| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| L1833 |
Knee orthosis, adjustable knee joints (unicentric or polycentric), positional orthosis, rigid support, prefabricated, off-the shelf |
639 |
399 |
$89K |
| L0648 |
Lumbar-sacral orthosis, sagittal control, with rigid anterior and posterior panels, posterior extends from sacrococcygeal junction to t-9 vertebra, produces intracavitary pressure to reduce load on the intervertebral discs, includes straps, closures, may include padding, shoulder straps, pendulous abdomen design, prefabricated, off-the-shelf |
308 |
276 |
$66K |
| A6530 |
Gradient compression stocking, below knee, 18-30 mmhg, each |
655 |
308 |
$23K |
| L3216 |
Orthopedic footwear, ladies shoe, depth inlay, each |
380 |
176 |
$19K |
| L2397 |
Addition to lower extremity orthosis, suspension sleeve |
681 |
418 |
$16K |
| L3030 |
Foot, insert, removable, formed to patient foot, each |
282 |
139 |
$15K |
| L3040 |
Foot, arch support, removable, premolded, longitudinal, each |
799 |
306 |
$14K |
| A6531 |
Gradient compression stocking, below knee, 30-40 mmhg, used as a surgical dressing, each |
1,175 |
508 |
$12K |
| A4595 |
Electrical stimulator supplies, 2 lead, per month, (e.g., tens, nmes) |
1,226 |
997 |
$8K |
| A4557 |
Lead wires, (e.g., apnea monitor), per pair |
1,232 |
995 |
$6K |
| L3809 |
Wrist hand finger orthosis, without joint(s), prefabricated, off-the-shelf, any type |
40 |
25 |
$3K |
| E0730 |
Transcutaneous electrical nerve stimulation (tens) device, four or more leads, for multiple nerve stimulation |
153 |
122 |
$2K |
| 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 |
1,034 |
471 |
$2K |
| 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 |
1,048 |
469 |
$2K |
| L3222 |
Orthopedic footwear, mens shoe, hightop, depth inlay, each |
60 |
25 |
$2K |
| L1832 |
Knee orthosis, adjustable knee joints (unicentric or polycentric), positional orthosis, rigid support, prefabricated item that has been trimmed, bent, molded, assembled, or otherwise customized to fit a specific patient by an individual with expertise |
22 |
12 |
$1K |