| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| L1970 |
Ankle foot orthosis, plastic with ankle joint, custom fabricated |
2,069 |
1,244 |
$1.18M |
| L1960 |
Ankle foot orthosis, posterior solid ankle, plastic, custom fabricated |
2,199 |
1,260 |
$993K |
| L1940 |
Ankle foot orthosis, plastic or other material, custom fabricated |
1,296 |
760 |
$587K |
| L2280 |
Addition to lower extremity, molded inner boot |
3,147 |
1,841 |
$433K |
| L2275 |
Addition to lower extremity, varus/valgus correction, plastic modification, padded/lined |
7,591 |
4,320 |
$308K |
| L2330 |
Addition to lower extremity, lacer molded to patient model, for custom fabricated orthosis only |
2,186 |
1,245 |
$225K |
| L2270 |
Addition to lower extremity, varus/valgus correction ('t') strap, padded/lined or malleolus pad |
7,223 |
4,081 |
$124K |
| L3906 |
Wrist hand orthosis, without joints, may include soft interface, straps, custom fabricated, includes fitting and adjustment |
459 |
281 |
$108K |
| L2820 |
Addition to lower extremity orthosis, soft interface for molded plastic, below knee section |
6,119 |
3,479 |
$106K |
| L3202 |
Orthopedic shoe, oxford with supinator or pronator, child |
3,226 |
1,786 |
$76K |
| L2340 |
Addition to lower extremity, pre-tibial shell, molded to patient model |
252 |
140 |
$62K |
| L0482 |
Tlso, triplanar control, one piece rigid plastic shell with interface liner, multiple straps and closures, posterior extends from sacrococcygeal junction and terminates just inferior to scapular spine, anterior extends from symphysis pubis to sternal notch, anterior or posterior opening, restricts gross trunk motion in sagittal, coronal, and transverse planes, includes a carved plaster or cad-cam model, custom fabricated |
55 |
54 |
$57K |
| S1040 |
Cranial remolding orthosis, pediatric, rigid, with soft interface material, custom fabricated, includes fitting and adjustment(s) |
12 |
12 |
$36K |
| L2200 |
Addition to lower extremity, limited ankle motion, each joint |
2,333 |
1,375 |
$31K |
| L2210 |
Addition to lower extremity, dorsiflexion assist (plantar flexion resist), each joint |
260 |
151 |
$16K |
| L2370 |
Addition to lower extremity, patten bottom |
187 |
114 |
$13K |
| L3010 |
Foot, insert, removable, molded to patient model, longitudinal arch support, each |
77 |
43 |
$9K |
| L1260 |
Addition to tlso, (low profile), anterior thoracic derotation pad |
216 |
205 |
$5K |
| L1290 |
Addition to tlso, (low profile), lateral trochanteric pad |
230 |
219 |
$4K |
| L1210 |
Addition to tlso, (low profile), lateral thoracic extension |
126 |
120 |
$3K |
| L1240 |
Addition to tlso, (low profile), lumbar derotation pad |
154 |
147 |
$3K |
| L2220 |
Addition to lower extremity, dorsiflexion and plantar flexion assist/resist, each joint |
42 |
13 |
$2K |
| L1280 |
Addition to tlso, (low profile), rib gusset (elastic), each |
69 |
68 |
$2K |
| L3203 |
Orthopedic shoe, oxford with supinator or pronator, junior |
48 |
24 |
$2K |