| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| L2840 |
Addition to lower extremity orthosis, tibial length sock, fracture or equal, each |
1,065 |
519 |
$114K |
| 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 |
1,171 |
592 |
$59K |
| L2275 |
Addition to lower extremity, varus/valgus correction, plastic modification, padded/lined |
101 |
78 |
$13K |
| 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 |
207 |
115 |
$9K |
| L2270 |
Addition to lower extremity, varus/valgus correction ('t') strap, padded/lined or malleolus pad |
113 |
90 |
$5K |
| L1960 |
Ankle foot orthosis, posterior solid ankle, plastic, custom fabricated |
12 |
12 |
$4K |
| 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 |
42 |
24 |
$978.20 |
| L4205 |
Repair of orthotic device, labor component, per 15 minutes |
15 |
15 |
$954.37 |