| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 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 |
48 |
40 |
$26K |
| L5671 |
Addition to lower extremity, below knee / above knee suspension locking mechanism (shuttle, lanyard or equal), excludes socket insert |
59 |
51 |
$26K |
| L5637 |
Addition to lower extremity, below knee, total contact |
43 |
37 |
$21K |
| L5620 |
Addition to lower extremity, test socket, below knee |
30 |
24 |
$11K |
| L8420 |
Prosthetic sock, multiple ply, below knee, each |
43 |
37 |
$8K |
| L5940 |
Addition, endoskeletal system, below knee, ultra-light material (titanium, carbon fiber or equal) |
16 |
12 |
$8K |
| L5986 |
All lower extremity prostheses, multi-axial rotation unit ('mcp' or equal) |
12 |
12 |
$2K |