Free 2007 HCPCS L Codes

  • L0100 Model cranial orthosis (helmet), with or without soft interface, molded to...
  • L0112 Interface material, adjustable range of motion joint, custom fabricated cra...
  • L0120 Cervical, flexible, non-adjustable (foam collar)
  • L0130 Cervical, flexible, thermoplastic collar, molded to patient
  • L0140 Cervical, semi-rigid, adjustable (plastic collar)
  • L0150 Cervical, semi-rigid, adjustable molded chin cup (plastic collar with mandi...
  • L0160 Cervical, semi-rigid, wire frame occipital/mandibular support
  • L0170 Cervical, collar, molded to patient model
  • L0172 Cervical, collar, semi-rigid thermoplastic foam, two piece
  • L0174 Cervical, collar, semi-rigid, thermoplastic foam, two piece with thoracic e...
  • L0180 Cervical, multiple post collar, occipital/mandibular supports, adjustable
  • L0190 Cervical, multiple post collar, occipital/mandibular supports, adjustable c...
  • L0200 Cervical, multiple post collar, occipital/mandibular supports, adjustable c...
  • L0210 Thoracic, rib belt
  • L0220 Thoracic, rib belt, custom fabricated
  • L0430 Custom fitted (dewall posture protector only) spinal orthosis, anterior-pos...
  • L0450 Tlso, flexible, provides trunk support, upper thoracic region, produces int...
  • L0452 Intracavitary pressure to reduce load on the intervertebral disks with rigi...
  • L0454 Above t-9 vertebra, restricts gross trunk motion in the sagittal plane, rig...
  • L0456 Tlso, flexible, provides trunk support, thoracic region, rigid posterior pa...
  • L0458 Tlso, triplanar control, modular segmented spinal system, two rigid plastic...
  • L0460 Tlso, triplanar control, modular segmented spinal system, two rigid plastic...
  • L0462 Shells, posterior extends from the sacrococcygeal junction and terminates j...
  • L0464 Tlso, triplanar control, modular segmented spinal system, four rigid plasti...
  • L0466 With straps, closures and padding, restricts gross trunk motion in sagittal...
  • L0468 Tlso, sagittal-coronal control, rigid posterior frame and flexible soft adj...
  • L0470 Scapula, lateral strength provided by pelvic, thoracic, and lateral frame p...
  • L0472 Tlso, triplanar control, hyperextension, rigid anterior and lateral frame e...
  • L0478 To xiphoid, usually laced together on one side, restricts gross trunk motio...
  • L0480 Junction and terminates just inferior to scapular spine, anterior extends f...
  • L0482 And terminates just inferior to scapular spine, anterior extends from symph...
  • L0484 With multiple straps and closures, posterior extends from sacrococcygeal pl...
  • L0486 Tlso, triplanar control, two piece rigid plastic shell with interface liner...
  • L0488 Tlso, triplanar control, one piece rigid plastic shell with interface liner...
  • L0490 Extends from symphysis pubis to xiphoid, anterior opening, restricts gross ...
  • L0491 Tlso, sagittal-coronal control, modular segmented spinal system, two rigid ...
  • L0492 Terminates just inferior to the scapular spine, anterior extends from the s...
  • L0621 About the sacroiliac joint, includes straps, closures, may include pendulou...
  • L0622 Sacroiliac orthosis, flexible, provides pelvic-sacral support, reduces moti...
  • L0623 Sacroiliac orthosis, provides pelvic-sacral support, with rigid or semi-rig...
  • L0624 Panels placed over the sacrum and abdomen, reduces motion about the sacroil...
  • L0625 Lumbar orthosis, flexible, provides lumbar support, posterior extends from ...
  • L0626 Includes fitting and adjustment lumbar orthosis, sagittal control, with rig...
  • L0627 Lumbar orthosis, sagittal control, with rigid anterior and posterior panels...
  • L0628 Lumbar-sacral orthosis, flexible, provides lumbo-sacral support, posterior ...
  • L0629 May include stays, shoulder straps, pendulous abdomen design, custom fabric...
  • L0630 Posterior extends from sacrococcygeal junction to t-9 vertebra, produces ab...
  • L0631 Lumbar-sacral orthosis, sagittal control, with rigid anterior and posterior...
  • L0632 Lumbar-sacral orthosis, sagittal control, with rigid anterior and posterior...
  • L0633 Lateral strength provided by rigid lateral frame/panels, produces intracavi...
  • L0634 Lumbar-sacral orthosis, sagittal-coronal control, with rigid posterior late...
  • L0635 Posterior extends from sacrococcygeal junction to t-9 vertebra, lateral pre...
  • L0636 Lumbar sacral orthosis, sagittal-coronal control, lumbar flexion, rigid pos...
  • L0637 Posterior frame/panels, posterior extends from sacrococcygeal junction to t...
  • L0638 Vertebra, lateral strength provided by rigid lateral frame/panels, produces...
  • L0639 May include soft interface, pendulous abdomen design, prefabricated, includ...
  • L0640 Posterior extends from sacrococcygeal junction to t-9 vertebra, anterior ov...
  • L0700 Cervical-thoracic-lumbar-sacral-orthoses (ctlso), anterior-posterior-latera...
  • L0710 Interface material, (minerva type) ctlso, anterior-posterior-lateral-contro...
  • L0810 Halo procedure, cervical halo incorporated into jacket vest
  • L0820 Halo procedure, cervical halo incorporated into plaster body jacket
  • L0830 Halo procedure, cervical halo incorporated into milwaukee type orthosis
  • L0859 Addition to halo procedure, magnetic resonance image compatible systems, ri...
  • L0861 Addition to halo procedure, replacement liner/interface material
  • L0960 Torso support, post surgical support, pads for post surgical support
  • L0970 Tlso, corset front
  • L0972 Lso, corset front
  • L0974 Tlso, full corset
  • L0976 Lso, full corset
  • L0978 Axillary crutch extension
  • L0980 Peroneal straps, pair
  • L0982 Stocking supporter grips, set of four (4)
  • L0984 Protective body sock, each
  • L0999 Addition to spinal orthosis, not otherwise specified
  • L1000 Cervical-thoracic-lumbar-sacral orthosis (ctlso) (milwaukee), inclusive of ...
  • L1001 Prefabricated, includes fitting and adjustment cervical thoracic lumbar sac...
  • L1005 Tension based scoliosis orthosis and accessory pads, includes fitting and a...
  • L1010 Addition to cervical-thoracic-lumbar-sacral orthosis (ctlso) or scoliosis o...
  • L1020 Addition to ctlso or scoliosis orthosis, kyphosis pad
  • L1025 Addition to ctlso or scoliosis orthosis, kyphosis pad, floating
  • L1030 Addition to ctlso or scoliosis orthosis, lumbar bolster pad
  • L1040 Addition to ctlso or scoliosis orthosis, lumbar or lumbar rib pad
  • L1050 Addition to ctlso or scoliosis orthosis, sternal pad
  • L1060 Addition to ctlso or scoliosis orthosis, thoracic pad
  • L1070 Addition to ctlso or scoliosis orthosis, trapezius sling
  • L1080 Addition to ctlso or scoliosis orthosis, outrigger
  • L1085 Addition to ctlso or scoliosis orthosis, outrigger, bilateral with vertical...
  • L1090 Addition to ctlso or scoliosis orthosis, lumbar sling
  • L1100 Addition to ctlso or scoliosis orthosis, ring flange, plastic or leather
  • L1110 Addition to ctlso or scoliosis orthosis, ring flange, plastic or leather, m...
  • L1120 Addition to ctlso, scoliosis orthosis, cover for upright, each
  • L1200 Orthosis only thoracic-lumbar-sacral-orthosis (tlso), inclusive of furnishi...
  • L1210 Addition to tlso, (low profile), lateral thoracic extension
  • L1220 Addition to tlso, (low profile), anterior thoracic extension
  • L1230 Addition to tlso, (low profile), milwaukee type superstructure
  • L1240 Addition to tlso, (low profile), lumbar derotation pad
  • L1250 Addition to tlso, (low profile), anterior asis pad
  • L1260 Addition to tlso, (low profile), anterior thoracic derotation pad
  • L1270 Addition to tlso, (low profile), abdominal pad
  • L1280 Addition to tlso, (low profile), rib gusset (elastic), each
  • L1290 Addition to tlso, (low profile), lateral trochanteric pad
  • L1300 Other scoliosis procedure, body jacket molded to patient model
  • L1310 Other scoliosis procedure, post-operative body jacket
  • L1499 Spinal orthosis, not otherwise specified
  • L1500 Thoracic-hip-knee-ankle orthosis (thkao), mobility frame (newington, parapo...
  • L1510 Thkao, standing frame, with or without tray and accessories
  • L1520 Thkao, swivel walker
  • L1600 Hip orthosis, abduction control of hip joints, flexible, frejka type with c...
  • L1610 Hip orthosis, abduction control of hip joints, flexible, (frejka cover only...
  • L1620 Hip orthosis, abduction control of hip joints, flexible, (pavlik harness), ...
  • L1630 Hip orthosis, abduction control of hip joints, semi-flexible (von rosen typ...
  • L1640 Bar, thigh cuffs, custom-fabricated hip orthosis, abduction control of hip ...
  • L1650 Hip orthosis, abduction control of hip joints, static, adjustable, (ilfled ...
  • L1652 Hip orthosis, bilateral thigh cuffs with adjustable abductor spreader bar, ...
  • L1660 Hip orthosis, abduction control of hip joints, static, plastic, prefabricat...
  • L1680 Fabricated adjustable hip motion control, thigh cuffs (rancho hip action ty...
  • L1685 Hip orthosis, abduction control of hip joint, postoperative hip abduction t...
  • L1686 Prefabricated, includes fitting and adjustment hip orthosis, abduction cont...
  • L1690 Combination, bilateral, lumbo-sacral, hip, femur orthosis providing adducti...
  • L1700 Legg perthes orthosis, (toronto type), custom-fabricated
  • L1710 Legg perthes orthosis, (newington type), custom fabricated
  • L1720 Legg perthes orthosis, trilateral, (tachdijan type), custom-fabricated
  • L1730 Legg perthes orthosis, (scottish rite type), custom-fabricated
  • L1750 Includes fitting and adjustment legg perthes orthosis, legg perthes sling (...
  • L1755 Legg perthes orthosis, (patten bottom type), custom-fabricated
  • L1800 Adjustment knee orthosis, elastic with stays, prefabricated, includes fitti...
  • L1810 Adjustment knee orthosis, elastic with joints, prefabricated, includes fitt...
  • L1815 Knee orthosis, elastic or other elastic type material with condylar pad(s),...
  • L1820 Control, prefabricated, includes fitting and adjustment knee orthosis, elas...
  • L1825 Knee orthosis, elastic knee cap, prefabricated, includes fitting and adjust...
  • L1830 Knee orthosis, immobilizer, canvas longitudinal, prefabricated, includes fi...
  • L1831 Includes fitting and adjustment knee orthosis, locking knee joint(s), posit...
  • L1832 Orthosis, rigid support, prefabricated, includes fitting and adjustment kne...
  • L1834 Knee orthosis, without knee joint, rigid, custom-fabricated
  • L1836 Prefabricated, includes fitting and adjustment knee orthosis, rigid, withou...
  • L1840 Knee orthosis, derotation, medial-lateral, anterior cruciate ligament, cust...
  • L1843 Fitting and adjustment extension joint (unicentric or polycentric), medial-...
  • L1844 Extension joint (unicentric or polycentric), medial-lateral and rotation co...
  • L1845 Control, with or without varus/valgus adjustment, prefabricated, includes e...
  • L1846 Knee orthosis, double upright, thigh and calf, with adjustable flexion and ...
  • L1847 Knee orthosis, double upright with adjustable joint, with inflatable air su...
  • L1850 Knee orthosis, swedish type, prefabricated, includes fitting and adjustment
  • L1855 Knee orthosis, molded plastic, thigh and calf sections, with double upright...
  • L1858 Knee orthosis, molded plastic, polycentric knee joints, pneumatic knee pads...
  • L1860 Knee orthosis, modification of supracondylar prosthetic socket, custom-fabr...
  • L1870 Knee orthosis, double upright, thigh and calf lacers with knee joints, cust...
  • L1880 Knee orthosis, double upright, non-molded thigh and calf cuffs/lacers with ...
  • L1885 Resistance control, prefabricated, includes fitting and adjustment knee ort...
  • L1900 Custom-fabricated ankle foot orthosis, spring wire, dorsiflexion assist cal...
  • L1901 Ankle orthosis, elastic, prefabricated, includes fitting and adjustment (e....
  • L1902 Ankle foot orthosis, ankle gauntlet, prefabricated, includes fitting and ad...
  • L1904 Ankle foot orthosis, molded ankle gauntlet, custom-fabricated
  • L1906 Fitting and adjustment ankle foot orthosis, multiligamentus ankle support, ...
  • L1907 Afo, supramalleolar with straps, with or without interface/pads, custom fab...
  • L1910 Prefabricated, includes fitting and adjustment ankle foot orthosis, posteri...
  • L1920 Ankle foot orthosis, single upright with static or adjustable stop (phelps ...
  • L1930 Ankle foot orthosis, plastic or other material, prefabricated, includes fit...
  • L1932 Afo, rigid anterior tibial section, total carbon fiber or equal material, p...
  • L1940 Ankle foot orthosis, plastic or other material, custom-fabricated
  • L1945 Custom-fabricated ankle foot orthosis, plastic, rigid anterior tibial secti...
  • L1950 Ankle foot orthosis, spiral, (institute of rehabilitative medicine type), p...
  • L1951 Ankle foot orthosis, spiral, (institute of rehabilitative medicine type), p...
  • L1960 Ankle foot orthosis, posterior solid ankle, plastic, custom-fabricated
  • L1970 Ankle foot orthosis, plastic with ankle joint, custom-fabricated
  • L1971 Includes fitting and adjustment ankle foot orthosis, plastic or other mater...
  • L1980 Calf band/cuff (single bar 'bk' orthosis), custom-fabricated ankle foot ort...
  • L1990 Ankle foot orthosis, double upright free plantar dorsiflexion, solid stirru...
  • L2000 Knee ankle foot orthosis, single upright, free knee, free ankle, solid stir...
  • L2005 Control, automatic lock and swing phase release, mechanical activation, inc...
  • L2010 Calf bands/cuffs (single bar 'ak' orthosis), without knee joint, custom-fab...
  • L2020 Calf bands/cuffs (double bar 'ak' orthosis), custom-fabricated knee ankle f...
  • L2030 Knee ankle foot orthosis, double upright, free ankle, solid stirrup, thigh ...
  • L2034 Knee ankle foot orthosis, full plastic, single upright, with or without fre...
  • L2035 Motion ankle, prefabricated, includes fitting and adjustment knee ankle foo...
  • L2036 Knee ankle foot orthosis, full plastic, double upright, with or without fre...
  • L2037 Knee ankle foot orthosis, full plastic, single upright, with or without fre...
  • L2038 Knee ankle foot orthosis, full plastic, with or without free motion knee, m...
  • L2039 Medial lateral rotation control, with or without free motion ankle, custom ...
  • L2040 Hip knee ankle foot orthosis, torsion control, bilateral rotation straps, p...
  • L2050 Hip knee ankle foot orthosis, torsion control, bilateral torsion cables, hi...
  • L2060 Hip knee ankle foot orthosis, torsion control, bilateral torsion cables, ba...
  • L2070 Hip knee ankle foot orthosis, torsion control, unilateral rotation straps, ...
  • L2080 Joint, pelvic band/belt, custom-fabricated hip knee ankle foot orthosis, to...
  • L2090 Bearing hip joint, pelvic band/ belt, custom-fabricated hip knee ankle foot...
  • L2102 Type casting material, custom-fabricated ankle foot orthosis, fracture orth...
  • L2104 Synthetic type casting material, custom-fabricated ankle foot orthosis, fra...
  • L2106 Thermoplastic type casting material, custom-fabricated ankle foot orthosis,...
  • L2108 Custom-fabricated ankle foot orthosis, fracture orthosis, tibial fracture c...
  • L2112 Prefabricated, includes fitting and adjustment ankle foot orthosis, fractur...
  • L2114 Ankle foot orthosis, fracture orthosis, tibial fracture orthosis, semi-rigi...
  • L2116 Ankle foot orthosis, fracture orthosis, tibial fracture orthosis, rigid, pr...
  • L2124 Synthetic type casting material, custom-fabricated knee ankle foot orthosis...
  • L2126 Knee ankle foot orthosis, fracture orthosis, femoral fracture cast orthosis...
  • L2128 Knee ankle foot orthosis, fracture orthosis, femoral fracture cast orthosis...
  • L2132 Kafo, fracture orthosis, femoral fracture cast orthosis, soft, prefabricate...
  • L2134 Prefabricated, includes fitting and adjustment kafo, fracture orthosis, fem...
  • L2136 Includes fitting and adjustment kafo, fracture orthosis, femoral fracture c...
  • L2180 Addition to lower extremity fracture orthosis, plastic shoe insert with ank...
  • L2182 Addition to lower extremity fracture orthosis, drop lock knee joint
  • L2184 Addition to lower extremity fracture orthosis, limited motion knee joint
  • L2186 Addition to lower extremity fracture orthosis, adjustable motion knee joint...
  • L2188 Addition to lower extremity fracture orthosis, quadrilateral brim
  • L2190 Addition to lower extremity fracture orthosis, waist belt
  • L2192 Addition to lower extremity fracture orthosis, hip joint, pelvic band, thig...
  • L2200 Addition to lower extremity, limited ankle motion, each joint
  • L2210 Addition to lower extremity, dorsiflexion assist (plantar flexion resist), ...
  • L2220 Addition to lower extremity, dorsiflexion and plantar flexion assist/resist...
  • L2230 Addition to lower extremity, split flat caliper stirrups and plate attachme...
  • L2232 Addition to lower extremity orthosis, rocker bottom for total contact ankle...
  • L2240 Addition to lower extremity, round caliper and plate attachment
  • L2250 Attachment addition to lower extremity, foot plate, molded to patient mode...
  • L2260 Addition to lower extremity, reinforced solid stirrup (scott-craig type)
  • L2265 Addition to lower extremity, long tongue stirrup
  • L2270 Addition to lower extremity, varus/valgus correction ('t') strap, padded/l...
  • L2275 Addition to lower extremity, varus/valgus correction, plastic modification,...
  • L2280 Addition to lower extremity, molded inner boot
  • L2300 Addition to lower extremity, abduction bar (bilateral hip involvement), jo...
  • L2310 Addition to lower extremity, abduction bar-straight
  • L2320 Addition to lower extremity, non-molded lacer, for custom fabricated orthos...
  • L2330 Addition to lower extremity, lacer molded to patient model, for custom fabr...
  • L2335 Addition to lower extremity, anterior swing band
  • L2340 Addition to lower extremity, pre-tibial shell, molded to patient model
  • L2350 Addition to lower extremity, prosthetic type, (bk) socket, molded to patie...
  • L2360 Addition to lower extremity, extended steel shank
  • L2370 Addition to lower extremity, patten bottom
  • L2375 Addition to lower extremity, torsion control, ankle joint and half solid s...
  • L2380 Addition to lower extremity, torsion control, straight knee joint, each jo...
  • L2385 Addition to lower extremity, straight knee joint, heavy duty, each joint
  • L2387 Addition to lower extremity, polycentric knee joint, for custom fabricated ...
  • L2390 Addition to lower extremity, offset knee joint, each joint
  • L2395 Addition to lower extremity, offset knee joint, heavy duty, each joint
  • L2397 Addition to lower extremity orthosis, suspension sleeve
  • L2405 Addition to knee joint, drop lock, each
  • L2415 Addition to knee lock with integrated release mechanism ( bail, cable, or e...
  • L2425 Addition to knee joint, disc or dial lock for adjustable knee flexion, each...
  • L2430 Addition to knee joint, ratchet lock for active and progressive knee extens...
  • L2492 Addition to knee joint, lift loop for drop lock ring
  • L2500 Bearing, ring addition to lower extremity, thigh/weight bearing, gluteal/ i...
  • L2510 Addition to lower extremity, thigh/weight bearing, quadri- lateral brim, mo...
  • L2520 Custom fitted addition to lower extremity, thigh/weight bearing, quadri- l...
  • L2525 M-l brim molded to patient model addition to lower extremity, thigh/weight ...
  • L2526 M-l brim, custom fitted addition to lower extremity, thigh/weight bearing, ...
  • L2530 Addition to lower extremity, thigh-weight bearing, lacer, non-molded
  • L2540 Addition to lower extremity, thigh/weight bearing, lacer, molded to patien...
  • L2550 Addition to lower extremity, thigh/weight bearing, high roll cuff
  • L2570 Position joint, each addition to lower extremity, pelvic control, hip joint...
  • L2580 Addition to lower extremity, pelvic control, pelvic sling
  • L2600 Addition to lower extremity, pelvic control, hip joint, clevis type, or thr...
  • L2610 Addition to lower extremity, pelvic control, hip joint, clevis or thrust be...
  • L2620 Addition to lower extremity, pelvic control, hip joint, heavy duty, each
  • L2622 Addition to lower extremity, pelvic control, hip joint, adjustable flexion,...
  • L2624 Addition to lower extremity, pelvic control, hip joint, adjustable flexion,...
  • L2627 Reciprocating hip joint and cables addition to lower extremity, pelvic cont...
  • L2628 Addition to lower extremity, pelvic control, metal frame, reciprocating hip...
  • L2630 Addition to lower extremity, pelvic control, band and belt, unilateral
  • L2640 Addition to lower extremity, pelvic control, band and belt, bilateral
  • L2650 Addition to lower extremity, pelvic and thoracic control, gluteal pad, each
  • L2660 Addition to lower extremity, thoracic control, thoracic band
  • L2670 Addition to lower extremity, thoracic control, paraspinal uprights
  • L2680 Addition to lower extremity, thoracic control, lateral support uprights
  • L2750 Addition to lower extremity orthosis, plating chrome or nickel, per bar
  • L2755 Hybrid lamination/prepreg composite, per segment, for custom fabricated ort...
  • L2760 Addition to lower extremity orthosis, extension, per extension, per bar (fo...
  • L2768 Orthotic side bar disconnect device, per bar
  • L2770 Addition to lower extremity orthosis, any material - per bar or joint
  • L2780 Addition to lower extremity orthosis, non-corrosive finish, per bar
  • L2785 Addition to lower extremity orthosis, drop lock retainer, each
  • L2795 Addition to lower extremity orthosis, knee control, full kneecap
  • L2800 Addition to lower extremity orthosis, knee control, knee cap, medial or lat...
  • L2810 Addition to lower extremity orthosis, knee control, condylar pad
  • L2820 Addition to lower extremity orthosis, soft interface for molded plastic, be...
  • L2830 Addition to lower extremity orthosis, soft interface for molded plastic, ab...
  • L2840 Addition to lower extremity orthosis, tibial length sock, fracture or equal...
  • L2850 Each addition to lower extremity orthosis, femoral length sock, fracture or...
  • L2860 Addition to lower extremity joint, knee or ankle, concentric adjustable tor...
  • L2999 Lower extremity orthoses, not otherwise specified
  • L3000 Each foot, insert, removable, molded to patient model, 'ucb' type, berkeley...
  • L3001 Foot, insert, removable, molded to patient model, spenco, each
  • L3002 Foot, insert, removable, molded to patient model, plastazote or equal, each
  • L3003 Foot, insert, removable, molded to patient model, silicone gel, each
  • L3010 Each foot, insert, removable, molded to patient model, longitudinal arch su...
  • L3020 Foot, insert, removable, molded to patient model, longitudinal/ metatarsal ...
  • L3030 Foot, insert, removable, formed to patient foot, each
  • L3031 Strength, lightweight material, all hybrid lamination/prepreg composite, ea...
  • L3040 Foot, arch support, removable, premolded, longitudinal, each
  • L3050 Foot, arch support, removable, premolded, metatarsal, each
  • L3060 Foot, arch support, removable, premolded, longitudinal/ metatarsal, each
  • L3070 Foot, arch support, non-removable attached to shoe, longitudinal, each
  • L3080 Foot, arch support, non-removable attached to shoe, metatarsal, each
  • L3090 Each foot, arch support, non-removable attached to shoe, longitudinal/metat...
  • L3100 Hallus-valgus night dynamic splint
  • L3140 Foot, abduction rotation bar, including shoes
  • L3150 Foot, abduction rotatation bar, without shoes
  • L3160 Foot, adjustable shoe-styled positioning device
  • L3170 Foot, plastic, silicone or equal, heel stabilizer, each
  • L3201 Orthopedic shoe, oxford with supinator or pronator, infant
  • L3202 Orthopedic shoe, oxford with supinator or pronator, child
  • L3203 Orthopedic shoe, oxford with supinator or pronator, junior
  • L3204 Orthopedic shoe, hightop with supinator or pronator, infant
  • L3206 Orthopedic shoe, hightop with supinator or pronator, child
  • L3207 Orthopedic shoe, hightop with supinator or pronator, junior
  • L3208 Surgical boot, each, infant
  • L3209 Surgical boot, each, child
  • L3211 Surgical boot, each, junior
  • L3212 Benesch boot, pair, infant
  • L3213 Benesch boot, pair, child
  • L3214 Benesch boot, pair, junior
  • L3215 Orthopedic footwear, ladies shoe, oxford, each
  • L3216 Orthopedic footwear, ladies shoe, depth inlay, each
  • L3217 Orthopedic footwear, ladies shoe, hightop, depth inlay, each
  • L3219 Orthopedic footwear, mens shoe, oxford, each
  • L3221 Orthopedic footwear, mens shoe, depth inlay, each
  • L3222 Orthopedic footwear, mens shoe, hightop, depth inlay, each
  • L3224 Orthopedic footwear, woman's shoe, oxford, used as an integral part of a br...
  • L3225 (orthosis) orthopedic footwear, man's shoe, oxford, used as an integral par...
  • L3230 Orthopedic footwear, custom shoe, depth inlay, each
  • L3250 Orthopedic footwear, custom molded shoe, removable inner mold, prosthetic s...
  • L3251 Foot, shoe molded to patient model, silicone shoe, each
  • L3252 Foot, shoe molded to patient model, plastazote (or similar), custom fabrica...
  • L3253 Foot, molded shoe plastazote (or similar) custom fitted, each
  • L3254 Non-standard size or width
  • L3255 Non-standard size or length
  • L3257 Orthopedic footwear, additional charge for split size
  • L3260 Surgical boot/shoe, each
  • L3265 Plastazote sandal, each
  • L3300 Lift, elevation, heel, tapered to metatarsals, per inch
  • L3310 Lift, elevation, heel and sole, neoprene, per inch
  • L3320 Lift, elevation, heel and sole, cork, per inch
  • L3330 Lift, elevation, metal extension (skate)
  • L3332 Lift, elevation, inside shoe, tapered, up to one-half inch
  • L3334 Lift, elevation, heel, per inch
  • L3340 Heel wedge, sach
  • L3350 Heel wedge
  • L3360 Sole wedge, outside sole
  • L3370 Sole wedge, between sole
  • L3380 Clubfoot wedge
  • L3390 Outflare wedge
  • L3400 Metatarsal bar wedge, rocker
  • L3410 Metatarsal bar wedge, between sole
  • L3420 Full sole and heel wedge, between sole
  • L3430 Heel, counter, plastic reinforced
  • L3440 Heel, counter, leather reinforced
  • L3450 Heel, sach cushion type
  • L3455 Heel, new leather, standard
  • L3460 Heel, new rubber, standard
  • L3465 Heel, thomas with wedge
  • L3470 Heel, thomas extended to ball
  • L3480 Heel, pad and depression for spur
  • L3485 Heel, pad, removable for spur
  • L3500 Orthopedic shoe addition, insole, leather
  • L3510 Orthopedic shoe addition, insole, rubber
  • L3520 Orthopedic shoe addition, insole, felt covered with leather
  • L3530 Orthopedic shoe addition, sole, half
  • L3540 Orthopedic shoe addition, sole, full
  • L3550 Orthopedic shoe addition, toe tap standard
  • L3560 Orthopedic shoe addition, toe tap, horseshoe
  • L3570 Orthopedic shoe addition, special extension to instep (leather with eyelets...
  • L3580 Orthopedic shoe addition, convert instep to velcro closure
  • L3590 Orthopedic shoe addition, convert firm shoe counter to soft counter
  • L3595 Orthopedic shoe addition, march bar
  • L3600 Transfer of an orthosis from one shoe to another, caliper plate, existing
  • L3610 Transfer of an orthosis from one shoe to another, caliper plate, new
  • L3620 Transfer of an orthosis from one shoe to another, solid stirrup, existing
  • L3630 Transfer of an orthosis from one shoe to another, solid stirrup, new
  • L3640 Transfer of an orthosis from one shoe to another, dennis browne splint (ri...
  • L3649 Orthopedic shoe, modification, addition or transfer, not otherwise specifie...
  • L3650 Shoulder orthosis, figure of eight design abduction restrainer, prefabricat...
  • L3651 Shoulder orthosis, single shoulder, elastic, prefabricated, includes fittin...
  • L3652 Shoulder orthosis, double shoulder, elastic, prefabricated, includes fittin...
  • L3660 Shoulder orthosis, figure of eight design abduction restrainer, canvas and ...
  • L3670 Includes fitting and adjustment shoulder orthosis, acromio/clavicular (canv...
  • L3671 Interface, straps, custom fabricated, includes fitting and adjustment shoul...
  • L3672 And support bar, without joints, may inlcude soft interface, straps, custom...
  • L3673 Shoulder orthosis, abduction positioning (airplane design), thoracic compon...
  • L3675 Shoulder orthosis, vest type abduction restrainer, canvas webbing type or e...
  • L3677 Shoulder orthosis, hard plastic, shoulder stabilizer, pre-fabricated, inclu...
  • L3700 Elbow orthosis, elastic with stays, prefabricated, includes fitting and adj...
  • L3701 Elbow orthosis, elastic, prefabricated, includes fitting and adjustment (e....
  • L3702 Fabricated, includes fitting and adjustment elbow orthosis, without joints,...
  • L3710 Elbow orthosis, elastic with metal joints, prefabricated, includes fitting ...
  • L3720 Custom-fabricated elbow orthosis, double upright with forearm/arm cuffs, fr...
  • L3730 Assist, custom-fabricated elbow orthosis, double upright with forearm/arm c...
  • L3740 With active control, custom-fabricated elbow orthosis, double upright with ...
  • L3760 Elbow orthosis, with adjustable position locking joint(s), prefabricated, i...
  • L3762 Elbow orthosis, rigid, without joints, includes soft interface material, pr...
  • L3763 Straps, custom fabricated, includes fitting and adjustment elbow wrist hand...
  • L3764 Elbow wrist hand orthosis, includes one or more nontorsion joints, elastic ...
  • L3765 Elbow wrist hand finger orthosis, rigid, without joints, may include soft i...
  • L3766 Elbow wrist hand finger orthosis, includes one or more nontorsion joints, f...
  • L3800 Wrist hand finger orthosis, short opponens, no attachments, custom-fabricat...
  • L3805 Wrist hand finger orthosis, long opponens, no attachment, custom-fabricated
  • L3806 Fabricated, includes fitting and adjustment wrist hand finger orthosis, inc...
  • L3807 And adjustments, any type wrist hand finger orthosis, without joint(s), pre...
  • L3808 Wrist hand finger orthosis, rigid without joints, may include soft interfac...
  • L3810 Whfo, addition to short and long opponens, thumb abduction ('c') bar
  • L3815 Whfo, addition to short and long opponens, second m.p. abduction assist
  • L3820 Whfo, addition to short and long opponens, i.p. extension assist, with m.p....
  • L3825 Whfo, addition to short and long opponens, m.p. extension stop
  • L3830 Whfo, addition to short and long opponens, m.p. extension assist
  • L3835 Whfo, addition to short and long opponens, m.p. spring extension assist
  • L3840 Whfo, addition to short and long opponens, spring swivel thumb
  • L3845 M.p. stop whfo, addition to short and long opponens, thumb i.p. extension ...
  • L3850 Who, addition to short and long opponens, action wrist, with dorsiflexion a...
  • L3855 Whfo, addition to short and long opponens, adjustable m.p. flexion control
  • L3860 I.p. whfo, addition to short and long opponens, adjustable m.p. flexion co...
  • L3890 Addition to upper extremity joint, wrist or elbow, concentric adjustable to...
  • L3900 Flexion, finger flexion/extension, wrist or finger driven, custom-fabricate...
  • L3901 Wrist hand finger orthosis, dynamic flexor hinge, reciprocal wrist extensio...
  • L3904 Wrist hand finger orthosis, external powered, electric, custom-fabricated
  • L3905 Turnbuckles, may include soft interface, straps, custom fabricated, include...
  • L3906 Fabricated, includes fitting and adjustment wrist hand orthosis, without jo...
  • L3907 Wrist hand finger orthosis, wrist gauntlet with thumb spica, custom-fabrica...
  • L3908 Wrist hand orthosis, wrist extension control cock-up, non molded, prefabric...
  • L3909 Wrist orthosis, elastic, prefabricated, includes fitting and adjustment (e....
  • L3910 Wrist hand finger orthosis, swanson design, prefabricated, includes fitting...
  • L3911 Wrist hand finger orthosis, elastic, prefabricated, includes fitting and ad...
  • L3912 Includes fitting and adjustment hand finger orthosis, flexion glove with el...
  • L3913 Hand finger orthosis, without joints, may include soft interface, straps, c...
  • L3914 Fitting/adjustment wrist hand orthosis, wrist extension cock-up, prefabrica...
  • L3915 Fitting and adjustment turnbuckles, may include soft interface, straps, pre...
  • L3916 Wrist hand finger orthosis, wrist extension cock-up with outrigger, prefabr...
  • L3917 And adjustment hand orthosis, metacarpal fracture orthosis, prefabricated, ...
  • L3918 Hand finger orthosis, knuckle bender, prefabricated, includes fitting and a...
  • L3919 Hand orthosis, without joints, may include soft interface, straps, custom f...
  • L3920 Hand finger orthosis, knuckle bender with outrigger, prefabricated, include...
  • L3921 Hand finger orthosis, includes one or more nontorsion joints, elastic bands...
  • L3922 Prefabricated, includes fitting and adjustment hand finger orthosis, knuckl...
  • L3923 Hand finger orthosis, without joints, may include soft interface, straps, p...
  • L3924 Wrist hand finger orthosis, oppenheimer, prefabricated, includes fitting an...
  • L3926 Wrist hand finger orthosis, thomas suspension, prefabricated, includes fitt...
  • L3928 Includes fitting and adjustment hand finger orthosis, finger extension, wit...
  • L3930 Wrist hand finger orthosis, finger extension, with wrist support, prefabric...
  • L3932 Finger orthosis, safety pin, spring wire, prefabricated, includes fitting a...
  • L3933 Finger orthosis, without joints, may include soft interface, custom fabrica...
  • L3934 Finger orthosis, safety pin, modified, prefabricated, includes fitting and ...
  • L3935 Finger orthosis, nontorsion joint, may include soft interface, custom fabri...
  • L3936 Adjustment wrist hand finger orthosis, palmer, prefabricated, includes fitt...
  • L3938 Adjustment wrist hand finger orthosis, dorsal wrist, prefabricated, include...
  • L3940 Wrist hand finger orthosis, dorsal wrist, with outrigger attachment, prefab...
  • L3942 Hand finger orthosis, reverse knuckle bender, prefabricated, includes fitti...
  • L3944 Hand finger orthosis, reverse knuckle bender, with outrigger, prefabricated...
  • L3946 Adjustment hand finger orthosis, composite elastic, prefabricated, includes...
  • L3948 Finger orthosis, finger knuckle bender, prefabricated, includes fitting and...
  • L3950 Wrist hand finger orthosis, combination oppenheimer, with knuckle bender an...
  • L3952 Wrist hand finger orthosis, combination oppenheimer, with reverse knuckle a...
  • L3954 Hand finger orthosis, spreading hand, prefabricated, includes fitting and a...
  • L3956 Addition of joint to upper extremity orthosis, any material; per joint
  • L3960 Shoulder elbow wrist hand orthosis, abduction positioning, airplane design,...
  • L3961 Shoulder elbow wrist hand orthosis, shoulder cap design, without joints, ma...
  • L3962 Prefabricated, includes fitting and adjustment shoulder elbow wrist hand or...
  • L3964 Adjustable, prefabricated, includes fitting and adjustment shoulder elbow o...
  • L3965 Adjustable rancho type, prefabricated, includes fitting and adjustment shou...
  • L3966 Reclining, prefabricated, includes fitting and adjustment shoulder elbow or...
  • L3967 Shoulder elbow wrist hand orthosis, abduction positioning (airplane design)...
  • L3968 Friction arm support (friction dampening to proximal and distal joints), pr...
  • L3969 Shoulder elbow orthosis, mobile arm support, monosuspension arm and hand su...
  • L3970 Seo, addition to mobile arm support, elevating proximal arm
  • L3971 Shoulder elbow wrist hand orthosis, shoulder cap design, includes one or mo...
  • L3972 Balance control seo, addition to mobile arm support, offset or lateral rock...
  • L3973 Shoulder elbow wrist hand orthosis, abduction positioning (airplane design)...
  • L3974 Seo, addition to mobile arm support, supinator
  • L3975 May include soft interface, straps, custom fabricated, includes fitting and...
  • L3976 Shoulder elbow wrist hand finger orthosis, abduction positioning (airplane ...
  • L3977 Shoulder elbow wrist hand finger orthosis, shoulder cap design, includes on...
  • L3978 Shoulder elbow wrist hand finger orthosis, abduction positioning (airplane ...
  • L3980 Upper extremity fracture orthosis, humeral, prefabricated, includes fitting...
  • L3982 Fitting and adjustment upper extremity fracture orthosis, radius/ulnar, pre...
  • L3984 Upper extremity fracture orthosis, wrist, prefabricated, includes fitting a...
  • L3985 Upper extremity fracture orthosis, forearm, hand with wrist hinge, custom-f...
  • L3986 (example--colles' fracture), custom fabricated upper extremity fracture ort...
  • L3995 Addition to upper extremity orthosis, sock, fracture or equal, each
  • L3999 Upper limb orthosis, not otherwise specified
  • L4000 Replace girdle for spinal orthosis (ctlso or so)
  • L4002 Replacement strap, any orthosis, includes all components, any length, any t...
  • L4010 Replace trilateral socket brim
  • L4020 Replace quadrilateral socket brim, molded to patient model
  • L4030 Replace quadrilateral socket brim, custom fitted
  • L4040 Replace molded thigh lacer, for custom fabricated orthosis only
  • L4045 Replace non-molded thigh lacer, for custom fabricated orthosis only
  • L4050 Replace molded calf lacer, for custom fabricated orthosis only
  • L4055 Replace non-molded calf lacer, for custom fabricated orthosis only
  • L4060 Replace high roll cuff
  • L4070 Replace proximal and distal upright for kafo
  • L4080 Replace metal bands kafo, proximal thigh
  • L4090 Replace metal bands kafo-afo, calf or distal thigh
  • L4100 Replace leather cuff kafo, proximal thigh
  • L4110 Replace leather cuff kafo-afo, calf or distal thigh
  • L4130 Replace pretibial shell
  • L4205 Repair of orthotic device, labor component, per 15 minutes
  • L4210 Repair of orthotic device, repair or replace minor parts
  • L4350 (e.g., pneumatic, gel), prefabricated, includes fitting and adjustment ank...
  • L4360 Material, prefabricated, includes fitting and adjustment walking boot, pneu...
  • L4370 Pneumatic full leg splint, prefabricated, includes fitting and adjustment
  • L4380 Pneumatic knee splint, prefabricated, includes fitting and adjustment
  • L4386 Material, prefabricated, includes fitting and adjustment walking boot, non-...
  • L4392 Replacement, soft interface material, static afo
  • L4394 Replace soft interface material, foot drop splint
  • L4396 Fit, for positioning, pressure reduction, may be used for minimal ambulati...
  • L4398 And adjustment foot drop splint, recumbent positioning device, prefabricate...
  • L5000 Partial foot, shoe insert with longitudinal arch, toe filler
  • L5010 Partial foot, molded socket, ankle height, with toe filler
  • L5020 Partial foot, molded socket, tibial tubercle height, with toe filler
  • L5050 Ankle, symes, molded socket, sach foot
  • L5060 Ankle, symes, metal frame, molded leather socket, articulated ankle/foot
  • L5100 Below knee, molded socket, shin, sach foot
  • L5105 Below knee, plastic socket, joints and thigh lacer, sach foot
  • L5150 Knee disarticulation (or through knee), molded socket, external knee joints...
  • L5160 External knee joints, shin, sach foot knee disarticulation (or through knee...
  • L5200 Above knee, molded socket, single axis constant friction knee, shin, sach f...
  • L5210 Above knee, short prosthesis, no knee joint ('stubbies'), with foot blocks,...
  • L5220 Above knee, short prosthesis, no knee joint ('stubbies'), with articulated ...
  • L5230 Shin, sach foot above knee, for proximal femoral focal deficiency, constant...
  • L5250 Constant friction knee, shin, sach foot hip disarticulation, canadian type;...
  • L5270 Hip disarticulation, tilt table type; molded socket, locking hip joint, sin...
  • L5280 Friction knee, shin, sach foot hemipelvectomy, canadian type; molded socket...
  • L5301 Below knee, molded socket, shin, sach foot, endoskeletal system
  • L5311 Knee disarticulation (or through knee), molded socket, external knee joints...
  • L5321 Above knee, molded socket, open end, sach foot, endoskeletal system, single...
  • L5331 Hip disarticulation, canadian type, molded socket, endoskeletal system, hip...
  • L5341 Hemipelvectomy, canadian type, molded socket, endoskeletal system, hip join...
  • L5400 Immediate post surgical or early fitting, application of initial rigid dres...
  • L5410 Dressing, including fitting, alignment and suspension, below knee, each imm...
  • L5420 Dressing, including fitting, alignment and suspension and one cast change '...
  • L5430 Immediate post surgical or early fitting, application of initial rigid each...
  • L5450 Immediate post surgical or early fitting, application of non-weight bearing...
  • L5460 Immediate post surgical or early fitting, application of non-weight bearing...
  • L5500 Sach foot, plaster socket, direct formed initial, below knee 'ptb' type soc...
  • L5505 Initial, above knee - knee disarticulation, ischial level socket, non-align...
  • L5510 Cover, sach foot, plaster socket, molded to model preparatory, below knee ...
  • L5520 Cover, sach foot, thermoplastic or equal, direct formed preparatory, below ...
  • L5530 Preparatory, below knee 'ptb' type socket, non-alignable system, pylon, no ...
  • L5535 Preparatory, below knee 'ptb' type socket, non-alignable system, no cover, ...
  • L5540 Preparatory, below knee 'ptb' type socket, non-alignable system, pylon, no ...
  • L5560 Preparatory, above knee- knee disarticulation, ischial level socket, non-al...
  • L5570 Non-alignable system, pylon, no cover, sach foot, thermoplastic or equal, d...
  • L5580 Preparatory, above knee - knee disarticulation ischial level socket, non-al...
  • L5585 Non-alignable system, pylon, no cover, sach foot, prefabricated adjustable ...
  • L5590 Preparatory, above knee - knee disarticulation ischial level socket, non-al...
  • L5595 Preparatory, hip disarticulation-hemipelvectomy, pylon, no cover, sach foot...
  • L5600 Preparatory, hip disarticulation-hemipelvectomy, pylon, no cover, sach foot...
  • L5610 Addition to lower extremity, endoskeletal system, above knee, hydracadence ...
  • L5611 Addition to lower extremity, endoskeletal system, above knee - knee disarti...
  • L5613 Addition to lower extremity, endoskeletal system, above knee-knee disarticu...
  • L5614 Addition to lower extremity, exoskeletal system, above knee-knee disarticul...
  • L5616 Addition to lower extremity, endoskeletal system, above knee, universal mul...
  • L5617 Addition to lower extremity, quick change self-aligning unit, above knee or...
  • L5618 Addition to lower extremity, test socket, symes
  • L5620 Addition to lower extremity, test socket, below knee
  • L5622 Addition to lower extremity, test socket, knee disarticulation
  • L5624 Addition to lower extremity, test socket, above knee
  • L5626 Addition to lower extremity, test socket, hip disarticulation
  • L5628 Addition to lower extremity, test socket, hemipelvectomy
  • L5629 Addition to lower extremity, below knee, acrylic socket
  • L5630 Addition to lower extremity, symes type, expandable wall socket
  • L5631 Addition to lower extremity, above knee or knee disarticulation, acrylic so...
  • L5632 Addition to lower extremity, symes type, 'ptb' brim design socket
  • L5634 Addition to lower extremity, symes type, posterior opening (canadian) socke...
  • L5636 Addition to lower extremity, symes type, medial opening socket
  • L5637 Addition to lower extremity, below knee, total contact
  • L5638 Addition to lower extremity, below knee, leather socket
  • L5639 Addition to lower extremity, below knee, wood socket
  • L5640 Addition to lower extremity, knee disarticulation, leather socket
  • L5642 Addition to lower extremity, above knee, leather socket
  • L5643 Addition to lower extremity, hip disarticulation, flexible inner socket, e...
  • L5644 Addition to lower extremity, above knee, wood socket
  • L5645 Addition to lower extremity, below knee, flexible inner socket, external f...
  • L5646 Addition to lower extremity, below knee, air, fluid, gel or equal, cushion...
  • L5647 Addition to lower extremity, below knee suction socket
  • L5648 Addition to lower extremity, above knee, air, fluid, gel or equal, cushio...
  • L5649 Addition to lower extremity, ischial containment/narrow m-l socket
  • L5650 Additions to lower extremity, total contact, above knee or knee disarticula...
  • L5651 Addition to lower extremity, above knee, flexible inner socket, external f...
  • L5652 Addition to lower extremity, suction suspension, above knee or knee disart...
  • L5653 Addition to lower extremity, knee disarticulation, expandable wall socket
  • L5654 Addition to lower extremity, socket insert, symes, (kemblo, pelite, alipla...
  • L5655 Addition to lower extremity, socket insert, below knee (kemblo, pelite, al...
  • L5656 Pelite, aliplast, plastazote or equal) addition to lower extremity, socket...
  • L5658 Aliplast, plastazote or equal) addition to lower extremity, socket insert,...
  • L5661 Addition to lower extremity, socket insert, multi-durometer symes
  • L5665 Addition to lower extremity, socket insert, multi-durometer, below knee
  • L5666 Addition to lower extremity, below knee, cuff suspension
  • L5668 Addition to lower extremity, below knee, molded distal cushion
  • L5670 Addition to lower extremity, below knee, molded supracondylar suspension (...
  • L5671 Mechanism (shuttle, lanyard or equal), excludes socket insert addition to l...
  • L5672 Addition to lower extremity, below knee, removable medial brim suspension
  • L5673 Addition to lower extremity, below knee/above knee, custom fabricated from ...
  • L5675 Material, each addition to lower extremity, below knee, suspension sleeve,...
  • L5676 Additions to lower extremity, below knee, knee joints, single axis, pair
  • L5677 Additions to lower extremity, below knee, knee joints, polycentric, pair
  • L5678 Additions to lower extremity, below knee, joint covers, pair
  • L5679 Addition to lower extremity, below knee/above knee, custom fabricated from ...
  • L5680 Addition to lower extremity, below knee, thigh lacer, nonmolded
  • L5681 Insert for congenital or atypical traumatic amputee, silicone gel, elastome...
  • L5682 Addition to lower extremity, below knee, thigh lacer, gluteal/ischial, mol...
  • L5683 Addition to lower extremity, below knee/above knee, custom fabricated socke...
  • L5684 Addition to lower extremity, below knee, fork strap
  • L5685 Addition to lower extremity prosthesis, below knee, suspension/sealing slee...
  • L5686 Addition to lower extremity, below knee, back check (extension control)
  • L5688 Addition to lower extremity, below knee, waist belt, webbing
  • L5690 Addition to lower extremity, below knee, waist belt, padded and lined
  • L5692 Addition to lower extremity, above knee, pelvic control belt, light
  • L5694 Addition to lower extremity, above knee, pelvic control belt, padded and l...
  • L5695 Addition to lower extremity, above knee, pelvic control, sleeve suspension,...
  • L5696 Addition to lower extremity, above knee or knee disarticulation, pelvic jo...
  • L5697 Addition to lower extremity, above knee or knee disarticulation, pelvic ba...
  • L5698 Bandage addition to lower extremity, above knee or knee disarticulation, s...
  • L5699 All lower extremity prostheses, shoulder harness
  • L5700 Replacement, socket, below knee, molded to patient model
  • L5701 Replacement, socket, above knee/knee disarticulation, including attachment ...
  • L5702 Replacement, socket, hip disarticulation, including hip joint, molded to pa...
  • L5703 Ankle, symes, molded to patient model, socket without solid ankle cushion h...
  • L5704 Custom shaped protective cover, below knee
  • L5705 Custom shaped protective cover, above knee
  • L5706 Custom shaped protective cover, knee disarticulation
  • L5707 Custom shaped protective cover, hip disarticulation
  • L5710 Addition, exoskeletal knee-shin system, single axis, manual lock
  • L5711 Additions exoskeletal knee-shin system, single axis, manual lock, ultra-lig...
  • L5712 Addition, exoskeletal knee-shin system, single axis, friction swing and st...
  • L5714 Addition, exoskeletal knee-shin system, single axis, variable friction swi...
  • L5716 Addition, exoskeletal knee-shin system, polycentric, mechanical stance pha...
  • L5718 Stance phase control addition, exoskeletal knee-shin system, polycentric, ...
  • L5722 Stance phase control addition, exoskeletal knee-shin system, single axis, ...
  • L5724 Addition, exoskeletal knee-shin system, single axis, fluid swing phase con...
  • L5726 Swing phase control addition, exoskeletal knee-shin system, single axis, e...
  • L5728 Addition, exoskeletal knee-shin system, single axis, fluid swing and stanc...
  • L5780 Swing phase control addition, exoskeletal knee-shin system, single axis, p...
  • L5781 And moisture evacuation system addition to lower limb prosthesis, vacuum pu...
  • L5782 And moisture evacuation system, heavy duty addition to lower limb prosthesi...
  • L5785 Addition, exoskeletal system, below knee, ultra-light material (titanium, c...
  • L5790 Addition, exoskeletal system, above knee, ultra-light material (titanium, c...
  • L5795 (titanium, carbon fiber or equal) addition, exoskeletal system, hip disarti...
  • L5810 Addition, endoskeletal knee-shin system, single axis, manual lock
  • L5811 Addition, endoskeletal knee-shin system, single axis, manual lock, ultra-li...
  • L5812 Addition, endoskeletal knee-shin system, single axis, friction swing and st...
  • L5814 Addition, endoskeletal knee-shin system, polycentric, hydraulic swing phase...
  • L5816 Addition, endoskeletal knee-shin system, polycentric, mechanical stance pha...
  • L5818 Stance phase control addition, endoskeletal knee-shin system, polycentric, ...
  • L5822 Stance phase control addition, endoskeletal knee-shin system, single axis, ...
  • L5824 Addition, endoskeletal knee-shin system, single axis, fluid swing phase con...
  • L5826 Addition, endoskeletal knee-shin system, single axis, hydraulic swing phase...
  • L5828 Addition, endoskeletal knee-shin system, single axis, fluid swing and stanc...
  • L5830 Control addition, endoskeletal knee-shin system, single axis, pneumatic/ sw...
  • L5840 Addition, endoskeletal knee/shin system, 4-bar linkage or multiaxial, pneum...
  • L5845 Addition, endoskeletal, knee-shin system, stance flexion feature, adjustabl...
  • L5846 Phase only addition, endoskeletal, knee-shin system, microprocessor control...
  • L5847 Phase addition, endoskeletal knee-shin system, microprocessor control featu...
  • L5848 Feature, with or without adjustability addition to endoskeletal knee-shin s...
  • L5850 Extension assist addition, endoskeletal system, above knee or hip disartic...
  • L5855 Addition, endoskeletal system, hip disarticulation, mechanical hip extensio...
  • L5856 Microprocessor control feature, swing and stance phase, includes electronic...
  • L5857 Addition to lower extremity prosthesis, endoskeletal knee-shin system, sens...
  • L5858 Microprocessor control feature, stance phase only, includes electronic addi...
  • L5910 Addition, endoskeletal system, below knee, alignable system
  • L5920 Addition, endoskeletal system, above knee or hip disarticulation, alignable...
  • L5925 Disarticulation, manual lock addition, endoskeletal system, above knee, kne...
  • L5930 Addition, endoskeletal system, high activity knee control frame
  • L5940 Addition, endoskeletal system, below knee, ultra-light material (titanium,...
  • L5950 Addition, endoskeletal system, above knee, ultra-light material (titanium,...
  • L5960 Addition, endoskeletal system, hip disarticulation, ultra-light material (...
  • L5962 Addition, endoskeletal system, below knee, flexible protective outer surfac...
  • L5964 Covering system addition, endoskeletal system, above knee, flexible protect...
  • L5966 Addition, endoskeletal system, hip disarticulation, flexible protective out...
  • L5968 Addition to lower limb prosthesis, multiaxial ankle with swing phase active...
  • L5970 All lower extremity prostheses, foot, external keel, sach foot
  • L5971 Replacement only all lower extremity prosthesis, solid ankle cushion heel (...
  • L5972 All lower extremity prostheses, flexible keel foot (safe, sten, bock dynami...
  • L5974 All lower extremity prostheses, foot, single axis ankle/foot
  • L5975 Foot all lower extremity prosthesis, combination single axis ankle and flex...
  • L5976 All lower extremity prostheses, energy storing foot (seattle carbon copy ii...
  • L5978 All lower extremity prostheses, foot, multiaxial ankle/foot
  • L5979 All lower extremity prosthesis, multi-axial ankle, dynamic response foot, o...
  • L5980 All lower extremity prostheses, flex foot system
  • L5981 All lower extremity prostheses, flex-walk system or equal
  • L5982 All exoskeletal lower extremity prostheses, axial rotation unit
  • L5984 Without adjustability all endoskeletal lower extremity prosthesis, axial ro...
  • L5985 All endoskeletal lower extremity prostheses, dynamic prosthetic pylon
  • L5986 All lower extremity prostheses, multi-axial rotation unit ('mcp' or equal)
  • L5987 All lower extremity prosthesis, shank foot system with vertical loading pyl...
  • L5988 Addition to lower limb prosthesis, vertical shock reducing pylon feature
  • L5990 Addition to lower extremity prosthesis, user adjustable heel height
  • L5993 Addition to lower extremity prosthesis, heavy duty feature, foot only, (for...
  • L5994 Addition to lower extremity prosthesis, heavy duty feature, knee only, (for...
  • L5995 Knee, (for patient weight greater than 300 lbs) addition to lower extremity...
  • L5999 Lower extremity prosthesis, not otherwise specified
  • L6000 Partial hand, robin-aids, thumb remaining (or equal)
  • L6010 Partial hand, robin-aids, little and/or ring finger remaining (or equal)
  • L6020 Partial hand, robin-aids, no finger remaining (or equal)
  • L6025 Power, self-suspended, inner socket with removable forearm section, electro...
  • L6050 Wrist disarticulation, molded socket, flexible elbow hinges, triceps pad
  • L6055 Hinges, triceps pad wrist disarticulation, molded socket with expandable in...
  • L6100 Below elbow, molded socket, flexible elbow hinge, triceps pad
  • L6110 Below elbow, molded socket, (muenster or northwestern suspension types)
  • L6120 Below elbow, molded double wall split socket, step-up hinges, half cuff
  • L6130 Half cuff below elbow, molded double wall split socket, stump activated loc...
  • L6200 Elbow disarticulation, molded socket, outside locking hinge, forearm
  • L6205 Hinges, forearm elbow disarticulation, molded socket with expandable interf...
  • L6250 Above elbow, molded double wall socket, internal locking elbow, forearm
  • L6300 Shoulder disarticulation, molded socket, shoulder bulkhead, humeral section...
  • L6310 Shoulder disarticulation, passive restoration (complete prosthesis)
  • L6320 Shoulder disarticulation, passive restoration (shoulder cap only)
  • L6350 Interscapular thoracic, molded socket, shoulder bulkhead, humeral section, ...
  • L6360 Interscapular thoracic, passive restoration (complete prosthesis)
  • L6370 Interscapular thoracic, passive restoration (shoulder cap only)
  • L6380 Immediate post surgical or early fitting, application of initial rigid dres...
  • L6382 Including fitting alignment and suspension of components, and one cast chan...
  • L6384 Shoulder disarticulation or interscapular thoracic immediate post surgical ...
  • L6386 Immediate post surgical or early fitting, each additional cast change and r...
  • L6388 Immediate post surgical or early fitting, application of rigid dressing onl...
  • L6400 Tissue shaping below elbow, molded socket, endoskeletal system, including s...
  • L6450 Elbow disarticulation, molded socket, endoskeletal system, including soft p...
  • L6500 Tissue shaping above elbow, molded socket, endoskeletal system, including s...
  • L6550 Prosthetic tissue shaping shoulder disarticulation, molded socket, endoskel...
  • L6570 Prosthetic tissue shaping interscapular thoracic, molded socket, endoskelet...
  • L6580 Bowden cable control, usmc or equal pylon, no cover, molded to patient mode...
  • L6582 Preparatory, wrist disarticulation or below elbow, single wall socket, fric...
  • L6584 Friction wrist, locking elbow, figure of eight harness, fair lead cable con...
  • L6586 Preparatory, elbow disarticulation or above elbow, single wall socket, fric...
  • L6588 Preparatory, shoulder disarticulation or interscapular thoracic, single wal...
  • L6590 Preparatory, shoulder disarticulation or interscapular thoracic, single wal...
  • L6600 Upper extremity additions, polycentric hinge, pair
  • L6605 Upper extremity additions, single pivot hinge, pair
  • L6610 Upper extremity additions, flexible metal hinge, pair
  • L6611 Addition to upper extremity prosthesis, external powered, additional switch...
  • L6615 Upper extremity addition, disconnect locking wrist unit
  • L6616 Each upper extremity addition, additional disconnect insert for locking wri...
  • L6620 Friction upper extremity addition, flexion/extension wrist unit, with or w...
  • L6621 Friction, for use with external powered terminal device upper extremity pro...
  • L6623 Upper extremity addition, spring assisted rotational wrist unit with latch...
  • L6624 Upper extremity addition, flexion/extension and rotation wrist unit
  • L6625 Upper extremity addition, rotation wrist unit with cable lock
  • L6628 Upper extremity addition, quick disconnect hook adapter, otto bock or equa...
  • L6629 Upper extremity addition, quick disconnect lamination collar with coupling...
  • L6630 Upper extremity addition, stainless steel, any wrist
  • L6632 Upper extremity addition, latex suspension sleeve, each
  • L6635 Upper extremity addition, lift assist for elbow
  • L6637 Upper extremity addition, nudge control elbow lock
  • L6638 Upper extremity addition to prosthesis, electric locking feature, only for ...
  • L6639 Upper extremity addition, heavy duty feature, any elbow
  • L6640 Upper extremity additions, shoulder abduction joint, pair
  • L6641 Upper extremity addition, excursion amplifier, pulley type
  • L6642 Upper extremity addition, excursion amplifier, lever type
  • L6645 Upper extremity addition, shoulder flexion-abduction joint, each
  • L6646 Adjustable abduction friction control, for use with body powered or externa...
  • L6647 Upper extremity addition, shoulder lock mechanism, body powered actuator
  • L6648 Upper extremity addition, shoulder lock mechanism, external powered actuato...
  • L6650 Upper extremity addition, shoulder universal joint, each
  • L6655 Upper extremity addition, standard control cable, extra
  • L6660 Upper extremity addition, heavy duty control cable
  • L6665 Upper extremity addition, teflon, or equal, cable lining
  • L6670 Upper extremity addition, hook to hand, cable adapter
  • L6672 Upper extremity addition, harness, chest or shoulder, saddle type
  • L6675 Upper extremity addition, harness, (e.g. figure of eight type), single cabl...
  • L6676 Design upper extremity addition, harness, (e.g. figure of eight type), dual...
  • L6677 Upper extremity addition, harness, triple control, simultaneous operation o...
  • L6680 Upper extremity addition, test socket, wrist disarticulation or below elbo...
  • L6682 Upper extremity addition, test socket, elbow disarticulation or above elbo...
  • L6684 Upper extremity addition, test socket, shoulder disarticulation or intersc...
  • L6686 Upper extremity addition, suction socket
  • L6687 Upper extremity addition, frame type socket, below elbow or wrist disarticu...
  • L6688 Disarticulation upper extremity addition, frame type socket, above elbow or...
  • L6689 Upper extremity addition, frame type socket, shoulder disarticulation
  • L6690 Upper extremity addition, frame type socket, interscapular-thoracic
  • L6691 Upper extremity addition, removable insert, each
  • L6692 Upper extremity addition, silicone gel insert or equal, each
  • L6693 Upper extremity addition, locking elbow, forearm counterbalance
  • L6694 Fabricated from existing mold or prefabricated, socket insert, silicone gel...
  • L6695 Fabricated from existing mold or prefabricated, socket insert, silicone gel...
  • L6696 Addition to upper extremity prosthesis, below elbow/above elbow, custom fab...
  • L6697 Fabricated socket insert for other than congenital or atypical traumatic me...
  • L6698 Addition to upper extremity prosthesis, below elbow/above elbow, lock mecha...
  • L6703 Terminal device, passive hand/mitt, any material, any size
  • L6704 Terminal device, sport/recreational/work attachment, any material, any size
  • L6706 Terminal device, hook, mechanical, voluntary opening, any material, any siz...
  • L6707 Terminal device, hook, mechanical, voluntary closing, any material, any siz...
  • L6708 Terminal device, hand, mechanical, voluntary opening, any material, any siz...
  • L6709 Terminal device, hand, mechanical, voluntary closing, any material, any siz...
  • L6805 Addition to terminal device, modifier wrist unit
  • L6810 Addition to terminal device, precision pinch device
  • L6881 Automatic grasp feature, addition to upper limb electric prosthetic termina...
  • L6882 Microprocessor control feature, addition to upper limb prosthetic terminal ...
  • L6883 Replacement socket, below elbow/wrist disarticulation, molded to patient mo...
  • L6884 For use with or without external power replacement socket, above elbow/elbo...
  • L6885 Replacement socket, shoulder disarticulation/interscapular thoracic, molded...
  • L6890 Material, prefabricated, includes fitting and adjustment addition to upper ...
  • L6895 Addition to upper extremity prosthesis, glove for terminal device, any mate...
  • L6900 Hand restoration (casts, shading and measurements included), partial hand, ...
  • L6905 Glove, multiple fingers remaining hand restoration (casts, shading and meas...
  • L6910 Hand restoration (casts, shading and measurements included), partial hand, ...
  • L6915 Hand restoration (shading, and measurements included), replacement glove fo...
  • L6920 Charger, switch control of terminal device wrist disarticulation, external ...
  • L6925 Wrist disarticulation, external power, self-suspended inner socket, removab...
  • L6930 Shell, otto bock or equal switch, cables, two batteries and one charger, sw...
  • L6935 Myoelectronic control of terminal device below elbow, external power, self-...
  • L6940 Batteries and one charger, switch control of terminal device shell, outside...
  • L6945 Two batteries and one charger, myoelectronic control of terminal device elb...
  • L6950 Above elbow, external power, molded inner socket, removable humeral shell, ...
  • L6955 Above elbow, external power, molded inner socket, removable humeral shell, ...
  • L6960 Shoulder disarticulation, external power, molded inner socket, removable ot...
  • L6965 Shoulder shell, shoulder bulkhead, humeral section, mechanical elbow, forea...
  • L6970 Terminal device or equal switch, cables, two batteries and one charger, swi...
  • L6975 Or equal electrodes, cables, two batteries and one charger, myoelectronic c...
  • L7007 Electric hand, switch or myoelectric controlled, adult
  • L7008 Electric hand, switch or myoelectric, controlled, pediatric
  • L7009 Electric hook, switch or myoelectric controlled, adult
  • L7040 Prehensile actuator, switch controlled
  • L7045 Electric hook, switch or myoelectric controlled, pediatric
  • L7170 Electronic elbow, hosmer or equal, switch controlled
  • L7180 Electronic elbow, microprocessor sequential control of elbow and terminal d...
  • L7181 Electronic elbow, microprocessor simultaneous control of elbow and terminal...
  • L7185 Electronic elbow, adolescent, variety village or equal, switch controlled
  • L7186 Electronic elbow, child, variety village or equal, switch controlled
  • L7190 Electronic elbow, adolescent, variety village or equal, myoelectronically c...
  • L7191 Electronic elbow, child, variety village or equal, myoelectronically contro...
  • L7260 Electronic wrist rotator, otto bock or equal
  • L7261 Electronic wrist rotator, for utah arm
  • L7266 Servo control, steeper or equal
  • L7272 Analogue control, unb or equal
  • L7274 Proportional control, 6-12 volt, liberty, utah or equal
  • L7360 Six volt battery, otto bock or equal, each
  • L7362 Battery charger, six volt, otto bock or equal
  • L7364 Twelve volt battery, utah or equal, each
  • L7366 Battery charger, twelve volt, utah or equal
  • L7367 Lithium ion battery, replacement
  • L7368 Lithium ion battery charger
  • L7400 Ultralight material (titanium, carbon fiber or equal) addition to upper ext...
  • L7401 Addition to upper extremity prosthesis, above elbow disarticulation, ultral...
  • L7402 Addition to upper extremity prosthesis, shoulder disarticulation/interscapu...
  • L7403 Acrylic material addition to upper extremity prosthesis, below elbow/wrist ...
  • L7404 Addition to upper extremity prosthesis, above elbow disarticulation, acryli...
  • L7405 Addition to upper extremity prosthesis, shoulder disarticulation/interscapu...
  • L7499 Upper extremity prosthesis, not otherwise specified
  • L7500 Laryngeal prosthesis or artificial larynx) repair of prosthetic device, hou...
  • L7510 Repair of prosthetic device, repair or replace minor parts
  • L7520 Repair prosthetic device, labor component, per 15 minutes
  • L7600 Prosthetic donning sleeve, any material, each
  • L7900 Male vacuum erection system
  • L8000 Breast prosthesis, mastectomy bra
  • L8001 Breast prosthesis, mastectomy bra, with integrated breast prosthesis form, ...
  • L8002 Breast prosthesis, mastectomy bra, with integrated breast prosthesis form, ...
  • L8010 Breast prosthesis, mastectomy sleeve
  • L8015 External breast prosthesis garment, with mastectomy form, post mastectomy
  • L8020 Breast prosthesis, mastectomy form
  • L8030 Breast prosthesis, silicone or equal
  • L8035 Custom breast prosthesis, post mastectomy, molded to patient model
  • L8039 Breast prosthesis, not otherwise specified
  • L8040 Nasal prosthesis, provided by a non-physician
  • L8041 Midfacial prosthesis, provided by a non-physician
  • L8042 Orbital prosthesis, provided by a non-physician
  • L8043 Upper facial prosthesis, provided by a non-physician
  • L8044 Hemi-facial prosthesis, provided by a non-physician
  • L8045 Auricular prosthesis, provided by a non-physician
  • L8046 Partial facial prosthesis, provided by a non-physician
  • L8047 Nasal septal prosthesis, provided by a non-physician
  • L8048 Unspecified maxillofacial prosthesis, by report, provided by a non-physicia...
  • L8049 Repair or modification of maxillofacial prosthesis, labor component, 15 min...
  • L8300 Truss, single with standard pad
  • L8310 Truss, double with standard pads
  • L8320 Truss, addition to standard pad, water pad
  • L8330 Truss, addition to standard pad, scrotal pad
  • L8400 Prosthetic sheath, below knee, each
  • L8410 Prosthetic sheath, above knee, each
  • L8415 Prosthetic sheath, upper limb, each
  • L8417 Prosthetic sheath/sock, including a gel cushion layer, below knee or above ...
  • L8420 Prosthetic sock, multiple ply, below knee, each
  • L8430 Prosthetic sock, multiple ply, above knee, each
  • L8435 Prosthetic sock, multiple ply, upper limb, each
  • L8440 Prosthetic shrinker, below knee, each
  • L8460 Prosthetic shrinker, above knee, each
  • L8465 Prosthetic shrinker, upper limb, each
  • L8470 Prosthetic sock, single ply, fitting, below knee, each
  • L8480 Prosthetic sock, single ply, fitting, above knee, each
  • L8485 Prosthetic sock, single ply, fitting, upper limb, each
  • L8499 Unlisted procedure for miscellaneous prosthetic services
  • L8500 Artificial larynx, any type
  • L8501 Tracheostomy speaking valve
  • L8505 Artificial larynx replacement battery / accessory, any type
  • L8507 Tracheo-esophageal voice prosthesis, patient inserted, any type, each
  • L8509 Provider, any type tracheo-esophageal voice prosthesis, inserted by a licen...
  • L8510 Voice amplifier
  • L8511 Insert for indwelling tracheoesophageal prosthesis, with or without valve, ...
  • L8512 Prosthesis, replacement only, per 10 gelatin capsules or equivalent, for us...
  • L8513 Cleaning device used with tracheoesophageal voice prosthesis, pipet, brush,...
  • L8514 Tracheoesophageal puncture dilator, replacement only, each
  • L8515 Prosthesis, each gelatin capsule, application device for use with tracheoes...
  • L8600 Implantable breast prosthesis, silicone or equal
  • L8603 Injectable bulking agent, collagen implant, urinary tract, 2.5 ml syringe, ...
  • L8606 Includes shipping and necessary supplies injectable bulking agent, syntheti...
  • L8609 Artificial cornea
  • L8610 Ocular implant
  • L8612 Aqueous shunt
  • L8613 Ossicula implant
  • L8614 Cochlear device, includes all internal and external components
  • L8615 Headset/headpiece for use with cochlear implant device, replacement
  • L8616 Microphone for use with cochlear implant device, replacement
  • L8617 Transmitting coil for use with cochlear implant device, replacement
  • L8618 Transmitter cable for use with cochlear implant device, replacement
  • L8619 Cochlear implant external speech processor, replacement
  • L8621 Zinc air battery for use with cochlear implant device, replacement, each
  • L8622 Each alkaline battery for use with cochlear implant device, any size, repla...
  • L8623 Other than ear level, replacement, each lithium ion battery for use with co...
  • L8624 Level, replacement, each lithium ion battery for use with cochlear implant ...
  • L8630 Metacarpophalangeal joint implant
  • L8631 For surgical implantation (all sizes, includes entire system) stainless ste...
  • L8641 Metatarsal joint implant
  • L8642 Hallux implant
  • L8658 Interphalangeal joint spacer, silicone or equal, each
  • L8659 Interphalangeal finger joint replacement, 2 or more pieces, metal (e.g., su...
  • L8670 Vascular graft material, synthetic, implant
  • L8680 Implantable neurostimulator electrode, each
  • L8681 Patient programmer (external) for use with implantable programmable neurost...
  • L8682 Implantable neurostimulator radiofrequency receiver
  • L8683 Radiofrequency transmitter (external) for use with implantable neurostimula...
  • L8684 Radiofrequency transmitter (external) for use with implantable sacral root ...
  • L8685 Implantable neurostimulator pulse generator, single array, rechargeable, in...
  • L8686 Implantable neurostimulator pulse generator, single array, non-rechargeable...
  • L8687 Implantable neurostimulator pulse generator, dual array, rechargeable, incl...
  • L8688 Includes extension implantable neurostimulator pulse generator, dual array,...
  • L8689 Neurostimulator external recharging system for battery (internal) for use w...
  • L8690 Auditory osseointegrated device, includes all internal and external compone...
  • L8691 Auditory osseointegrated device, external sound processor, replacement
  • L8695 Neurostimulator external recharging system for battery (external) for use w...
  • L8699 Prosthetic implant, not otherwise specified
  • L9900 Orthotic and prosthetic supply, accessory, and/or service component of anot...