| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 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 |
5,951 |
5,767 |
$679K |
| L4361 |
Walking boot, pneumatic and/or vacuum, with or without joints, with or without interface material, prefabricated, off-the-shelf |
4,651 |
4,132 |
$652K |
| L3670 |
Shoulder orthosis, acromio/clavicular (canvas and webbing type), prefabricated, off-the-shelf |
9,496 |
9,005 |
$452K |
| L3807 |
Wrist hand finger orthosis, without joint(s), prefabricated item that has been trimmed, bent, molded, assembled, or otherwise customized to fit a specific patient by an individual with expertise |
3,794 |
3,606 |
$387K |
| E0114 |
Crutches underarm, other than wood, adjustable or fixed, pair, with pads, tips and handgrips |
14,510 |
13,902 |
$348K |
| L3908 |
Wrist hand orthosis, wrist extension control cock-up, non molded, prefabricated, off-the-shelf |
12,473 |
10,954 |
$347K |
| L0633 |
Lumbar-sacral orthosis, sagittal-coronal control, with rigid posterior frame/panel(s), posterior extends from sacrococcygeal junction to t-9 vertebra, lateral strength provided by rigid lateral frame/panels, produces intracavitary pressure to reduce load on intervertebral discs, includes straps, closures, may include padding, stays, shoulder straps, pendulous abdomen design, prefabricated item that has been trimmed, bent, molded, assembled, or otherwise customized to fit a specific patient by an individual with expertise |
1,540 |
1,489 |
$272K |
| L3809 |
Wrist hand finger orthosis, without joint(s), prefabricated, off-the-shelf, any type |
2,015 |
1,842 |
$256K |
| L4350 |
Ankle control orthosis, stirrup style, rigid, includes any type interface (e.g., pneumatic, gel), prefabricated, off-the-shelf |
5,091 |
4,802 |
$227K |
| E0466 |
Home ventilator, any type, used with non-invasive interface, (e.g., mask, chest shell) |
666 |
559 |
$210K |
| 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 |
673 |
636 |
$204K |
| L1820 |
Knee orthosis, elastic with condylar pads and joints, with or without patellar control, prefabricated item that has been trimmed, bent, molded, assembled, or otherwise customized to fit a specific patient by an individual with expertise |
2,409 |
2,173 |
$128K |
| L1810 |
Knee orthosis, elastic with joints, prefabricated item that has been trimmed, bent, molded, assembled, or otherwise customized to fit a specific patient by an individual with expertise |
2,642 |
2,427 |
$124K |
| L1830 |
Knee orthosis, immobilizer, canvas longitudinal, prefabricated, off-the-shelf |
2,853 |
2,670 |
$122K |
| L1902 |
Ankle orthosis, ankle gauntlet or similar, with or without joints, prefabricated, off-the-shelf |
3,090 |
2,900 |
$95K |
| E0601 |
Continuous positive airway pressure (cpap) device |
2,106 |
1,950 |
$75K |
| E0470 |
Respiratory assist device, bi-level pressure capability, without backup rate feature, used with noninvasive interface, e.g., nasal or facial mask (intermittent assist device with continuous positive airway pressure device) |
688 |
600 |
$60K |
| L2795 |
Addition to lower extremity orthosis, knee control, full kneecap |
2,164 |
1,903 |
$57K |
| L0639 |
Lumbar-sacral orthosis, sagittal-coronal control, rigid shell(s)/panel(s), posterior extends from sacrococcygeal junction to t-9 vertebra, anterior extends from symphysis pubis to xyphoid, produces intracavitary pressure to reduce load on the intervertebral discs, overall strength is provided by overlapping rigid material and stabilizing closures, includes straps, closures, may include soft interface, pendulous abdomen design, prefabricated item that has been trimmed, bent, molded, assembled, or otherwise customized to fit a specific patient by an individual with expertise |
110 |
107 |
$51K |
| E1390 |
Oxygen concentrator, single delivery port, capable of delivering 85 percent or greater oxygen concentration at the prescribed flow rate |
970 |
894 |
$45K |
| L0627 |
Lumbar orthosis, sagittal control, with rigid anterior and posterior panels, posterior extends from l-1 to below l-5 vertebra, produces intracavitary pressure to reduce load on the intervertebral discs, includes straps, closures, may include padding, shoulder straps, pendulous abdomen design, prefabricated item that has been trimmed, bent, molded, assembled, or otherwise customized to fit a specific patient by an individual with expertise |
388 |
382 |
$38K |
| L3660 |
Shoulder orthosis, figure of eight design abduction restrainer, canvas and webbing, prefabricated, off-the-shelf |
630 |
601 |
$31K |
| E0562 |
Humidifier, heated, used with positive airway pressure device |
1,436 |
1,307 |
$30K |
| L3650 |
Shoulder orthosis, figure of eight design abduction restrainer, prefabricated, off-the-shelf |
940 |
910 |
$29K |
| A7031 |
Face mask interface, replacement for full face mask, each |
1,140 |
1,037 |
$29K |
| L1833 |
Knee orthosis, adjustable knee joints (unicentric or polycentric), positional orthosis, rigid support, prefabricated, off-the shelf |
93 |
83 |
$27K |
| L1812 |
Knee orthosis, elastic with joints, prefabricated, off-the-shelf |
467 |
397 |
$26K |
| A4604 |
Tubing with integrated heating element for use with positive airway pressure device |
710 |
674 |
$21K |
| L0649 |
Lumbar-sacral orthosis, sagittal-coronal control, with rigid posterior frame/panel(s), posterior extends from sacrococcygeal junction to t-9 vertebra, lateral strength provided by rigid lateral frame/panels, produces intracavitary pressure to reduce load on intervertebral discs, includes straps, closures, may include padding, stays, shoulder straps, pendulous abdomen design, prefabricated, off-the-shelf |
116 |
115 |
$17K |
| L3260 |
Surgical boot/shoe, each |
2,358 |
2,196 |
$15K |
| L4387 |
Walking boot, non-pneumatic, with or without joints, with or without interface material, prefabricated, off-the-shelf |
172 |
151 |
$15K |
| A7032 |
Cushion for use on nasal mask interface, replacement only, each |
457 |
411 |
$10K |
| L2810 |
Addition to lower extremity orthosis, knee control, condylar pad |
180 |
160 |
$9K |
| A7038 |
Filter, disposable, used with positive airway pressure device |
2,628 |
2,394 |
$8K |
| L1906 |
Ankle foot orthosis, multiligamentous ankle support, prefabricated, off-the-shelf |
147 |
130 |
$6K |
| E0603 |
Breast pump, electric (ac and/or dc), any type |
45 |
45 |
$6K |
| E1392 |
Portable oxygen concentrator, rental |
339 |
328 |
$5K |
| A7030 |
Full face mask used with positive airway pressure device, each |
77 |
72 |
$5K |
| E0570 |
Nebulizer, with compressor |
62 |
53 |
$5K |
| A7035 |
Headgear used with positive airway pressure device |
289 |
276 |
$4K |
| L0642 |
Lumbar orthosis, sagittal control, with rigid anterior and posterior panels, posterior extends from l-1 to below l-5 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 |
25 |
24 |
$3K |
| E0431 |
Portable gaseous oxygen system, rental; includes portable container, regulator, flowmeter, humidifier, cannula or mask, and tubing |
157 |
146 |
$2K |
| A7033 |
Pillow for use on nasal cannula type interface, replacement only, pair |
156 |
145 |
$2K |
| A7034 |
Nasal interface (mask or cannula type) used with positive airway pressure device, with or without head strap |
18 |
15 |
$710.10 |
| L4396 |
Static or dynamic ankle foot orthosis, including soft interface material, adjustable for fit, for positioning, may be used for minimal ambulation, prefabricated item that has been trimmed, bent, molded, assembled, or otherwise customized to fit a specific patient by an individual with expertise |
13 |
13 |
$696.90 |
| A7037 |
Tubing used with positive airway pressure device |
69 |
60 |
$576.80 |
| L2830 |
Addition to lower extremity orthosis, soft interface for molded plastic, above knee section |
12 |
12 |
$446.16 |
| L2820 |
Addition to lower extremity orthosis, soft interface for molded plastic, below knee section |
12 |
12 |
$412.44 |
| A7046 |
Water chamber for humidifier, used with positive airway pressure device, replacement, each |
52 |
52 |
$375.94 |
| A7000 |
Canister, disposable, used with suction pump, each |
12 |
12 |
$90.00 |