| 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 |
1,054 |
948 |
$694K |
| L4361 |
Walking boot, pneumatic and/or vacuum, with or without joints, with or without interface material, prefabricated, off-the-shelf |
3,163 |
3,053 |
$544K |
| A6512 |
Compression burn garment, not otherwise classified |
823 |
658 |
$421K |
| L5637 |
Addition to lower extremity, below knee, total contact |
1,593 |
1,452 |
$290K |
| L0174 |
Cervical, collar, semi-rigid, thermoplastic foam, two piece with thoracic extension, prefabricated, off-the-shelf |
1,705 |
1,571 |
$264K |
| L5301 |
Below knee, molded socket, shin, sach foot, endoskeletal system |
169 |
158 |
$263K |
| L5671 |
Addition to lower extremity, below knee / above knee suspension locking mechanism (shuttle, lanyard or equal), excludes socket insert |
830 |
741 |
$247K |
| 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 |
1,342 |
1,296 |
$228K |
| L8420 |
Prosthetic sock, multiple ply, below knee, each |
1,925 |
1,720 |
$206K |
| L2275 |
Addition to lower extremity, varus/valgus correction, plastic modification, padded/lined |
1,486 |
1,379 |
$199K |
| 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 |
1,291 |
1,203 |
$189K |
| L0650 |
Lumbar-sacral orthosis, sagittal-coronal control, with rigid anterior and posterior frame/panel(s), posterior extends from sacrococcygeal junction to t-9 vertebra, lateral strength provided by rigid lateral frame/panel(s), produces intracavitary pressure to reduce load on intervertebral discs, includes straps, closures, may include padding, shoulder straps, pendulous abdomen design, prefabricated, off-the-shelf |
405 |
379 |
$179K |
| L2820 |
Addition to lower extremity orthosis, soft interface for molded plastic, below knee section |
2,192 |
2,033 |
$173K |
| L1960 |
Ankle foot orthosis, posterior solid ankle, plastic, custom fabricated |
259 |
243 |
$169K |
| L5940 |
Addition, endoskeletal system, below knee, ultra-light material (titanium, carbon fiber or equal) |
630 |
577 |
$161K |
| L3020 |
Foot, insert, removable, molded to patient model, longitudinal/ metatarsal support, each |
640 |
610 |
$149K |
| E0114 |
Crutches underarm, other than wood, adjustable or fixed, pair, with pads, tips and handgrips |
3,600 |
3,540 |
$147K |
| L3908 |
Wrist hand orthosis, wrist extension control cock-up, non molded, prefabricated, off-the-shelf |
3,260 |
3,176 |
$141K |
| 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 |
1,127 |
1,107 |
$138K |
| L5620 |
Addition to lower extremity, test socket, below knee |
705 |
640 |
$123K |
| L5910 |
Addition, endoskeletal system, below knee, alignable system |
680 |
623 |
$121K |
| L1970 |
Ankle foot orthosis, plastic with ankle joint, custom fabricated |
210 |
188 |
$120K |
| L5629 |
Addition to lower extremity, below knee, acrylic socket |
604 |
555 |
$95K |
| L8440 |
Prosthetic shrinker, below knee, each |
1,309 |
1,215 |
$88K |
| L5700 |
Replacement, socket, below knee, molded to patient model |
45 |
42 |
$75K |
| 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 |
1,263 |
1,070 |
$74K |
| 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 |
216 |
205 |
$71K |
| 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 |
103 |
95 |
$59K |
| L3260 |
Surgical boot/shoe, each |
1,682 |
1,515 |
$57K |
| L1833 |
Knee orthosis, adjustable knee joints (unicentric or polycentric), positional orthosis, rigid support, prefabricated, off-the shelf |
151 |
146 |
$53K |
| A6533 |
Gradient compression stocking, thigh length, 18-30 mmhg, each |
494 |
459 |
$51K |
| A6530 |
Gradient compression stocking, below knee, 18-30 mmhg, each |
532 |
482 |
$46K |
| L8400 |
Prosthetic sheath, below knee, each |
688 |
636 |
$46K |
| A5514 |
For diabetics only, multiple density insert, made by direct carving with cam technology from a rectified cad model created from a digitized scan of the patient, 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 |
1,053 |
819 |
$45K |
| L0984 |
Protective body sock, prefabricated, off-the-shelf, each |
603 |
574 |
$45K |
| L1902 |
Ankle orthosis, ankle gauntlet or similar, with or without joints, prefabricated, off-the-shelf |
875 |
849 |
$43K |
| 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 |
525 |
492 |
$43K |
| L0999 |
Addition to spinal orthosis, not otherwise specified |
1,753 |
1,412 |
$38K |
| L3670 |
Shoulder orthosis, acromio/clavicular (canvas and webbing type), prefabricated, off-the-shelf |
505 |
495 |
$35K |
| L4350 |
Ankle control orthosis, stirrup style, rigid, includes any type interface (e.g., pneumatic, gel), prefabricated, off-the-shelf |
534 |
514 |
$32K |
| L1830 |
Knee orthosis, immobilizer, canvas longitudinal, prefabricated, off-the-shelf |
550 |
512 |
$30K |
| A6509 |
Compression burn garment, upper trunk to waist including arm openings (vest), custom fabricated |
30 |
27 |
$26K |
| L3030 |
Foot, insert, removable, formed to patient foot, each |
487 |
438 |
$21K |
| L0460 |
Tlso, triplanar control, modular segmented spinal system, two rigid plastic shells, posterior extends from the sacrococcygeal junction and terminates just inferior to the scapular spine, anterior extends from the symphysis pubis to the sternal notch, soft liner, restricts gross trunk motion in the sagittal, coronal, and transverse planes, lateral strength is provided by overlapping plastic and stabilizing closures, includes straps and closures, prefabricated item that has been trimmed, bent, molded, assembled, or otherwise customized to fit a specific patient by an individual with expertise |
42 |
38 |
$20K |
| L2270 |
Addition to lower extremity, varus/valgus correction ('t') strap, padded/lined or malleolus pad |
277 |
245 |
$17K |
| L2840 |
Addition to lower extremity orthosis, tibial length sock, fracture or equal, each |
350 |
320 |
$17K |
| L3010 |
Foot, insert, removable, molded to patient model, longitudinal arch support, each |
82 |
78 |
$17K |
| L5450 |
Immediate post surgical or early fitting, application of non-weight bearing rigid dressing, below knee |
73 |
65 |
$14K |
| L0637 |
Lumbar-sacral orthosis, sagittal-coronal control, with rigid anterior and posterior frame/panels, posterior extends from sacrococcygeal junction to t-9 vertebra, lateral strength provided by rigid lateral frame/panels, produces intracavitary pressure to reduce load on intervertebral discs, includes straps, closures, may include padding, shoulder straps, 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 |
29 |
25 |
$14K |
| 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 |
148 |
145 |
$13K |
| L5968 |
Addition to lower limb prosthesis, multiaxial ankle with swing phase active dorsiflexion feature |
15 |
12 |
$13K |
| L2220 |
Addition to lower extremity, dorsiflexion and plantar flexion assist/resist, each joint |
132 |
108 |
$13K |
| L5986 |
All lower extremity prostheses, multi-axial rotation unit ('mcp' or equal) |
26 |
24 |
$12K |
| L5650 |
Additions to lower extremity, total contact, above knee or knee disarticulation socket |
43 |
40 |
$11K |
| L5685 |
Addition to lower extremity prosthesis, below knee, suspension/sealing sleeve, with or without valve, any material, each |
75 |
64 |
$9K |
| L5972 |
All lower extremity prostheses, foot, flexible keel |
29 |
25 |
$8K |
| L8430 |
Prosthetic sock, multiple ply, above knee, each |
53 |
50 |
$7K |
| 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 |
185 |
116 |
$7K |
| L3400 |
Metatarsal bar wedge, rocker |
409 |
342 |
$7K |
| L1951 |
Ankle foot orthosis, spiral, (institute of rehabilitative medicine type), plastic or other material, prefabricated item that has been trimmed, bent, molded, assembled, or otherwise customized to fit a specific patient by an individual with expertise |
14 |
13 |
$6K |
| L2999 |
Lower extremity orthoses, not otherwise specified |
147 |
133 |
$6K |
| L1812 |
Knee orthosis, elastic with joints, prefabricated, off-the-shelf |
89 |
86 |
$6K |
| L5690 |
Addition to lower extremity, below knee, waist belt, padded and lined |
69 |
64 |
$5K |
| 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 |
28 |
26 |
$4K |
| L2200 |
Addition to lower extremity, limited ankle motion, each joint |
68 |
57 |
$3K |
| L0456 |
Tlso, flexible, provides trunk support, thoracic region, rigid posterior panel and soft anterior apron, extends from the sacrococcygeal junction and terminates just inferior to the scapular spine, restricts gross trunk motion in the sagittal plane, produces intracavitary pressure to reduce load on the intervertebral disks, includes straps and closures, prefabricated item that has been trimmed, bent, molded, assembled, or otherwise customized to fit a specific patient by an individual with expertise |
14 |
12 |
$3K |
| L3809 |
Wrist hand finger orthosis, without joint(s), prefabricated, off-the-shelf, any type |
13 |
13 |
$2K |
| L5684 |
Addition to lower extremity, below knee, fork strap |
69 |
64 |
$2K |
| L2780 |
Addition to lower extremity orthosis, non-corrosive finish, per bar |
27 |
26 |
$2K |
| L3206 |
Orthopedic shoe, hightop with supinator or pronator, child |
19 |
18 |
$1K |
| A6539 |
Gradient compression stocking, waist length, 18-30 mmhg, each |
12 |
12 |
$1K |
| E0143 |
Walker, folding, wheeled, adjustable or fixed height |
30 |
28 |
$949.95 |
| 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 |
12 |
12 |
$805.66 |
| L2830 |
Addition to lower extremity orthosis, soft interface for molded plastic, above knee section |
12 |
12 |
$772.98 |
| A5512 |
For diabetics only, multiple density insert, direct formed, molded to foot after external heat source of 230 degrees fahrenheit or higher, total contact with patient's foot, including arch, base layer minimum of 1/4 inch material of shore a 35 durometer or 3/16 inch material of shore a 40 durometer (or higher), prefabricated, each |
13 |
13 |
$330.95 |