| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| L1833 |
Knee orthosis, adjustable knee joints (unicentric or polycentric), positional orthosis, rigid support, prefabricated, off-the shelf |
7,311 |
6,457 |
$1.36M |
| L4361 |
Walking boot, pneumatic and/or vacuum, with or without joints, with or without interface material, prefabricated, off-the-shelf |
5,702 |
5,360 |
$765K |
| E0935 |
Continuous passive motion exercise device for use on knee only |
9,681 |
6,890 |
$701K |
| E0673 |
Segmental gradient pressure pneumatic appliance, half leg |
4,888 |
3,702 |
$469K |
| L3960 |
Shoulder elbow wrist hand orthosis, abduction positioning, airplane design, prefabricated, includes fitting and adjustment |
2,143 |
1,835 |
$408K |
| L3809 |
Wrist hand finger orthosis, without joint(s), prefabricated, off-the-shelf, any type |
3,128 |
2,898 |
$360K |
| 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 |
855 |
779 |
$291K |
| E0650 |
Pneumatic compressor, non-segmental home model |
9,190 |
8,406 |
$271K |
| E0114 |
Crutches underarm, other than wood, adjustable or fixed, pair, with pads, tips and handgrips |
9,242 |
8,767 |
$270K |
| E0936 |
Continuous passive motion exercise device for use other than knee |
4,425 |
3,497 |
$239K |
| E0675 |
Pneumatic compression device, high pressure, rapid inflation/deflation cycle, for arterial insufficiency (unilateral or bilateral system) |
4,863 |
4,581 |
$210K |
| L3650 |
Shoulder orthosis, figure of eight design abduction restrainer, prefabricated, off-the-shelf |
5,758 |
5,454 |
$175K |
| E0672 |
Segmental gradient pressure pneumatic appliance, full arm |
1,574 |
1,497 |
$164K |
| L3908 |
Wrist hand orthosis, wrist extension control cock-up, non molded, prefabricated, off-the-shelf |
4,790 |
4,074 |
$148K |
| L1686 |
Hip orthosis, abduction control of hip joint, postoperative hip abduction type, prefabricated, includes fitting and adjustment |
397 |
357 |
$112K |
| E1399 |
Durable medical equipment, miscellaneous |
1,692 |
1,206 |
$105K |
| L3660 |
Shoulder orthosis, figure of eight design abduction restrainer, canvas and webbing, prefabricated, off-the-shelf |
1,433 |
1,380 |
$93K |
| E0249 |
Pad for water circulating heat unit, for replacement only |
6,128 |
5,684 |
$89K |
| E0603 |
Breast pump, electric (ac and/or dc), any type |
528 |
484 |
$86K |
| E0143 |
Walker, folding, wheeled, adjustable or fixed height |
3,039 |
2,765 |
$86K |
| 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 |
218 |
182 |
$82K |
| L3670 |
Shoulder orthosis, acromio/clavicular (canvas and webbing type), prefabricated, off-the-shelf |
1,644 |
1,489 |
$74K |
| L1902 |
Ankle orthosis, ankle gauntlet or similar, with or without joints, prefabricated, off-the-shelf |
1,632 |
1,520 |
$70K |
| L1812 |
Knee orthosis, elastic with joints, prefabricated, off-the-shelf |
1,451 |
1,279 |
$65K |
| E0666 |
Non-segmental pneumatic appliance for use with pneumatic compressor, half leg |
1,633 |
1,554 |
$63K |
| L4350 |
Ankle control orthosis, stirrup style, rigid, includes any type interface (e.g., pneumatic, gel), prefabricated, off-the-shelf |
1,030 |
974 |
$49K |
| E0188 |
Synthetic sheepskin pad |
4,352 |
3,876 |
$48K |
| L1830 |
Knee orthosis, immobilizer, canvas longitudinal, prefabricated, off-the-shelf |
1,033 |
981 |
$46K |
| E0676 |
Intermittent limb compression device (includes all accessories), not otherwise specified |
1,197 |
1,033 |
$41K |
| E0236 |
Pump for water circulating pad |
11,084 |
10,103 |
$40K |
| E0218 |
Fluid circulating cold pad with pump, any type |
5,408 |
4,576 |
$28K |
| A9901 |
Dme delivery, set up, and/or dispensing service component of another hcpcs code |
11,223 |
10,063 |
$25K |
| L3260 |
Surgical boot/shoe, each |
1,774 |
1,661 |
$24K |
| L4387 |
Walking boot, non-pneumatic, with or without joints, with or without interface material, prefabricated, off-the-shelf |
281 |
267 |
$21K |
| L1846 |
Knee orthosis, 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, custom fabricated |
44 |
30 |
$20K |
| A4556 |
Electrodes, (e.g., apnea monitor), per pair |
698 |
644 |
$16K |
| 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 |
165 |
160 |
$13K |
| L3984 |
Upper extremity fracture orthosis, wrist, prefabricated, includes fitting and adjustment |
48 |
48 |
$10K |
| E0730 |
Transcutaneous electrical nerve stimulation (tens) device, four or more leads, for multiple nerve stimulation |
128 |
95 |
$7K |
| L8000 |
Breast prosthesis, mastectomy bra, without integrated breast prosthesis form, any size, any type |
212 |
129 |
$5K |
| E0100 |
Cane, includes canes of all materials, adjustable or fixed, with tip |
300 |
281 |
$3K |
| A4595 |
Electrical stimulator supplies, 2 lead, per month, (e.g., tens, nmes) |
87 |
59 |
$537.49 |
| A9900 |
Miscellaneous dme supply, accessory, and/or service component of another hcpcs code |
52 |
43 |
$477.21 |
| A4557 |
Lead wires, (e.g., apnea monitor), per pair |
26 |
25 |
$459.16 |
| L3995 |
Addition to upper extremity orthosis, sock, fracture or equal, each |
14 |
14 |
$334.32 |
| E0105 |
Cane, quad or three prong, includes canes of all materials, adjustable or fixed, with tips |
16 |
14 |
$329.64 |
| E0745 |
Neuromuscular stimulator, electronic shock unit |
14 |
12 |
$284.58 |
| E0135 |
Walker, folding (pickup), adjustable or fixed height |
14 |
14 |
$263.05 |
| A9270 |
Non-covered item or service |
174 |
139 |
$89.85 |
| A4565 |
Slings |
14 |
13 |
$55.11 |
| A4630 |
Replacement batteries, medically necessary, transcutaneous electrical stimulator, owned by patient |
12 |
12 |
$32.14 |