| 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 |
137 |
106 |
$57K |
| L5679 |
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, not for use with locking mechanism |
123 |
80 |
$55K |
| L5645 |
Addition to lower extremity, below knee, flexible inner socket, external frame |
119 |
95 |
$30K |
| L5301 |
Below knee, molded socket, shin, sach foot, endoskeletal system |
17 |
15 |
$17K |
| L5940 |
Addition, endoskeletal system, below knee, ultra-light material (titanium, carbon fiber or equal) |
131 |
108 |
$16K |
| L5620 |
Addition to lower extremity, test socket, below knee |
161 |
125 |
$16K |
| L5637 |
Addition to lower extremity, below knee, total contact |
131 |
108 |
$12K |
| L8440 |
Prosthetic shrinker, below knee, each |
712 |
565 |
$11K |
| L8420 |
Prosthetic sock, multiple ply, below knee, each |
317 |
251 |
$10K |
| L5629 |
Addition to lower extremity, below knee, acrylic socket |
115 |
95 |
$10K |
| L5910 |
Addition, endoskeletal system, below knee, alignable system |
99 |
83 |
$9K |
| L5671 |
Addition to lower extremity, below knee / above knee suspension locking mechanism (shuttle, lanyard or equal), excludes socket insert |
56 |
41 |
$7K |
| L8400 |
Prosthetic sheath, below knee, each |
235 |
182 |
$5K |
| L8470 |
Prosthetic sock, single ply, fitting, below knee, each |
115 |
96 |
$994.88 |
| L5685 |
Addition to lower extremity prosthesis, below knee, suspension/sealing sleeve, with or without valve, any material, each |
19 |
16 |
$756.16 |
| L8460 |
Prosthetic shrinker, above knee, each |
13 |
12 |
$185.88 |