| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| L1960 |
Ankle foot orthosis, posterior solid ankle, plastic, custom fabricated |
2,616 |
1,569 |
$689K |
| L2820 |
Addition to lower extremity orthosis, soft interface for molded plastic, below knee section |
4,241 |
2,468 |
$235K |
| L2275 |
Addition to lower extremity, varus/valgus correction, plastic modification, padded/lined |
3,361 |
1,917 |
$195K |
| L1200 |
Thoracic-lumbar-sacral-orthosis (tlso), inclusive of furnishing initial orthosis only |
64 |
57 |
$67K |
| L1210 |
Addition to tlso, (low profile), lateral thoracic extension |
252 |
236 |
$30K |
| L1930 |
Ankle foot orthosis, plastic or other material, prefabricated, includes fitting and adjustment |
215 |
112 |
$23K |
| L4386 |
Walking boot, non-pneumatic, with or without joints, with or without interface material, prefabricated item that has been trimmed, bent, molded, assembled, or otherwise customized to fit a specific patient by an individual with expertise |
280 |
271 |
$14K |
| L2280 |
Addition to lower extremity, molded inner boot |
47 |
29 |
$9K |
| 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 |
26 |
26 |
$6K |
| L1970 |
Ankle foot orthosis, plastic with ankle joint, custom fabricated |
17 |
12 |
$6K |
| L1907 |
Ankle orthosis, supramalleolar with straps, with or without interface/pads, custom fabricated |
23 |
13 |
$5K |
| L2768 |
Orthotic side bar disconnect device, per bar |
53 |
28 |
$4K |
| L1240 |
Addition to tlso, (low profile), lumbar derotation pad |
27 |
27 |
$632.79 |
| L3150 |
Foot, abduction rotation bar, without shoes |
13 |
13 |
$614.04 |
| L1290 |
Addition to tlso, (low profile), lateral trochanteric pad |
15 |
15 |
$533.49 |
| L1260 |
Addition to tlso, (low profile), anterior thoracic derotation pad |
14 |
14 |
$332.95 |
| L4205 |
Repair of orthotic device, labor component, per 15 minutes |
13 |
12 |
$238.82 |
| L2999 |
Lower extremity orthoses, not otherwise specified |
15 |
12 |
$169.36 |