| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| L2280 |
Addition to lower extremity, molded inner boot |
1,401 |
733 |
$473K |
| L1970 |
Ankle foot orthosis, plastic with ankle joint, custom fabricated |
758 |
431 |
$382K |
| L2820 |
Addition to lower extremity orthosis, soft interface for molded plastic, below knee section |
2,356 |
1,305 |
$141K |
| 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 |
184 |
157 |
$111K |
| L1907 |
Ankle orthosis, supramalleolar with straps, with or without interface/pads, custom fabricated |
165 |
81 |
$75K |
| L2275 |
Addition to lower extremity, varus/valgus correction, plastic modification, padded/lined |
615 |
327 |
$58K |
| L5637 |
Addition to lower extremity, below knee, total contact |
285 |
254 |
$42K |
| L1960 |
Ankle foot orthosis, posterior solid ankle, plastic, custom fabricated |
71 |
38 |
$33K |
| L5671 |
Addition to lower extremity, below knee / above knee suspension locking mechanism (shuttle, lanyard or equal), excludes socket insert |
113 |
98 |
$30K |
| 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 |
42 |
38 |
$23K |
| L5620 |
Addition to lower extremity, test socket, below knee |
92 |
81 |
$19K |
| L3202 |
Orthopedic shoe, oxford with supinator or pronator, child |
370 |
182 |
$16K |
| L8420 |
Prosthetic sock, multiple ply, below knee, each |
313 |
276 |
$16K |
| L5629 |
Addition to lower extremity, below knee, acrylic socket |
74 |
65 |
$15K |
| L5940 |
Addition, endoskeletal system, below knee, ultra-light material (titanium, carbon fiber or equal) |
72 |
63 |
$15K |
| L2270 |
Addition to lower extremity, varus/valgus correction ('t') strap, padded/lined or malleolus pad |
309 |
178 |
$12K |
| L2200 |
Addition to lower extremity, limited ankle motion, each joint |
96 |
47 |
$6K |
| L2210 |
Addition to lower extremity, dorsiflexion assist (plantar flexion resist), each joint |
44 |
25 |
$5K |
| L5685 |
Addition to lower extremity prosthesis, below knee, suspension/sealing sleeve, with or without valve, any material, each |
26 |
24 |
$4K |
| L5986 |
All lower extremity prostheses, multi-axial rotation unit ('mcp' or equal) |
14 |
12 |
$3K |
| L8470 |
Prosthetic sock, single ply, fitting, below knee, each |
300 |
267 |
$3K |
| L5910 |
Addition, endoskeletal system, below knee, alignable system |
15 |
13 |
$2K |
| L3310 |
Lift, elevation, heel and sole, neoprene, per inch |
14 |
13 |
$990.94 |
| 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 |
22 |
13 |
$783.43 |
| L8440 |
Prosthetic shrinker, below knee, each |
13 |
12 |
$469.42 |