| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 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 |
587 |
557 |
$82K |
| L3010 |
Foot, insert, removable, molded to patient model, longitudinal arch support, each |
256 |
116 |
$22K |
| 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 |
445 |
218 |
$13K |
| 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 |
142 |
131 |
$11K |
| L2820 |
Addition to lower extremity orthosis, soft interface for molded plastic, below knee section |
276 |
177 |
$10K |
| L2275 |
Addition to lower extremity, varus/valgus correction, plastic modification, padded/lined |
131 |
72 |
$9K |
| 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 |
121 |
56 |
$2K |
| 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 |
14 |
13 |
$1K |