| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| A6549 |
Gradient compression garment, not otherwise specified, for daytime use, each |
862 |
447 |
$644K |
| L2840 |
Addition to lower extremity orthosis, tibial length sock, fracture or equal, each |
3,106 |
1,299 |
$387K |
| L1960 |
Ankle foot orthosis, posterior solid ankle, plastic, custom fabricated |
888 |
391 |
$293K |
| L2275 |
Addition to lower extremity, varus/valgus correction, plastic modification, padded/lined |
2,927 |
1,224 |
$229K |
| L2820 |
Addition to lower extremity orthosis, soft interface for molded plastic, below knee section |
3,063 |
1,291 |
$158K |
| S1040 |
Cranial remolding orthosis, pediatric, rigid, with soft interface material, custom fabricated, includes fitting and adjustment(s) |
52 |
47 |
$123K |
| L2280 |
Addition to lower extremity, molded inner boot |
429 |
188 |
$123K |
| L3254 |
Non-standard size or width |
2,671 |
1,108 |
$59K |
| 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 |
695 |
321 |
$41K |
| A6530 |
Gradient compression stocking, below knee, 18-30 mmhg, each |
300 |
139 |
$39K |
| L3202 |
Orthopedic shoe, oxford with supinator or pronator, child |
1,112 |
461 |
$30K |
| 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 |
970 |
439 |
$28K |
| L3060 |
Foot, arch support, removable, premolded, longitudinal/ metatarsal, each |
132 |
62 |
$8K |
| L3360 |
Sole wedge, outside sole |
28 |
13 |
$614.16 |