| 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 |
428 |
377 |
$253K |
| L5671 |
Addition to lower extremity, below knee / above knee suspension locking mechanism (shuttle, lanyard or equal), excludes socket insert |
441 |
395 |
$162K |
| L5940 |
Addition, endoskeletal system, below knee, ultra-light material (titanium, carbon fiber or equal) |
57 |
50 |
$25K |
| L5910 |
Addition, endoskeletal system, below knee, alignable system |
59 |
52 |
$22K |
| L5645 |
Addition to lower extremity, below knee, flexible inner socket, external frame |
44 |
40 |
$20K |
| L5637 |
Addition to lower extremity, below knee, total contact |
44 |
40 |
$10K |
| L5629 |
Addition to lower extremity, below knee, acrylic socket |
27 |
24 |
$7K |
| L8470 |
Prosthetic sock, single ply, fitting, below knee, each |
100 |
89 |
$7K |
| L8420 |
Prosthetic sock, multiple ply, below knee, each |
100 |
89 |
$7K |
| L5620 |
Addition to lower extremity, test socket, below knee |
12 |
12 |
$7K |
| L5704 |
Custom shaped protective cover, below knee |
12 |
12 |
$6K |
| L8400 |
Prosthetic sheath, below knee, each |
86 |
76 |
$4K |
| L5685 |
Addition to lower extremity prosthesis, below knee, suspension/sealing sleeve, with or without valve, any material, each |
34 |
27 |
$3K |
| L8440 |
Prosthetic shrinker, below knee, each |
15 |
14 |
$814.94 |