| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| L2840 |
Addition to lower extremity orthosis, tibial length sock, fracture or equal, each |
1,926 |
781 |
$233K |
| L2280 |
Addition to lower extremity, molded inner boot |
655 |
278 |
$176K |
| L2275 |
Addition to lower extremity, varus/valgus correction, plastic modification, padded/lined |
2,149 |
884 |
$148K |
| L2820 |
Addition to lower extremity orthosis, soft interface for molded plastic, below knee section |
1,501 |
680 |
$64K |
| L1907 |
Ankle orthosis, supramalleolar with straps, with or without interface/pads, custom fabricated |
137 |
56 |
$46K |
| L3202 |
Orthopedic shoe, oxford with supinator or pronator, child |
1,239 |
498 |
$32K |
| L1960 |
Ankle foot orthosis, posterior solid ankle, plastic, custom fabricated |
92 |
43 |
$30K |
| L1970 |
Ankle foot orthosis, plastic with ankle joint, custom fabricated |
44 |
25 |
$23K |
| 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 |
14 |
12 |
$4K |
| 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 |
120 |
44 |
$2K |
| L2200 |
Addition to lower extremity, limited ankle motion, each joint |
20 |
12 |
$766.91 |
| 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 |
37 |
12 |
$744.58 |