| Code | Description | Total Paid |
|---|
| L2275 |
Addition to lower extremity, varus/valgus correction, plastic modification, padded/lined |
$106K |
| E0745 |
Neuromuscular stimulator, electronic shock unit |
$52K |
| L1907 |
Ankle orthosis, supramalleolar with straps, with or without interface/pads, custom fabricated |
$49K |
| L4361 |
Walking boot, pneumatic and/or vacuum, with or without joints, with or without interface material, prefabricated, off-the-shelf |
$48K |
| L2820 |
Addition to lower extremity orthosis, soft interface for molded plastic, below knee section |
$18K |
| L2280 |
Addition to lower extremity, molded inner boot |
$14K |
| L1833 |
Knee orthosis, adjustable knee joints (unicentric or polycentric), positional orthosis, rigid support, prefabricated, off-the shelf |
$13K |
| L1902 |
Ankle orthosis, ankle gauntlet or similar, with or without joints, prefabricated, off-the-shelf |
$6K |
| L8000 |
Breast prosthesis, mastectomy bra, without integrated breast prosthesis form, any size, any type |
$6K |
| L3908 |
Wrist hand orthosis, wrist extension control cock-up, non molded, prefabricated, off-the-shelf |
$3K |