| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| L2397 |
Addition to lower extremity orthosis, suspension sleeve |
552 |
466 |
$5K |
| L0976 |
Lso, full corset |
746 |
702 |
$3K |
| L2810 |
Addition to lower extremity orthosis, knee control, condylar pad |
361 |
319 |
$3K |
| L0650 |
Lumbar-sacral orthosis, sagittal-coronal control, with rigid anterior and posterior frame/panel(s), posterior extends from sacrococcygeal junction to t-9 vertebra, lateral strength provided by rigid lateral frame/panel(s), produces intracavitary pressure to reduce load on intervertebral discs, includes straps, closures, may include padding, shoulder straps, pendulous abdomen design, prefabricated, off-the-shelf |
16 |
14 |
$3K |
| L2395 |
Addition to lower extremity, offset knee joint, heavy duty, each joint |
99 |
99 |
$2K |
| E0691 |
Ultraviolet light therapy system, includes bulbs/lamps, timer and eye protection; treatment area 2 square feet or less |
40 |
39 |
$2K |
| L1833 |
Knee orthosis, adjustable knee joints (unicentric or polycentric), positional orthosis, rigid support, prefabricated, off-the shelf |
17 |
13 |
$1K |
| 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 |
30 |
29 |
$1K |
| L1030 |
Addition to ctlso or scoliosis orthosis, lumbar bolster pad |
415 |
380 |
$994.44 |
| L1040 |
Addition to ctlso or scoliosis orthosis, lumbar or lumbar rib pad |
286 |
261 |
$901.79 |
| L1060 |
Addition to ctlso or scoliosis orthosis, thoracic pad |
219 |
206 |
$769.78 |
| L1020 |
Addition to ctlso or scoliosis orthosis, kyphosis pad |
265 |
248 |
$654.04 |
| L2830 |
Addition to lower extremity orthosis, soft interface for molded plastic, above knee section |
111 |
73 |
$603.26 |
| L1050 |
Addition to ctlso or scoliosis orthosis, sternal pad |
188 |
177 |
$572.86 |
| K0672 |
Addition to lower extremity orthosis, removable soft interface, all components, replacement only, each |
107 |
105 |
$567.54 |
| L1852 |
Knee orthosis (ko), double upright, thigh and calf, with adjustable flexion and extension joint (unicentric or polycentric), medial-lateral and rotation control, with or without varus/valgus adjustment, prefabricated, off-the-shelf |
24 |
19 |
$510.21 |
| L2800 |
Addition to lower extremity orthosis, knee control, knee cap, medial or lateral pull, for use with custom fabricated orthosis only |
87 |
85 |
$471.31 |
| L1812 |
Knee orthosis, elastic with joints, prefabricated, off-the-shelf |
34 |
31 |
$367.42 |
| L2425 |
Addition to knee joint, disc or dial lock for adjustable knee flexion, each joint |
51 |
46 |
$253.56 |
| L3962 |
Shoulder elbow wrist hand orthosis, abduction positioning, erb's palsey design, prefabricated, includes fitting and adjustment |
14 |
14 |
$197.32 |
| L1210 |
Addition to tlso, (low profile), lateral thoracic extension |
34 |
32 |
$181.94 |
| L1070 |
Addition to ctlso or scoliosis orthosis, trapezius sling |
14 |
14 |
$179.82 |
| L8320 |
Truss, addition to standard pad, water pad |
41 |
40 |
$168.33 |
| L1025 |
Addition to ctlso or scoliosis orthosis, kyphosis pad, floating |
34 |
32 |
$152.37 |
| L8300 |
Truss, single with standard pad |
41 |
40 |
$148.93 |
| L2275 |
Addition to lower extremity, varus/valgus correction, plastic modification, padded/lined |
21 |
19 |
$131.03 |
| L1240 |
Addition to tlso, (low profile), lumbar derotation pad |
50 |
44 |
$95.29 |
| L0972 |
Lso, corset front |
23 |
18 |
$68.35 |
| L1250 |
Addition to tlso, (low profile), anterior asis pad |
26 |
23 |
$62.50 |
| L1260 |
Addition to tlso, (low profile), anterior thoracic derotation pad |
34 |
32 |
$61.92 |
| L2820 |
Addition to lower extremity orthosis, soft interface for molded plastic, below knee section |
33 |
31 |
$58.94 |