design, abduction restrainer, with or without swathe control, prefabricated, includes fitting and adjustment |
13 |
13 |
$51.63 |
| A4637 |
Replacement, tip, cane, crutch, walker, each. |
169 |
149 |
$37.26 |