| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 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 |
548 |
312 |
$18K |
| 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 |
245 |
233 |
$9K |
| L2397 |
Addition to lower extremity orthosis, suspension sleeve |
367 |
314 |
$6K |
| L3960 |
Shoulder elbow wrist hand orthosis, abduction positioning, airplane design, prefabricated, includes fitting and adjustment |
192 |
187 |
$5K |
| L3916 |
Wrist hand orthosis, includes one or more nontorsion joint(s), elastic bands, turnbuckles, may include soft interface, straps, prefabricated, off-the-shelf |
94 |
84 |
$4K |
| L1971 |
Ankle foot orthosis, plastic or other material with ankle joint, with or without dorsiflexion assist, prefabricated, includes fitting and adjustment |
126 |
71 |
$3K |
| L3761 |
Elbow orthosis (eo), with adjustable position locking joint(s), prefabricated, off-the-shelf |
20 |
13 |
$264.63 |
| L3170 |
Foot, plastic, silicone or equal, heel stabilizer, prefabricated, off-the-shelf, each |
42 |
34 |
$181.71 |