| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
22,184 |
17,310 |
$583K |
| L3000 |
Foot, insert, removable, molded to patient model, 'ucb' type, berkeley shell, each |
2,807 |
1,333 |
$315K |
| 99203 |
Office or other outpatient visit for the evaluation and management of a new patient, low complexity |
6,304 |
5,560 |
$268K |
| 11721 |
|
17,670 |
14,388 |
$243K |
| 76881 |
|
3,619 |
2,186 |
$187K |
| 11306 |
|
4,865 |
3,820 |
$184K |
| 17110 |
|
3,112 |
2,043 |
$137K |
| E0730 |
Transcutaneous electrical nerve stimulation (tens) device, four or more leads, for multiple nerve stimulation |
1,389 |
1,121 |
$120K |
| 29580 |
|
5,218 |
2,719 |
$110K |
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
3,053 |
2,324 |
$101K |
| 29540 |
|
8,968 |
4,869 |
$97K |
| 99212 |
Office or other outpatient visit for the evaluation and management of an established patient, straightforward |
5,295 |
4,087 |
$73K |
| L2275 |
Addition to lower extremity, varus/valgus correction, plastic modification, padded/lined |
726 |
335 |
$53K |
| 11056 |
|
4,098 |
3,170 |
$51K |
| 99204 |
Office or other outpatient visit for the evaluation and management of a new patient, moderate complexity |
798 |
697 |
$51K |
| 73630 |
|
2,957 |
2,010 |
$47K |
| 97032 |
|
4,108 |
2,677 |
$36K |
| L2820 |
Addition to lower extremity orthosis, soft interface for molded plastic, below knee section |
804 |
370 |
$36K |
| L3030 |
Foot, insert, removable, formed to patient foot, each |
642 |
266 |
$32K |
| 97035 |
|
4,594 |
2,953 |
$30K |
| 97110 |
Therapeutic procedure, each 15 minutes; therapeutic exercises to develop strength and endurance, flexibility and range of motion |
2,066 |
1,194 |
$28K |
| 11305 |
|
925 |
678 |
$22K |
| 97760 |
|
546 |
497 |
$22K |
| 11730 |
|
893 |
657 |
$20K |
| 97140 |
Manual therapy techniques, each 15 minutes (e.g., mobilization/manipulation, manual lymphatic drainage) |
1,715 |
1,310 |
$19K |
| 76942 |
|
410 |
247 |
$13K |
| 29581 |
|
774 |
397 |
$13K |
| 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 |
251 |
167 |
$12K |
| L1930 |
Ankle foot orthosis, plastic or other material, prefabricated, includes fitting and adjustment |
86 |
37 |
$11K |
| L3020 |
Foot, insert, removable, molded to patient model, longitudinal/ metatarsal support, each |
114 |
55 |
$10K |
| 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 |
218 |
141 |
$10K |
| 11720 |
|
3,038 |
2,067 |
$9K |
| L2112 |
Ankle foot orthosis, fracture orthosis, tibial fracture orthosis, soft, prefabricated, includes fitting and adjustment |
28 |
26 |
$8K |
| 97597 |
|
315 |
244 |
$8K |
| L1906 |
Ankle foot orthosis, multiligamentous ankle support, prefabricated, off-the-shelf |
94 |
64 |
$5K |
| G0127 |
Trimming of dystrophic nails, any number |
2,423 |
1,553 |
$5K |
| 76882 |
|
240 |
170 |
$4K |
| L4396 |
Static or dynamic ankle foot orthosis, including soft interface material, adjustable for fit, for positioning, may be used for minimal ambulation, prefabricated item that has been trimmed, bent, molded, assembled, or otherwise customized to fit a specific patient by an individual with expertise |
51 |
24 |
$4K |
| 11057 |
|
170 |
141 |
$3K |
| 99406 |
|
524 |
421 |
$3K |
| 73620 |
|
154 |
78 |
$2K |
| 20550 |
|
103 |
49 |
$2K |
| 11000 |
|
131 |
115 |
$2K |
| 93922 |
|
57 |
51 |
$2K |
| A6212 |
Foam dressing, wound cover, sterile, pad size 16 sq. in. or less, with any size adhesive border, each dressing |
29 |
28 |
$2K |
| A4595 |
Electrical stimulator supplies, 2 lead, per month, (e.g., tens, nmes) |
107 |
68 |
$1K |
| 64450 |
|
80 |
49 |
$1K |
| A6266 |
Gauze, impregnated, other than water, normal saline, or zinc paste, sterile, any width, per linear yard |
3,551 |
2,304 |
$1K |
| A4590 |
Special casting material (e.g., fiberglass) |
75 |
60 |
$1K |
| 11750 |
|
19 |
12 |
$1K |
| 11307 |
|
14 |
14 |
$1K |
| 10061 |
|
13 |
12 |
$808.50 |
| 11042 |
Debridement, subcutaneous tissue (includes epidermis, dermis, and subcutaneous tissue); first 20 sq cm |
20 |
13 |
$759.35 |
| 29799 |
|
106 |
89 |
$745.23 |
| L1902 |
Ankle orthosis, ankle gauntlet or similar, with or without joints, prefabricated, off-the-shelf |
14 |
13 |
$575.23 |
| J3301 |
Injection, triamcinolone acetonide, not otherwise specified, 10 mg |
324 |
185 |
$542.04 |
| A4580 |
Cast supplies (e.g., plaster) |
208 |
126 |
$456.91 |
| J0702 |
Injection, betamethasone acetate 3 mg and betamethasone sodium phosphate 3 mg |
22 |
12 |
$348.24 |
| 29550 |
|
27 |
24 |
$244.58 |
| J1100 |
Injection, dexamethasone sodium phosphate, 1 mg |
379 |
222 |
$172.93 |
| 11732 |
|
12 |
12 |
$115.55 |
| A4208 |
Syringe with needle, sterile 3 cc, each |
797 |
527 |
$97.72 |
| A4649 |
Surgical supply; miscellaneous |
14 |
14 |
$0.22 |
| Q4050 |
Cast supplies, for unlisted types and materials of casts |
91 |
71 |
$0.00 |
| S0395 |
Impression casting of a foot performed by a practitioner other than the manufacturer of the orthotic |
654 |
294 |
$0.00 |
| A4550 |
Surgical trays |
15 |
14 |
$0.00 |