| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 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 |
3,362 |
1,769 |
$166K |
| L2820 |
Addition to lower extremity orthosis, soft interface for molded plastic, below knee section |
1,403 |
1,090 |
$88K |
| L1932 |
Ankle foot orthosis, rigid anterior tibial section, total carbon fiber or equal material, prefabricated item that has been trimmed, bent, molded, assembled, or otherwise customized to fit a specific patient by an individual with expertise |
45 |
38 |
$20K |
| L2220 |
Addition to lower extremity, dorsiflexion and plantar flexion assist/resist, each joint |
215 |
162 |
$18K |
| L2275 |
Addition to lower extremity, varus/valgus correction, plastic modification, padded/lined |
204 |
150 |
$13K |
| L5000 |
Partial foot, shoe insert with longitudinal arch, toe filler |
52 |
49 |
$10K |
| L4387 |
Walking boot, non-pneumatic, with or without joints, with or without interface material, prefabricated, off-the-shelf |
57 |
55 |
$7K |
| L3809 |
Wrist hand finger orthosis, without joint(s), prefabricated, off-the-shelf, any type |
30 |
25 |
$5K |
| L2265 |
Addition to lower extremity, long tongue stirrup |
108 |
81 |
$5K |
| L2360 |
Addition to lower extremity, extended steel shank |
109 |
81 |
$2K |
| L4397 |
Static or dynamic ankle foot orthosis, including soft interface material, adjustable for fit, for positioning, may be used for minimal ambulation, prefabricated, off-the-shelf |
18 |
12 |
$2K |
| L4110 |
Replace leather cuff kafo-afo, calf or distal thigh |
28 |
24 |
$796.83 |
| L3630 |
Transfer of an orthosis from one shoe to another, solid stirrup, new |
13 |
12 |
$266.23 |