| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| L2250 |
Addition to lower extremity, foot plate, molded to patient model, stirrup attachment |
391 |
218 |
$127K |
| L2275 |
Addition to lower extremity, varus/valgus correction, plastic modification, padded/lined |
1,062 |
601 |
$93K |
| L2270 |
Addition to lower extremity, varus/valgus correction ('t') strap, padded/lined or malleolus pad |
1,070 |
608 |
$93K |
| S1040 |
Cranial remolding orthosis, pediatric, rigid, with soft interface material, custom fabricated, includes fitting and adjustment(s) |
24 |
24 |
$88K |
| L1940 |
Ankle foot orthosis, plastic or other material, custom fabricated |
167 |
87 |
$61K |
| L1970 |
Ankle foot orthosis, plastic with ankle joint, custom fabricated |
76 |
45 |
$38K |
| L4360 |
Walking boot, pneumatic and/or vacuum, 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 |
161 |
154 |
$27K |
| 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 |
368 |
208 |
$17K |
| L2220 |
Addition to lower extremity, dorsiflexion and plantar flexion assist/resist, each joint |
79 |
46 |
$10K |
| L3808 |
Wrist hand finger orthosis, rigid without joints, may include soft interface material; straps, custom fabricated, includes fitting and adjustment |
37 |
24 |
$9K |
| 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 |
70 |
37 |
$4K |