| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 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 |
675 |
641 |
$10K |
| L1851 |
Knee orthosis (ko), single 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 |
462 |
407 |
$7K |
| L3960 |
Shoulder elbow wrist hand orthosis, abduction positioning, airplane design, prefabricated, includes fitting and adjustment |
228 |
214 |
$4K |
| L3916 |
Wrist hand orthosis, includes one or more nontorsion joint(s), elastic bands, turnbuckles, may include soft interface, straps, prefabricated, off-the-shelf |
294 |
264 |
$3K |
| L1971 |
Ankle foot orthosis, plastic or other material with ankle joint, with or without dorsiflexion assist, prefabricated, includes fitting and adjustment |
83 |
41 |
$3K |
| L3761 |
Elbow orthosis (eo), with adjustable position locking joint(s), prefabricated, off-the-shelf |
72 |
41 |
$2K |
| L2397 |
Addition to lower extremity orthosis, suspension sleeve |
467 |
433 |
$1K |
| L1833 |
Knee orthosis, adjustable knee joints (unicentric or polycentric), positional orthosis, rigid support, prefabricated, off-the shelf |
21 |
19 |
$932.43 |
| L3170 |
Foot, plastic, silicone or equal, heel stabilizer, prefabricated, off-the-shelf, each |
60 |
40 |
$108.45 |