| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| L1907 |
Ankle orthosis, supramalleolar with straps, with or without interface/pads, custom fabricated |
1,081 |
964 |
$774K |
| L2275 |
Addition to lower extremity, varus/valgus correction, plastic modification, padded/lined |
1,845 |
1,624 |
$284K |
| L3202 |
Orthopedic shoe, oxford with supinator or pronator, child |
2,697 |
2,453 |
$239K |
| L3010 |
Foot, insert, removable, molded to patient model, longitudinal arch support, each |
859 |
706 |
$192K |
| L2820 |
Addition to lower extremity orthosis, soft interface for molded plastic, below knee section |
1,046 |
870 |
$92K |
| L2840 |
Addition to lower extremity orthosis, tibial length sock, fracture or equal, each |
1,095 |
965 |
$80K |
| L1970 |
Ankle foot orthosis, plastic with ankle joint, custom fabricated |
105 |
82 |
$69K |
| 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 |
659 |
420 |
$34K |
| L3060 |
Foot, arch support, removable, premolded, longitudinal/ metatarsal, each |
85 |
78 |
$9K |
| A5513 |
For diabetics only, multiple density insert, custom molded from model of patient's foot, total contact with patient's foot, including arch, base layer minimum of 3/16 inch material of shore a 35 durometer (or higher), includes arch filler and other shaping material, custom fabricated, each |
102 |
97 |
$8K |
| A5514 |
For diabetics only, multiple density insert, made by direct carving with cam technology from a rectified cad model created from a digitized scan of the patient, total contact with patient's foot, including arch, base layer minimum of 3/16 inch material of shore a 35 durometer (or higher), includes arch filler and other shaping material, custom fabricated, each |
114 |
64 |
$6K |
| L8420 |
Prosthetic sock, multiple ply, below knee, each |
64 |
54 |
$2K |
| L5685 |
Addition to lower extremity prosthesis, below knee, suspension/sealing sleeve, with or without valve, any material, each |
22 |
13 |
$2K |
| L5910 |
Addition, endoskeletal system, below knee, alignable system |
15 |
12 |
$851.80 |
| L5637 |
Addition to lower extremity, below knee, total contact |
15 |
12 |
$679.45 |
| L8470 |
Prosthetic sock, single ply, fitting, below knee, each |
66 |
55 |
$641.32 |