| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| S1040 |
Cranial remolding orthosis, pediatric, rigid, with soft interface material, custom fabricated, includes fitting and adjustment(s) |
421 |
378 |
$838K |
| L1960 |
Ankle foot orthosis, posterior solid ankle, plastic, custom fabricated |
1,058 |
797 |
$557K |
| L2275 |
Addition to lower extremity, varus/valgus correction, plastic modification, padded/lined |
1,617 |
1,253 |
$194K |
| A6530 |
Gradient compression stocking, below knee, 18-30 mmhg, each |
2,451 |
1,772 |
$135K |
| L2820 |
Addition to lower extremity orthosis, soft interface for molded plastic, below knee section |
1,318 |
1,021 |
$99K |
| 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 |
1,638 |
1,018 |
$97K |
| L2270 |
Addition to lower extremity, varus/valgus correction ('t') strap, padded/lined or malleolus pad |
1,442 |
1,097 |
$67K |
| L2280 |
Addition to lower extremity, molded inner boot |
113 |
91 |
$51K |
| 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 |
1,261 |
747 |
$48K |
| L2999 |
Lower extremity orthoses, not otherwise specified |
1,004 |
507 |
$45K |
| L3809 |
Wrist hand finger orthosis, without joint(s), prefabricated, off-the-shelf, any type |
104 |
81 |
$19K |
| A6533 |
Gradient compression stocking, thigh length, 18-30 mmhg, each |
252 |
183 |
$18K |
| A6549 |
Gradient compression garment, not otherwise specified, for daytime use, each |
15 |
12 |
$7K |
| L1930 |
Ankle foot orthosis, plastic or other material, prefabricated, includes fitting and adjustment |
17 |
12 |
$5K |
| L1940 |
Ankle foot orthosis, plastic or other material, custom fabricated |
15 |
12 |
$5K |
| L4361 |
Walking boot, pneumatic and/or vacuum, with or without joints, with or without interface material, prefabricated, off-the-shelf |
12 |
12 |
$3K |
| L1820 |
Knee orthosis, elastic with condylar pads and joints, with or without patellar control, prefabricated item that has been trimmed, bent, molded, assembled, or otherwise customized to fit a specific patient by an individual with expertise |
20 |
14 |
$1K |
| L3908 |
Wrist hand orthosis, wrist extension control cock-up, non molded, prefabricated, off-the-shelf |
32 |
25 |
$1K |