HCPCS L Codes – Orthotic and Prosthetic Procedures and Devices

• L0112 – Cranial cervical orthosis, congenital torticollis type, with or without soft interface material, adjustable range of motion joint, custom fabricated
• L0113 – Cranial cervical orthosis, torticollis type, with or without joint, with or without soft interface material, prefabricated, includes fitting and adjustment
• L0120 – Cervical, flexible, non-adjustable, prefabricated, off-the-shelf (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 mandibular/occipital piece)
• L0160 – Cervical, semi-rigid, wire frame occipital/mandibular support, prefabricated, off-the-shelf
• L0170 – Cervical, collar, molded to patient model
• L0172 – Cervical, collar, semi-rigid thermoplastic foam, two-piece, prefabricated, off-the-shelf
• L0174 – Cervical, collar, semi-rigid, thermoplastic foam, two piece with thoracic extension, prefabricated, off-the-shelf
• L0180 – Cervical, multiple post collar, occipital/mandibular supports, adjustable
• L0190 – Cervical, multiple post collar, occipital/mandibular supports, adjustable cervical bars (somi, guilford, taylor types)
• L0200 – Cervical, multiple post collar, occipital/mandibular supports, adjustable cervical bars, and thoracic extension
• L0220 – Thoracic, rib belt, custom fabricated
• L0450 – Tlso, flexible, provides trunk support, upper thoracic region, produces intracavitary pressure to reduce load on the intervertebral disks with rigid stays or panel(s), includes shoulder straps and closures, prefabricated, off-the-shelf
• L0452 – Tlso, flexible, provides trunk support, upper thoracic region, produces intracavitary pressure to reduce load on the intervertebral disks with rigid stays or panel(s), includes shoulder straps and closures, custom fabricated
• L0454 – Tlso flexible, provides trunk support, extends from sacrococcygeal junction to above t-9 vertebra, restricts gross trunk motion in the sagittal plane, produces intracavitary pressure to reduce load on the intervertebral disks with rigid stays or panel(s), includes shoulder straps and closures, prefabricated item that has been trimmed, bent, molded, assembled, or otherwise customized to fit a specific patient by an individual with expertise
• L0455 – Tlso, flexible, provides trunk support, extends from sacrococcygeal junction to above t-9 vertebra, restricts gross trunk motion in the sagittal plane, produces intracavitary pressure to reduce load on the intervertebral disks with rigid stays or panel(s), includes shoulder straps and closures, prefabricated, off-the-shelf
• L0456 – Tlso, flexible, provides trunk support, thoracic region, rigid posterior panel and soft anterior apron, extends from the sacrococcygeal junction and terminates just inferior to the scapular spine, restricts gross trunk motion in the sagittal plane, produces intracavitary pressure to reduce load on the intervertebral disks, includes straps and closures, prefabricated item that has been trimmed, bent, molded, assembled, or otherwise customized to fit a specific patient by an individual with expertise
• L0457 – Tlso, flexible, provides trunk support, thoracic region, rigid posterior panel and soft anterior apron, extends from the sacrococcygeal junction and terminates just inferior to the scapular spine, restricts gross trunk motion in the sagittal plane, produces intracavitary pressure to reduce load on the intervertebral disks, includes straps and closures, prefabricated, off-the-shelf
• L0458 – Tlso, triplanar control, modular segmented spinal system, two rigid plastic shells, posterior extends from the sacrococcygeal junction and terminates just inferior to the scapular spine, anterior extends from the symphysis pubis to the xiphoid, soft liner, restricts gross trunk motion in the sagittal, coronal, and transverse planes, lateral strength is provided by overlapping plastic and stabilizing closures, includes straps and closures, prefabricated, includes fitting and adjustment
• L0460 – Tlso, triplanar control, modular segmented spinal system, two rigid plastic shells, posterior extends from the sacrococcygeal junction and terminates just inferior to the scapular spine, anterior extends from the symphysis pubis to the sternal notch, soft liner, restricts gross trunk motion in the sagittal, coronal, and transverse planes, lateral strength is provided by overlapping plastic and stabilizing closures, includes straps and closures, prefabricated item that has been trimmed, bent, molded, assembled, or otherwise customized to fit a specific patient by an individual with expertise
• L0462 – Tlso, triplanar control, modular segmented spinal system, three rigid plastic shells, posterior extends from the sacrococcygeal junction and terminates just inferior to the scapular spine, anterior extends from the symphysis pubis to the sternal notch, soft liner, restricts gross trunk motion in the sagittal, coronal, and transverse planes, lateral strength is provided by overlapping plastic and stabilizing closures, includes straps and closures, prefabricated, includes fitting and adjustment
• L0464 – Tlso, triplanar control, modular segmented spinal system, four rigid plastic shells, posterior extends from sacrococcygeal junction and terminates just inferior to scapular spine, anterior extends from symphysis pubis to the sternal notch, soft liner, restricts gross trunk motion in sagittal, coronal, and transverse planes, lateral strength is provided by overlapping plastic and stabilizing closures, includes straps and closures, prefabricated, includes fitting and adjustment
• L0466 – Tlso, sagittal control, rigid posterior frame and flexible soft anterior apron with straps, closures and padding, restricts gross trunk motion in sagittal plane, produces intracavitary pressure to reduce load on intervertebral disks, prefabricated item that has been trimmed, bent, molded, assembled, or otherwise customized to fit a specific patient by an individual with expertise
• L0467 – Tlso, sagittal control, rigid posterior frame and flexible soft anterior apron with straps, closures and padding, restricts gross trunk motion in sagittal plane, produces intracavitary pressure to reduce load on intervertebral disks, prefabricated, off-the-shelf
• L0468 – Tlso, sagittal-coronal control, rigid posterior frame and flexible soft anterior apron with straps, closures and padding, extends from sacrococcygeal junction over scapulae, lateral strength provided by pelvic, thoracic, and lateral frame pieces, restricts gross trunk motion in sagittal, and coronal planes, produces intracavitary pressure to reduce load on intervertebral disks, prefabricated item that has been trimmed, bent, molded, assembled, or otherwise customized to fit a specific patient by an individual with expertise
• L0469 – Tlso, sagittal-coronal control, rigid posterior frame and flexible soft anterior apron with straps, closures and padding, extends from sacrococcygeal junction over scapulae, lateral strength provided by pelvic, thoracic, and lateral frame pieces, restricts gross trunk motion in sagittal and coronal planes, produces intracavitary pressure to reduce load on intervertebral disks, prefabricated, off-the-shelf
• L0470 – Tlso, triplanar control, rigid posterior frame and flexible soft anterior apron with straps, closures and padding, extends from sacrococcygeal junction to scapula, lateral strength provided by pelvic, thoracic, and lateral frame pieces, rotational strength provided by subclavicular extensions, restricts gross trunk motion in sagittal, coronal, and transverse planes, provides intracavitary pressure to reduce load on the intervertebral disks, includes fitting and shaping the frame, prefabricated, includes fitting and adjustment
• L0472 – Tlso, triplanar control, hyperextension, rigid anterior and lateral frame extends from symphysis pubis to sternal notch with two anterior components (one pubic and one sternal), posterior and lateral pads with straps and closures, limits spinal flexion, restricts gross trunk motion in sagittal, coronal, and transverse planes, includes fitting and shaping the frame, prefabricated, includes fitting and adjustment
• L0480 – Tlso, triplanar control, one piece rigid plastic shell without interface liner, with multiple straps and closures, posterior extends from sacrococcygeal junction and terminates just inferior to scapular spine, anterior extends from symphysis pubis to sternal notch, anterior or posterior opening, restricts gross trunk motion in sagittal, coronal, and transverse planes, includes a carved plaster or cad-cam model, custom fabricated
• L0482 – Tlso, triplanar control, one piece rigid plastic shell with interface liner, multiple straps and closures, posterior extends from sacrococcygeal junction and terminates just inferior to scapular spine, anterior extends from symphysis pubis to sternal notch, anterior or posterior opening, restricts gross trunk motion in sagittal, coronal, and transverse planes, includes a carved plaster or cad-cam model, custom fabricated
• L0484 – Tlso, triplanar control, two piece rigid plastic shell without interface liner, with multiple straps and closures, posterior extends from sacrococcygeal junction and terminates just inferior to scapular spine, anterior extends from symphysis pubis to sternal notch, lateral strength is enhanced by overlapping plastic, restricts gross trunk motion in the sagittal, coronal, and transverse planes, includes a carved plaster or cad-cam model, custom fabricated
• L0486 – Tlso, triplanar control, two piece rigid plastic shell with interface liner, multiple straps and closures, posterior extends from sacrococcygeal junction and terminates just inferior to scapular spine, anterior extends from symphysis pubis to sternal notch, lateral strength is enhanced by overlapping plastic, restricts gross trunk motion in the sagittal, coronal, and transverse planes, includes a carved plaster or cad-cam model, custom fabricated
• L0488 – Tlso, triplanar control, one piece rigid plastic shell with interface liner, multiple straps and closures, posterior extends from sacrococcygeal junction and terminates just inferior to scapular spine, anterior extends from symphysis pubis to sternal notch, anterior or posterior opening, restricts gross trunk motion in sagittal, coronal, and transverse planes, prefabricated, includes fitting and adjustment
• L0490 – Tlso, sagittal-coronal control, one piece rigid plastic shell, with overlapping reinforced anterior, with multiple straps and closures, posterior extends from sacrococcygeal junction and terminates at or before the t-9 vertebra, anterior extends from symphysis pubis to xiphoid, anterior opening, restricts gross trunk motion in sagittal and coronal planes, prefabricated, includes fitting and adjustment
• L0491 – Tlso, sagittal-coronal control, modular segmented spinal system, two rigid plastic shells, posterior extends from the sacrococcygeal junction and terminates just inferior to the scapular spine, anterior extends from the symphysis pubis to the xiphoid, soft liner, restricts gross trunk motion in the sagittal and coronal planes, lateral strength is provided by overlapping plastic and stabilizing closures, includes straps and closures, prefabricated, includes fitting and adjustment
• L0492 – Tlso, sagittal-coronal control, modular segmented spinal system, three rigid plastic shells, posterior extends from the sacrococcygeal junction and terminates just inferior to the scapular spine, anterior extends from the symphysis pubis to the xiphoid, soft liner, restricts gross trunk motion in the sagittal and coronal planes, lateral strength is provided by overlapping plastic and stabilizing closures, includes straps and closures, prefabricated, includes fitting and adjustment
• L0621 – Sacroiliac orthosis, flexible, provides pelvic-sacral support, reduces motion about the sacroiliac joint, includes straps, closures, may include pendulous abdomen design, prefabricated, off-the-shelf
• L0622 – Sacroiliac orthosis, flexible, provides pelvic-sacral support, reduces motion about the sacroiliac joint, includes straps, closures, may include pendulous abdomen design, custom fabricated
• L0623 – Sacroiliac orthosis, provides pelvic-sacral support, with rigid or semi-rigid panels over the sacrum and abdomen, reduces motion about the sacroiliac joint, includes straps, closures, may include pendulous abdomen design, prefabricated, off-the-shelf
• L0624 – Sacroiliac orthosis, provides pelvic-sacral support, with rigid or semi-rigid panels placed over the sacrum and abdomen, reduces motion about the sacroiliac joint, includes straps, closures, may include pendulous abdomen design, custom fabricated
• L0625 – Lumbar orthosis, flexible, provides lumbar support, posterior extends from l-1 to below l-5 vertebra, produces intracavitary pressure to reduce load on the intervertebral discs, includes straps, closures, may include pendulous abdomen design, shoulder straps, stays, prefabricated, off-the-shelf
• L0626 – Lumbar orthosis, sagittal control, with rigid posterior panel(s), posterior extends from l-1 to below l-5 vertebra, produces intracavitary pressure to reduce load on the intervertebral discs, includes straps, closures, may include padding, stays, shoulder straps, pendulous abdomen design, prefabricated item that has been trimmed, bent, molded, assembled, or otherwise customized to fit a specific patient by an individual with expertise
• L0627 – Lumbar orthosis, sagittal control, with rigid anterior and posterior panels, posterior extends from l-1 to below l-5 vertebra, produces intracavitary pressure to reduce load on the intervertebral discs, includes straps, closures, may include padding, shoulder straps, pendulous abdomen design, prefabricated item that has been trimmed, bent, molded, assembled, or otherwise customized to fit a specific patient by an individual with expertise
• L0628 – Lumbar-sacral orthosis, flexible, provides lumbo-sacral support, posterior extends from sacrococcygeal junction to t-9 vertebra, produces intracavitary pressure to reduce load on the intervertebral discs, includes straps, closures, may include stays, shoulder straps, pendulous abdomen design, prefabricated, off-the-shelf
• L0629 – Lumbar-sacral orthosis, flexible, provides lumbo-sacral support, posterior extends from sacrococcygeal junction to t-9 vertebra, produces intracavitary pressure to reduce load on the intervertebral discs, includes straps, closures, may include stays, shoulder straps, pendulous abdomen design, custom fabricated
• L0630 – Lumbar-sacral orthosis, sagittal control, with rigid posterior panel(s), posterior extends from sacrococcygeal junction to t-9 vertebra, produces intracavitary pressure to reduce load on the intervertebral discs, includes straps, closures, may include padding, stays, shoulder straps, pendulous abdomen design, prefabricated item that has been trimmed, bent, molded, assembled, or otherwise customized to fit a specific patient by an individual with expertise
• L0631 – Lumbar-sacral orthosis, sagittal control, with rigid anterior and posterior panels, posterior extends from sacrococcygeal junction to t-9 vertebra, produces intracavitary pressure to reduce load on the intervertebral discs, includes straps, closures, may include padding, shoulder straps, pendulous abdomen design, prefabricated item that has been trimmed, bent, molded, assembled, or otherwise customized to fit a specific patient by an individual with expertise
• L0632 – Lumbar-sacral orthosis, sagittal control, with rigid anterior and posterior panels, posterior extends from sacrococcygeal junction to t-9 vertebra, produces intracavitary pressure to reduce load on the intervertebral discs, includes straps, closures, may include padding, shoulder straps, pendulous abdomen design, custom fabricated
• L0633 – Lumbar-sacral orthosis, sagittal-coronal control, with rigid posterior frame/panel(s), posterior extends from sacrococcygeal junction to t-9 vertebra, lateral strength provided by rigid lateral frame/panels, produces intracavitary pressure to reduce load on intervertebral discs, includes straps, closures, may include padding, stays, shoulder straps, pendulous abdomen design, prefabricated item that has been trimmed, bent, molded, assembled, or otherwise customized to fit a specific patient by an individual with expertise
• L0634 – Lumbar-sacral orthosis, sagittal-coronal control, with rigid 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, stays, shoulder straps, pendulous abdomen design, custom fabricated
• L0635 – Lumbar-sacral orthosis, sagittal-coronal control, lumbar flexion, rigid posterior frame/panel(s), lateral articulating design to flex the lumbar spine, 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, anterior panel, pendulous abdomen design, prefabricated, includes fitting and adjustment
• L0636 – Lumbar sacral orthosis, sagittal-coronal control, lumbar flexion, rigid posterior frame/panels, lateral articulating design to flex the lumbar spine, posterior extends from sacrococcygeal junction to t-9 vertebra, lateral strength provided by rigid lateral frame/panels, produces intracavitary pressure to reduce load on intervertebral discs, includes straps, closures, may include padding, anterior panel, pendulous abdomen design, custom fabricated
• L0637 – Lumbar-sacral orthosis, sagittal-coronal control, with rigid anterior and posterior frame/panels, posterior extends from sacrococcygeal junction to t-9 vertebra, lateral strength provided by rigid lateral frame/panels, produces intracavitary pressure to reduce load on intervertebral discs, includes straps, closures, may include padding, shoulder straps, pendulous abdomen design, prefabricated item that has been trimmed, bent, molded, assembled, or otherwise customized to fit a specific patient by an individual with expertise
• L0638 – Lumbar-sacral orthosis, sagittal-coronal control, with rigid anterior and posterior frame/panels, posterior extends from sacrococcygeal junction to t-9 vertebra, lateral strength provided by rigid lateral frame/panels, produces intracavitary pressure to reduce load on intervertebral discs, includes straps, closures, may include padding, shoulder straps, pendulous abdomen design, custom fabricated
• L0639 – Lumbar-sacral orthosis, sagittal-coronal control, rigid shell(s)/panel(s), posterior extends from sacrococcygeal junction to t-9 vertebra, anterior extends from symphysis pubis to xyphoid, produces intracavitary pressure to reduce load on the intervertebral discs, overall strength is provided by overlapping rigid material and stabilizing closures, includes straps, closures, may include soft interface, pendulous abdomen design, prefabricated item that has been trimmed, bent, molded, assembled, or otherwise customized to fit a specific patient by an individual with expertise
• L0640 – Lumbar-sacral orthosis, sagittal-coronal control, rigid shell(s)/panel(s), posterior extends from sacrococcygeal junction to t-9 vertebra, anterior extends from symphysis pubis to xyphoid, produces intracavitary pressure to reduce load on the intervertebral discs, overall strength is provided by overlapping rigid material and stabilizing closures, includes straps, closures, may include soft interface, pendulous abdomen design, custom fabricated
• L0641 – Lumbar orthosis, sagittal control, with rigid posterior panel(s), posterior extends from l-1 to below l-5 vertebra, produces intracavitary pressure to reduce load on the intervertebral discs, includes straps, closures, may include padding, stays, shoulder straps, pendulous abdomen design, prefabricated, off-the-shelf
• L0642 – Lumbar orthosis, sagittal control, with rigid anterior and posterior panels, posterior extends from l-1 to below l-5 vertebra, produces intracavitary pressure to reduce load on the intervertebral discs, includes straps, closures, may include padding, shoulder straps, pendulous abdomen design, prefabricated, off-the-shelf
• L0643 – Lumbar-sacral orthosis, sagittal control, with rigid posterior panel(s), posterior extends from sacrococcygeal junction to t-9 vertebra, produces intracavitary pressure to reduce load on the intervertebral discs, includes straps, closures, may include padding, stays, shoulder straps, pendulous abdomen design, prefabricated, off-the-shelf
• L0648 – Lumbar-sacral orthosis, sagittal control, with rigid anterior and posterior panels, posterior extends from sacrococcygeal junction to t-9 vertebra, produces intracavitary pressure to reduce load on the intervertebral discs, includes straps, closures, may include padding, shoulder straps, pendulous abdomen design, prefabricated, off-the-shelf
• L0649 – Lumbar-sacral orthosis, sagittal-coronal control, with rigid posterior frame/panel(s), posterior extends from sacrococcygeal junction to t-9 vertebra, lateral strength provided by rigid lateral frame/panels, produces intracavitary pressure to reduce load on intervertebral discs, includes straps, closures, may include padding, stays, shoulder straps, pendulous abdomen design, prefabricated, off-the-shelf
• 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
• L0651 – Lumbar-sacral orthosis, sagittal-coronal control, rigid shell(s)/panel(s), posterior extends from sacrococcygeal junction to t-9 vertebra, anterior extends from symphysis pubis to xyphoid, produces intracavitary pressure to reduce load on the intervertebral discs, overall strength is provided by overlapping rigid material and stabilizing closures, includes straps, closures, may include soft interface, pendulous abdomen design, prefabricated, off-the-shelf
• L0700 – Cervical-thoracic-lumbar-sacral-orthoses (ctlso), anterior-posterior-lateral control, molded to patient model, (minerva type)
• L0710 – Ctlso, anterior-posterior-lateral-control, molded to patient model, with interface material, (minerva type)
• L0720 – Cervical-thoracic-lumbar-sacral-orthoses (ctlso), anterior-posterior-lateral control, prefabricated item that has been trimmed, bent, molded, assembled, or otherwise customized to fit a specific patient by an individual with expertise
• 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, rings and pins, any material
• L0861 – Addition to halo procedure, replacement liner/interface material
• L0970 – Tlso, corset front
• L0972 – Lso, corset front
• L0974 – Tlso, full corset
• L0976 – Lso, full corset
• L0978 – Axillary crutch extension
• L0980 – Peroneal straps, prefabricated, off-the-shelf, pair
• L0982 – Stocking supporter grips, prefabricated, off-the-shelf, set of four (4)
• L0984 – Protective body sock, prefabricated, off-the-shelf, each
• L0999 – Addition to spinal orthosis, not otherwise specified
• L1000 – Cervical-thoracic-lumbar-sacral orthosis (ctlso) (milwaukee), inclusive of furnishing initial orthosis, including model
• L1001 – Cervical thoracic lumbar sacral orthosis, immobilizer, infant size, prefabricated, includes fitting and adjustment
• L1005 – Tension based scoliosis orthosis and accessory pads, includes fitting and adjustment
• L1006 – Scoliosis orthosis, sagittal-coronal control provided by a rigid lateral frame, extends from axilla to trochanter, includes all accessory pads, straps and interface, prefabricated item that has been trimmed, bent, molded, assembled, or otherwise customized to fit a specific patient by an individual with expertise
• L1007 – Scoliosis orthosis, sagittal-coronal control provided by a rigid lateral frame, extends from axilla, to trochanter, includes all accessory pads, straps, and interface, custom fabricated
• L1010 – Addition to cervical-thoracic-lumbar-sacral orthosis (ctlso) or scoliosis orthosis, axilla sling
• 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 extensions
• 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, molded to patient model
• L1120 – Addition to ctlso, scoliosis orthosis, cover for upright, each
• L1200 – Thoracic-lumbar-sacral-orthosis (tlso), inclusive of furnishing initial orthosis only
• 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
• L1320 – Thoracic, pectus carinatum orthosis, sternal compression, rigid circumferential frame with anterior and posterior rigid pads, custom fabricated
• L1330 – Thoracic orthosis, sternal and/or sternocostal compression, may include anterior and/or posterior pads, panels, with or without frame, prefabricated, off the shelf
• L1499 – Spinal orthosis, not otherwise specified
• L1600 – Hip orthosis, abduction control of hip joints, flexible, frejka type with cover, prefabricated item that has been trimmed, bent, molded, assembled, or otherwise customized to fit a specific patient by an inidividual with expertise
• L1610 – Hip orthosis, abduction control of hip joints, flexible, (frejka cover only), prefabricated item that has been trimmed, bent, molded, assembled, or otherwise customized to fit a specific patient by an individual with expertise
• L1620 – Hip orthosis, abduction control of hip joints, flexible, (pavlik harness), prefabricated item that has been trimmed, bent, molded, assembled, or otherwise customized to fit a specific patient by an individual with expertise
• L1630 – Hip orthosis, abduction control of hip joints, semi-flexible (von rosen type), custom fabricated
• L1640 – Hip orthosis, abduction control of hip joints, static, pelvic band or spreader bar, thigh cuffs, custom fabricated
• L1650 – Hip orthosis, abduction control of hip joints, static, adjustable, (ilfled type), prefabricated, includes fitting and adjustment
• L1652 – Hip orthosis, bilateral thigh cuffs with adjustable abductor spreader bar, adult size, prefabricated, includes fitting and adjustment, prefabricated item that has been trimmed, bent, molded, assembled, or otherwise customized to fit a specific patient by an individual with expertise
• L1653 – Hip orthosis, bilateral thigh cuffs with adjustable abductor spreader bar, adult size, prefabricated, off the shelf
• L1660 – Hip orthosis, abduction control of hip joints, static, plastic, prefabricated, includes fitting and adjustment
• L1680 – Hip orthosis, abduction control of hip joints, dynamic, pelvic control, adjustable hip motion control, thigh cuffs (rancho hip action type), custom fabricated
• L1681 – Hip orthosis, bilateral hip joints and thigh cuffs, adjustable flexion, extension, abduction control of hip joint, postoperative hip abduction type, prefabricated item that has been trimmed, bent, molded, assembled, or otherwise customized to fit a specific patient by an individual with expertise
• L1685 – Hip orthosis, abduction control of hip joint, postoperative hip abduction type, custom fabricated
• L1686 – Hip orthosis, abduction control of hip joint, postoperative hip abduction type, prefabricated, includes fitting and adjustment
• L1690 – Combination, bilateral, lumbo-sacral, hip, femur orthosis providing adduction and internal rotation control, prefabricated, includes fitting and adjustment
• 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
• L1755 – Legg perthes orthosis, (patten bottom type), custom fabricated
• L1810 – Knee orthosis, elastic with joints, prefabricated item that has been trimmed, bent, molded, assembled, or otherwise customized to fit a specific patient by an individual with expertise
• L1812 – Knee orthosis, elastic with joints, prefabricated, off-the-shelf
• 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
• L1821 – Knee orthosis, elastic with condylar pads and joints, with or without patellar control, prefabricated, off the shelf
• L1830 – Knee orthosis, immobilizer, canvas longitudinal, prefabricated, off-the-shelf
• L1831 – Knee orthosis, locking knee joint(s), positional orthosis, prefabricated, includes fitting and adjustment
• L1832 – Knee orthosis, adjustable knee joints (unicentric or polycentric), positional orthosis, rigid support, prefabricated item that has been trimmed, bent, molded, assembled, or otherwise customized to fit a specific patient by an individual with expertise
• L1833 – Knee orthosis, adjustable knee joints (unicentric or polycentric), positional orthosis, rigid support, prefabricated, off-the shelf
• L1834 – Knee orthosis, without knee joint, rigid, custom fabricated
• L1836 – Knee orthosis, rigid, without joint(s), includes soft interface material, prefabricated, off-the-shelf
• L1840 – Knee orthosis, derotation, medial-lateral, anterior cruciate ligament, custom fabricated
• L1843 – Knee orthosis, 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 item that has been trimmed, bent, molded, assembled, or otherwise customized to fit a specific patient by an individual with expertise
• L1844 – Knee orthosis, 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, custom fabricated
• L1845 – 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, prefabricated item that has been trimmed, bent, molded, assembled, or otherwise customized to fit a specific patient by an individual with expertise
• 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
• L1847 – Knee orthosis, double upright with adjustable joint, with inflatable air support chamber(s), prefabricated item that has been trimmed, bent, molded, assembled, or otherwise customized to fit a specific patient by an individual with expertise
• L1848 – Knee orthosis, double upright with adjustable joint, with inflatable air support chamber(s), prefabricated, off-the-shelf
• L1850 – Knee orthosis, swedish type, prefabricated, off-the-shelf
• 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
• 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
• L1860 – Knee orthosis, modification of supracondylar prosthetic socket, custom fabricated (sk)
• L1900 – Ankle foot orthosis, spring wire, dorsiflexion assist calf band, custom fabricated
• L1902 – Ankle orthosis, ankle gauntlet or similar, with or without joints, prefabricated, off-the-shelf
• L1904 – Ankle orthosis, ankle gauntlet or similar, with or without joints, custom fabricated
• L1906 – Ankle foot orthosis, multiligamentous ankle support, prefabricated, off-the-shelf
• L1907 – Ankle orthosis, supramalleolar with straps, with or without interface/pads, custom fabricated
• L1910 – Ankle foot orthosis, posterior, single bar, clasp attachment to shoe counter, prefabricated, includes fitting and adjustment
• L1920 – Ankle foot orthosis, single upright with static or adjustable stop (phelps or perlstein type), custom fabricated
• L1930 – Ankle foot orthosis, plastic or other material, prefabricated, includes fitting and adjustment
• L1932 – Ankle foot orthosis, rigid anterior tibial section, total carbon fiber or equal material, prefabricated item that has been trimmed, bent, molded, assembled, or otherwise customized to fit a specific patient by an individual with expertise
• L1933 – Ankle foot orthosis, rigid anterior tibial section, total carbon fiber or equal material, prefabricated, off-the-shelf
• L1940 – Ankle foot orthosis, plastic or other material, custom fabricated
• L1945 – Ankle foot orthosis, plastic, rigid anterior tibial section (floor reaction), custom fabricated
• L1950 – Ankle foot orthosis, spiral, (institute of rehabilitative medicine type), plastic, custom fabricated
• L1951 – Ankle foot orthosis, spiral, (institute of rehabilitative medicine type), plastic or other material, prefabricated item that has been trimmed, bent, molded, assembled, or otherwise customized to fit a specific patient by an individual with expertise
• L1952 – Ankle foot orthosis, spiral, (institute of rehabilitative medicine type), plastic or other material, prefabricated, off-the-shelf
• L1960 – Ankle foot orthosis, posterior solid ankle, plastic, custom fabricated
• L1970 – Ankle foot orthosis, plastic with ankle joint, custom fabricated
• L1971 – Ankle foot orthosis, plastic or other material with ankle joint, with or without dorsiflexion assist, prefabricated, item that has been trimmed, bent, molded, assembled, or otherwise customized to fit a specific patient by an individual with expertise
• L1972 – Ankle foot orthosis, plastic or other material with ankle joint, with or without dorsiflexion assist, prefabricated, off-the shelf
• L1980 – Ankle foot orthosis, single upright free plantar dorsiflexion, solid stirrup, calf band/cuff (single bar 'bk' orthosis), custom fabricated
• L1990 – Ankle foot orthosis, double upright free plantar dorsiflexion, solid stirrup, calf band/cuff (double bar 'bk' orthosis), custom fabricated
• L2000 – Knee ankle foot orthosis, single upright, free knee, free ankle, solid stirrup, thigh and calf bands/cuffs (single bar 'ak' orthosis), custom fabricated
• L2005 – Knee ankle foot orthosis, any material, single or double upright, stance control, automatic lock and swing phase release, any type activation, includes ankle joint, any type, custom fabricated
• L2006 – Knee ankle foot device, any material, single or double upright, swing and stance phase microprocessor control with adjustability, includes all components (e.g., sensors, batteries, charger), any type activation, with or without ankle joint(s), custom fabricated
• L2010 – Knee ankle foot orthosis, single upright, free ankle, solid stirrup, thigh and calf bands/cuffs (single bar 'ak' orthosis), without knee joint, custom fabricated
• L2020 – Knee ankle foot orthosis, double upright, free ankle, solid stirrup, thigh and calf bands/cuffs (double bar 'ak' orthosis), custom fabricated
• L2030 – Knee ankle foot orthosis, double upright, free ankle, solid stirrup, thigh and calf bands/cuffs, (double bar 'ak' orthosis), without knee joint, custom fabricated
• L2034 – Knee ankle foot orthosis, full plastic, single upright, with or without free motion knee, medial lateral rotation control, with or without free motion ankle, custom fabricated
• L2035 – Knee ankle foot orthosis, full plastic, static (pediatric size), without free motion ankle, prefabricated, includes fitting and adjustment
• L2036 – Knee ankle foot orthosis, full plastic, double upright, with or without free motion knee, with or without free motion ankle, custom fabricated
• L2037 – Knee ankle foot orthosis, full plastic, single upright, with or without free motion knee, with or without free motion ankle, custom fabricated
• L2038 – Knee ankle foot orthosis, full plastic, with or without free motion knee, multi-axis ankle, custom fabricated
• L2040 – Hip knee ankle foot orthosis, torsion control, bilateral rotation straps, pelvic band/belt, custom fabricated
• L2050 – Hip knee ankle foot orthosis, torsion control, bilateral torsion cables, hip joint, pelvic band/belt, custom fabricated
• L2060 – Hip knee ankle foot orthosis, torsion control, bilateral torsion cables, ball bearing hip joint, pelvic band/ belt, custom fabricated
• L2070 – Hip knee ankle foot orthosis, torsion control, unilateral rotation straps, pelvic band/belt, custom fabricated
• L2080 – Hip knee ankle foot orthosis, torsion control, unilateral torsion cable, hip joint, pelvic band/belt, custom fabricated
• L2090 – Hip knee ankle foot orthosis, torsion control, unilateral torsion cable, ball bearing hip joint, pelvic band/ belt, custom fabricated
• L2106 – Ankle foot orthosis, fracture orthosis, tibial fracture cast orthosis, thermoplastic type casting material, custom fabricated
• L2108 – Ankle foot orthosis, fracture orthosis, tibial fracture cast orthosis, custom fabricated
• L2112 – Ankle foot orthosis, fracture orthosis, tibial fracture orthosis, soft, prefabricated, includes fitting and adjustment
• L2114 – Ankle foot orthosis, fracture orthosis, tibial fracture orthosis, semi-rigid, prefabricated, includes fitting and adjustment
• L2116 – Ankle foot orthosis, fracture orthosis, tibial fracture orthosis, rigid, prefabricated, includes fitting and adjustment
• L2126 – Knee ankle foot orthosis, fracture orthosis, femoral fracture cast orthosis, thermoplastic type casting material, custom fabricated
• L2128 – Knee ankle foot orthosis, fracture orthosis, femoral fracture cast orthosis, custom fabricated
• L2132 – Kafo, fracture orthosis, femoral fracture cast orthosis, soft, prefabricated, includes fitting and adjustment
• L2134 – Kafo, fracture orthosis, femoral fracture cast orthosis, semi-rigid, prefabricated, includes fitting and adjustment
• L2136 – Kafo, fracture orthosis, femoral fracture cast orthosis, rigid, prefabricated, includes fitting and adjustment
• L2180 – Addition to lower extremity fracture orthosis, plastic shoe insert with ankle joints
• 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, lerman type
• 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, thigh flange, and pelvic belt
• L2200 – Addition to lower extremity, limited ankle motion, each joint
• L2210 – Addition to lower extremity, dorsiflexion assist (plantar flexion resist), each joint
• L2220 – Addition to lower extremity, dorsiflexion and plantar flexion assist/resist, each joint
• L2221 – Addition to lower extremity orthosis, ankle system, microprocessor-controlled feature plantarflexion and/or dorsiflexion, includes power source
• L2230 – Addition to lower extremity, split flat caliper stirrups and plate attachment
• L2232 – Addition to lower extremity orthosis, rocker bottom for total contact ankle foot orthosis, for custom fabricated orthosis only
• L2240 – Addition to lower extremity, round caliper and plate attachment
• L2250 – Addition to lower extremity, foot plate, molded to patient model, stirrup attachment
• 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/lined or malleolus pad
• L2275 – Addition to lower extremity, varus/valgus correction, plastic modification, padded/lined
• L2280 – Addition to lower extremity, molded inner boot
• L2300 – Addition to lower extremity, abduction bar (bilateral hip involvement), jointed, adjustable
• L2310 – Addition to lower extremity, abduction bar-straight
• L2320 – Addition to lower extremity, non-molded lacer, for custom fabricated orthosis only
• L2330 – Addition to lower extremity, lacer molded to patient model, for custom fabricated orthosis only
• 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 patient model, (used for 'ptb' 'afo' orthoses)
• 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 stirrup
• L2380 – Addition to lower extremity, torsion control, straight knee joint, each joint
• L2385 – Addition to lower extremity, straight knee joint, heavy duty, each joint
• L2387 – Addition to lower extremity, polycentric knee joint, for custom fabricated knee ankle foot orthosis, each joint
• 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 equal), any material, each joint
• L2425 – Addition to knee joint, disc or dial lock for adjustable knee flexion, each joint
• L2430 – Addition to knee joint, ratchet lock for active and progressive knee extension, each joint
• L2492 – Addition to knee joint, lift loop for drop lock ring
• L2500 – Addition to lower extremity, thigh/weight bearing, gluteal/ ischial weight bearing, ring
• L2510 – Addition to lower extremity, thigh/weight bearing, quadri- lateral brim, molded to patient model
• L2520 – Addition to lower extremity, thigh/weight bearing, quadri- lateral brim, custom fitted
• L2525 – Addition to lower extremity, thigh/weight bearing, ischial containment/narrow m-l brim molded to patient model
• L2526 – Addition to lower extremity, thigh/weight bearing, ischial containment/narrow m-l brim, custom fitted
• L2530 – Addition to lower extremity, thigh-weight bearing, lacer, non-molded
• L2540 – Addition to lower extremity, thigh/weight bearing, lacer, molded to patient model
• L2550 – Addition to lower extremity, thigh/weight bearing, high roll cuff
• L2570 – Addition to lower extremity, pelvic control, hip joint, clevis type two position joint, each
• L2580 – Addition to lower extremity, pelvic control, pelvic sling
• L2600 – Addition to lower extremity, pelvic control, hip joint, clevis type, or thrust bearing, free, each
• L2610 – Addition to lower extremity, pelvic control, hip joint, clevis or thrust bearing, lock, each
• L2620 – Addition to lower extremity, pelvic control, hip joint, heavy duty, each
• L2622 – Addition to lower extremity, pelvic control, hip joint, adjustable flexion, each
• L2624 – Addition to lower extremity, pelvic control, hip joint, adjustable flexion, extension, abduction control, each
• L2627 – Addition to lower extremity, pelvic control, plastic, molded to patient model, reciprocating hip joint and cables
• L2628 – Addition to lower extremity, pelvic control, metal frame, reciprocating hip joint and cables
• 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 – Addition to lower extremity orthosis, high strength, lightweight material, all hybrid lamination/prepreg composite, per segment, for custom fabricated orthosis only
• L2760 – Addition to lower extremity orthosis, extension, per extension, per bar (for lineal adjustment for growth)
• L2768 – Orthotic side bar disconnect device, per bar
• 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 lateral pull, for use with custom fabricated orthosis only
• L2810 – Addition to lower extremity orthosis, knee control, condylar pad
• L2820 – Addition to lower extremity orthosis, soft interface for molded plastic, below knee section
• L2830 – Addition to lower extremity orthosis, soft interface for molded plastic, above knee section
• L2840 – Addition to lower extremity orthosis, tibial length sock, fracture or equal, each
• L2850 – Addition to lower extremity orthosis, femoral length sock, fracture or equal, each
• L2861 – Addition to lower extremity joint, knee or ankle, concentric adjustable torsion style mechanism for custom fabricated orthotics only, each
• L2999 – Lower extremity orthoses, not otherwise specified
• L3000 – Foot, insert, removable, molded to patient model, 'ucb' type, berkeley shell, each
• 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 – Foot, insert, removable, molded to patient model, longitudinal arch support, each
• L3020 – Foot, insert, removable, molded to patient model, longitudinal/ metatarsal support, each
• L3030 – Foot, insert, removable, formed to patient foot, each
• L3031 – Foot, insert/plate, removable, addition to lower extremity orthosis, high strength, lightweight material, all hybrid lamination/prepreg composite, each
• 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 – Foot, arch support, non-removable attached to shoe, longitudinal/metatarsal, each
• L3100 – Hallus-valgus night dynamic splint, prefabricated, off-the-shelf
• L3140 – Foot, abduction rotation bar, including shoes
• L3150 – Foot, abduction rotation bar, without shoes
• L3160 – Foot, adjustable shoe-styled positioning device
• L3161 – Foot, adductus positioning device, adjustable
• L3170 – Foot, plastic, silicone or equal, heel stabilizer, prefabricated, off-the-shelf, 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 brace (orthosis)
• L3225 – Orthopedic footwear, man's shoe, oxford, used as an integral part of a brace (orthosis)
• L3230 – Orthopedic footwear, custom shoe, depth inlay, each
• L3250 – Orthopedic footwear, custom molded shoe, removable inner mold, prosthetic shoe, each
• L3251 – Foot, shoe molded to patient model, silicone shoe, each
• L3252 – Foot, shoe molded to patient model, plastazote (or similar), custom fabricated, each
• 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 (riveton), both shoes
• L3649 – Orthopedic shoe, modification, addition or transfer, not otherwise specified
• L3650 – Shoulder orthosis, figure of eight design abduction restrainer, prefabricated, off-the-shelf
• L3660 – Shoulder orthosis, figure of eight design abduction restrainer, canvas and webbing, prefabricated, off-the-shelf
• L3670 – Shoulder orthosis, acromio/clavicular (canvas and webbing type), prefabricated, off-the-shelf
• L3671 – Shoulder orthosis, shoulder joint design, without joints, may include soft interface, straps, custom fabricated, includes fitting and adjustment
• L3674 – Shoulder orthosis, abduction positioning (airplane design), thoracic component and support bar, with or without nontorsion joint/turnbuckle, may include soft interface, straps, custom fabricated, includes fitting and adjustment
• L3675 – Shoulder orthosis, vest type abduction restrainer, canvas webbing type or equal, prefabricated, off-the-shelf
• L3677 – Shoulder orthosis, shoulder joint design, without joints, may include soft interface, straps, prefabricated item that has been trimmed, bent, molded, assembled, or otherwise customized to fit a specific patient by an individual with expertise
• L3678 – Shoulder orthosis, shoulder joint design, without joints, may include soft interface, straps, prefabricated, off-the-shelf
• L3702 – Elbow orthosis, without joints, may include soft interface, straps, custom fabricated, includes fitting and adjustment
• L3710 – Elbow orthosis, elastic with metal joints, prefabricated, off-the-shelf
• L3720 – Elbow orthosis, double upright with forearm/arm cuffs, free motion, custom fabricated
• L3730 – Elbow orthosis, double upright with forearm/arm cuffs, extension/ flexion assist, custom fabricated
• L3740 – Elbow orthosis, double upright with forearm/arm cuffs, adjustable position lock with active control, custom fabricated
• L3760 – Elbow orthosis (eo), with adjustable position locking joint(s), prefabricated, item that has been trimmed, bent, molded, assembled, or otherwise customized to fit a specific patient by an individual with expertise
• L3761 – Elbow orthosis (eo), with adjustable position locking joint(s), prefabricated, off-the-shelf
• L3762 – Elbow orthosis, rigid, without joints, includes soft interface material, prefabricated, off-the-shelf
• L3763 – Elbow wrist hand orthosis, rigid, without joints, may include soft interface, straps, custom fabricated, includes fitting and adjustment
• L3764 – Elbow wrist hand orthosis, includes one or more nontorsion joints, elastic bands, turnbuckles, may include soft interface, straps, custom fabricated, includes fitting and adjustment
• L3765 – Elbow wrist hand finger orthosis, rigid, without joints, may include soft interface, straps, custom fabricated, includes fitting and adjustment
• L3766 – Elbow wrist hand finger orthosis, includes one or more nontorsion joints, elastic bands, turnbuckles, may include soft interface, straps, custom fabricated, includes fitting and adjustment
• L3806 – Wrist hand finger orthosis, includes one or more nontorsion joint(s), turnbuckles, elastic bands/springs, may include soft interface material, straps, custom fabricated, includes fitting and adjustment
• L3807 – Wrist hand finger orthosis, without joint(s), prefabricated item that has been trimmed, bent, molded, assembled, or otherwise customized to fit a specific patient by an individual with expertise
• L3808 – Wrist hand finger orthosis, rigid without joints, may include soft interface material; straps, custom fabricated, includes fitting and adjustment
• L3809 – Wrist hand finger orthosis, without joint(s), prefabricated, off-the-shelf, any type
• L3891 – Addition to upper extremity joint, wrist or elbow, concentric adjustable torsion style mechanism for custom fabricated orthotics only, each
• L3900 – Wrist hand finger orthosis, dynamic flexor hinge, reciprocal wrist extension/ flexion, finger flexion/extension, wrist or finger driven, custom fabricated
• L3901 – Wrist hand finger orthosis, dynamic flexor hinge, reciprocal wrist extension/ flexion, finger flexion/extension, cable driven, custom fabricated
• L3904 – Wrist hand finger orthosis, external powered, electric, custom fabricated
• L3905 – Wrist hand orthosis, includes one or more nontorsion joints, elastic bands, turnbuckles, may include soft interface, straps, custom fabricated, includes fitting and adjustment
• L3906 – Wrist hand orthosis, without joints, may include soft interface, straps, custom fabricated, includes fitting and adjustment
• L3908 – Wrist hand orthosis, wrist extension control cock-up, non molded, prefabricated, off-the-shelf
• L3912 – Hand finger orthosis (hfo), flexion glove with elastic finger control, prefabricated, off-the-shelf
• L3913 – Hand finger orthosis, without joints, may include soft interface, straps, custom fabricated, includes fitting and adjustment
• L3915 – Wrist hand orthosis, includes one or more nontorsion joint(s), elastic bands, turnbuckles, may include soft interface, straps, prefabricated item that has been trimmed, bent, molded, assembled, or otherwise customized to fit a specific patient by an individual with expertise
• L3916 – Wrist hand orthosis, includes one or more nontorsion joint(s), elastic bands, turnbuckles, may include soft interface, straps, prefabricated, off-the-shelf
• L3917 – Hand orthosis, metacarpal fracture orthosis, prefabricated item that has been trimmed, bent, molded, assembled, or otherwise customized to fit a specific patient by an individual with expertise
• L3918 – Hand orthosis, metacarpal fracture orthosis, prefabricated, off-the-shelf
• L3919 – Hand orthosis, without joints, may include soft interface, straps, custom fabricated, includes fitting and adjustment
• L3921 – Hand finger orthosis, includes one or more nontorsion joints, elastic bands, turnbuckles, may include soft interface, straps, custom fabricated, includes fitting and adjustment
• L3923 – Hand finger orthosis, without joints, may include soft interface, straps, prefabricated item that has been trimmed, bent, molded, assembled, or otherwise customized to fit a specific patient by an individual with expertise
• L3924 – Hand finger orthosis, without joints, may include soft interface, straps, prefabricated, off-the-shelf
• L3925 – Finger orthosis, proximal interphalangeal (pip)/distal interphalangeal (dip), non torsion joint/spring, extension/flexion, may include soft interface material, prefabricated, off-the-shelf
• L3927 – Finger orthosis, proximal interphalangeal (pip)/distal interphalangeal (dip), without joint/spring, extension/flexion (e.g., static or ring type), may include soft interface material, prefabricated, off-the-shelf
• L3929 – Hand finger orthosis, includes one or more nontorsion joint(s), turnbuckles, elastic bands/springs, may include soft interface material, straps, prefabricated item that has been trimmed, bent, molded, assembled, or otherwise customized to fit a specific patient by an individual with expertise
• L3930 – Hand finger orthosis, includes one or more nontorsion joint(s), turnbuckles, elastic bands/springs, may include soft interface material, straps, prefabricated, off-the-shelf
• L3931 – Wrist hand finger orthosis, includes one or more nontorsion joint(s), turnbuckles, elastic bands/springs, may include soft interface material, straps, prefabricated, includes fitting and adjustment
• L3933 – Finger orthosis, without joints, may include soft interface, custom fabricated, includes fitting and adjustment
• L3935 – Finger orthosis, nontorsion joint, may include soft interface, custom fabricated, includes fitting and adjustment
• L3956 – Addition of joint to upper extremity orthosis, any material; per joint
• L3960 – Shoulder elbow wrist hand orthosis, abduction positioning, airplane design, prefabricated, includes fitting and adjustment
• L3961 – Shoulder elbow wrist hand orthosis, shoulder cap design, without joints, may include soft interface, straps, custom fabricated, includes fitting and adjustment
• L3962 – Shoulder elbow wrist hand orthosis, abduction positioning, erb's palsey design, prefabricated, includes fitting and adjustment
• L3967 – Shoulder elbow wrist hand orthosis, abduction positioning (airplane design), thoracic component and support bar, without joints, may include soft interface, straps, custom fabricated, includes fitting and adjustment
• L3971 – Shoulder elbow wrist hand orthosis, shoulder cap design, includes one or more nontorsion joints, elastic bands, turnbuckles, may include soft interface, straps, custom fabricated, includes fitting and adjustment
• L3973 – Shoulder elbow wrist hand orthosis, abduction positioning (airplane design), thoracic component and support bar, includes one or more nontorsion joints, elastic bands, turnbuckles, may include soft interface, straps, custom fabricated, includes fitting and adjustment
• L3975 – Shoulder elbow wrist hand finger orthosis, shoulder cap design, without joints, may include soft interface, straps, custom fabricated, includes fitting and adjustment
• L3976 – Shoulder elbow wrist hand finger orthosis, abduction positioning (airplane design), thoracic component and support bar, without joints, may include soft interface, straps, custom fabricated, includes fitting and adjustment
• L3977 – Shoulder elbow wrist hand finger orthosis, shoulder cap design, includes one or more nontorsion joints, elastic bands, turnbuckles, may include soft interface, straps, custom fabricated, includes fitting and adjustment
• L3978 – Shoulder elbow wrist hand finger orthosis, abduction positioning (airplane design), thoracic component and support bar, includes one or more nontorsion joints, elastic bands, turnbuckles, may include soft interface, straps, custom fabricated, includes fitting and adjustment
• L3980 – Upper extremity fracture orthosis, humeral, prefabricated, includes fitting and adjustment
• L3981 – Upper extremity fracture orthosis, humeral, prefabricated, includes shoulder cap design, with or without joints, forearm section, may include soft interface, straps, includes fitting and adjustments
• L3982 – Upper extremity fracture orthosis, radius/ulnar, prefabricated, includes fitting and adjustment
• L3984 – Upper extremity fracture orthosis, wrist, prefabricated, includes fitting and adjustment
• 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 type
• 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 – Ankle control orthosis, stirrup style, rigid, includes any type interface (e.g., pneumatic, gel), prefabricated, off-the-shelf
• L4360 – Walking boot, pneumatic and/or vacuum, with or without joints, with or without interface material, prefabricated item that has been trimmed, bent, molded, assembled, or otherwise customized to fit a specific patient by an individual with expertise
• L4361 – Walking boot, pneumatic and/or vacuum, with or without joints, with or without interface material, prefabricated, off-the-shelf
• L4370 – Pneumatic full leg splint, prefabricated, off-the-shelf
• L4386 – Walking boot, non-pneumatic, with or without joints, with or without interface material, prefabricated item that has been trimmed, bent, molded, assembled, or otherwise customized to fit a specific patient by an individual with expertise
• L4387 – Walking boot, non-pneumatic, with or without joints, with or without interface material, prefabricated, off-the-shelf
• L4392 – Replacement, soft interface material, static afo
• L4394 – Replace soft interface material, foot drop splint
• L4396 – Static or dynamic ankle foot orthosis, including soft interface material, adjustable for fit, for positioning, may be used for minimal ambulation, prefabricated item that has been trimmed, bent, molded, assembled, or otherwise customized to fit a specific patient by an individual with expertise
• L4397 – Static or dynamic ankle foot orthosis, including soft interface material, adjustable for fit, for positioning, may be used for minimal ambulation, prefabricated, off-the-shelf
• L4398 – Foot drop splint, recumbent positioning device, prefabricated, off-the-shelf
• L4631 – Ankle foot orthosis, walking boot type, varus/valgus correction, rocker bottom, anterior tibial shell, soft interface, custom arch support, plastic or other material, includes straps and closures, custom fabricated
• 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, shin, sach foot
• L5160 – Knee disarticulation (or through knee), molded socket, bent knee configuration, external knee joints, shin, sach foot
• L5200 – Above knee, molded socket, single axis constant friction knee, shin, sach foot
• L5210 – Above knee, short prosthesis, no knee joint ('stubbies'), with foot blocks, no ankle joints, each
• L5220 – Above knee, short prosthesis, no knee joint ('stubbies'), with articulated ankle/foot, dynamically aligned, each
• L5230 – Above knee, for proximal femoral focal deficiency, constant friction knee, shin, sach foot
• L5250 – Hip disarticulation, canadian type; molded socket, hip joint, single axis constant friction knee, shin, sach foot
• L5270 – Hip disarticulation, tilt table type; molded socket, locking hip joint, single axis constant friction knee, shin, sach foot
• L5280 – Hemipelvectomy, canadian type; molded socket, hip joint, single axis constant friction knee, shin, sach foot
• L5301 – Below knee, molded socket, shin, sach foot, endoskeletal system
• L5312 – Knee disarticulation (or through knee), molded socket, single axis knee, pylon, sach foot, endoskeletal system
• L5321 – Above knee, molded socket, open end, sach foot, endoskeletal system, single axis knee
• L5331 – Hip disarticulation, canadian type, molded socket, endoskeletal system, hip joint, single axis knee, sach foot
• L5341 – Hemipelvectomy, canadian type, molded socket, endoskeletal system, hip joint, single axis knee, sach foot
• L5400 – Immediate post surgical or early fitting, application of initial rigid dressing, including fitting, alignment, suspension, and one cast change, below knee
• L5410 – Immediate post surgical or early fitting, application of initial rigid dressing, including fitting, alignment and suspension, below knee, each additional cast change and realignment
• L5420 – Immediate post surgical or early fitting, application of initial rigid dressing, including fitting, alignment and suspension and one cast change 'ak' or knee disarticulation
• L5430 – Immediate post surgical or early fitting, application of initial rigid dressing, incl. fitting, alignment and supension, 'ak' or knee disarticulation, each additional cast change and realignment
• L5450 – Immediate post surgical or early fitting, application of non-weight bearing rigid dressing, below knee
• L5460 – Immediate post surgical or early fitting, application of non-weight bearing rigid dressing, above knee
• L5500 – Initial, below knee 'ptb' type socket, non-alignable system, pylon, no cover, sach foot, plaster socket, direct formed
• L5505 – Initial, above knee - knee disarticulation, ischial level socket, non-alignable system, pylon, no cover, sach foot, plaster socket, direct formed
• L5510 – Preparatory, below knee 'ptb' type socket, non-alignable system, pylon, no cover, sach foot, plaster socket, molded to model
• L5520 – Preparatory, below knee 'ptb' type socket, non-alignable system, pylon, no cover, sach foot, thermoplastic or equal, direct formed
• L5530 – Preparatory, below knee 'ptb' type socket, non-alignable system, pylon, no cover, sach foot, thermoplastic or equal, molded to model
• L5535 – Preparatory, below knee 'ptb' type socket, non-alignable system, no cover, sach foot, prefabricated, adjustable open end socket
• L5540 – Preparatory, below knee 'ptb' type socket, non-alignable system, pylon, no cover, sach foot, laminated socket, molded to model
• L5560 – Preparatory, above knee- knee disarticulation, ischial level socket, non-alignable system, pylon, no cover, sach foot, plaster socket, molded to model
• L5570 – Preparatory, above knee - knee disarticulation, ischial level socket, non-alignable system, pylon, no cover, sach foot, thermoplastic or equal, direct formed
• L5580 – Preparatory, above knee - knee disarticulation ischial level socket, non-alignable system, pylon, no cover, sach foot, thermoplastic or equal, molded to model
• L5585 – Preparatory, above knee - knee disarticulation, ischial level socket, non-alignable system, pylon, no cover, sach foot, prefabricated adjustable open end socket
• L5590 – Preparatory, above knee - knee disarticulation ischial level socket, non-alignable system, pylon no cover, sach foot, laminated socket, molded to model
• L5595 – Preparatory, hip disarticulation-hemipelvectomy, pylon, no cover, sach foot, thermoplastic or equal, molded to patient model
• L5600 – Preparatory, hip disarticulation-hemipelvectomy, pylon, no cover, sach foot, laminated socket, molded to patient model
• L5610 – Addition to lower extremity, endoskeletal system, above knee, hydracadence system
• L5611 – Addition to lower extremity, endoskeletal system, above knee - knee disarticulation, 4 bar linkage, with friction swing phase control
• L5613 – Addition to lower extremity, endoskeletal system, above knee-knee disarticulation, 4 bar linkage, with hydraulic swing phase control
• L5614 – Addition to lower extremity, exoskeletal system, above knee-knee disarticulation, 4 bar linkage, with pneumatic swing phase control
• L5615 – Addition, endoskeletal knee-shin system, 4 bar linkage or multiaxial, fluid swing and stance phase control
• L5616 – Addition to lower extremity, endoskeletal system, above knee, universal multiplex system, friction swing phase control
• L5617 – Addition to lower extremity, quick change self-aligning unit, above knee or below knee, each
• 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 socket
• L5632 – Addition to lower extremity, symes type, 'ptb' brim design socket
• L5634 – Addition to lower extremity, symes type, posterior opening (canadian) socket
• 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, external frame
• L5644 – Addition to lower extremity, above knee, wood socket
• L5645 – Addition to lower extremity, below knee, flexible inner socket, external frame
• L5646 – Addition to lower extremity, below knee, air, fluid, gel or equal, cushion socket
• L5647 – Addition to lower extremity, below knee suction socket
• L5648 – Addition to lower extremity, above knee, air, fluid, gel or equal, cushion socket
• L5649 – Addition to lower extremity, ischial containment/narrow m-l socket
• L5650 – Additions to lower extremity, total contact, above knee or knee disarticulation socket
• L5651 – Addition to lower extremity, above knee, flexible inner socket, external frame
• L5652 – Addition to lower extremity, suction suspension, above knee or knee disarticulation socket
• L5653 – Addition to lower extremity, knee disarticulation, expandable wall socket
• L5654 – Addition to lower extremity, socket insert, symes, (kemblo, pelite, aliplast, plastazote or equal)
• L5655 – Addition to lower extremity, socket insert, below knee (kemblo, pelite, aliplast, plastazote or equal)
• L5656 – Addition to lower extremity, socket insert, knee disarticulation (kemblo, pelite, aliplast, plastazote or equal)
• L5657 – Addition to lower extremity prosthesis, manual/automated adjustable air, fluid, gel or equal socket insert for limb volume management, any materials
• L5658 – Addition to lower extremity, socket insert, above knee (kemblo, pelite, aliplast, plastazote or equal)
• 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 ('pts' or similar)
• L5671 – Addition to lower extremity, below knee / above knee suspension locking mechanism (shuttle, lanyard or equal), excludes socket insert
• L5672 – Addition to lower extremity, below knee, removable medial brim suspension
• L5673 – Addition to lower extremity, below knee/above knee, custom fabricated from existing mold or prefabricated, socket insert, silicone gel, elastomeric, or equal, with or without perforations, with or without breathable material, for use with locking mechanism
• 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 existing mold or prefabricated, socket insert, silicone gel, elastomeric, or equal, with or without perforations, with or without breathable material, not for use with locking mechanism
• L5680 – Addition to lower extremity, below knee, thigh lacer, nonmolded
• L5681 – Addition to lower extremity, below knee/above knee, custom fabricated socket insert for congenital or atypical traumatic amputee, silicone gel, elastomeric or equal, for use with or without locking mechanism, initial only (for other than initial, use code l5673 or l5679)
• L5682 – Addition to lower extremity, below knee, thigh lacer, gluteal/ischial, molded
• L5683 – Addition to lower extremity, below knee/above knee, custom fabricated socket insert for other than congenital or atypical traumatic amputee, silicone gel, elastomeric or equal, for use with or without locking mechanism, initial only (for other than initial, use code l5673 or l5679)
• L5684 – Addition to lower extremity, below knee, fork strap
• L5685 – Addition to lower extremity prosthesis, below knee, suspension/sealing sleeve, with or without valve, any material, each
• 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 lined
• L5695 – Addition to lower extremity, above knee, pelvic control, sleeve suspension, neoprene or equal, each
• L5696 – Addition to lower extremity, above knee or knee disarticulation, pelvic joint
• L5697 – Addition to lower extremity, above knee or knee disarticulation, pelvic band
• L5698 – Addition to lower extremity, above knee or knee disarticulation, silesian bandage
• 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 plate, molded to patient model
• L5702 – Replacement, socket, hip disarticulation, including hip joint, molded to patient model
• L5703 – Ankle, symes, molded to patient model, socket without solid ankle cushion heel (sach) foot, replacement only
• 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-light material
• L5712 – Addition, exoskeletal knee-shin system, single axis, friction swing and stance phase control (safety knee)
• L5714 – Addition, exoskeletal knee-shin system, single axis, variable friction swing phase control
• L5716 – Addition, exoskeletal knee-shin system, polycentric, mechanical stance phase lock
• L5718 – Addition, exoskeletal knee-shin system, polycentric, friction swing and stance phase control
• L5722 – Addition, exoskeletal knee-shin system, single axis, pneumatic swing, friction stance phase control
• L5724 – Addition, exoskeletal knee-shin system, single axis, fluid swing phase control
• L5726 – Addition, exoskeletal knee-shin system, single axis, external joints fluid swing phase control
• L5728 – Addition, exoskeletal knee-shin system, single axis, fluid swing and stance phase control
• L5780 – Addition, exoskeletal knee-shin system, single axis, pneumatic/hydra pneumatic swing phase control
• L5781 – Addition to lower limb prosthesis, vacuum pump, residual limb volume management and moisture evacuation system
• L5782 – Addition to lower limb prosthesis, vacuum pump, residual limb volume management and moisture evacuation system, heavy duty
• L5783 – Addition to lower extremity, user adjustable, mechanical, residual limb volume management system (with or without lamination kit)
• L5785 – Addition, exoskeletal system, below knee, ultra-light material (titanium, carbon fiber or equal)
• L5790 – Addition, exoskeletal system, above knee, ultra-light material (titanium, carbon fiber or equal)
• L5795 – Addition, exoskeletal system, hip disarticulation, ultra-light material (titanium, carbon fiber or equal)
• L5810 – Addition, endoskeletal knee-shin system, single axis, manual lock
• L5811 – Addition, endoskeletal knee-shin system, single axis, manual lock, ultra-light material
• L5812 – Addition, endoskeletal knee-shin system, single axis, friction swing and stance phase control (safety knee)
• L5814 – Addition, endoskeletal knee-shin system, polycentric, hydraulic swing phase control, mechanical stance phase lock
• L5816 – Addition, endoskeletal knee-shin system, polycentric, mechanical stance phase lock
• L5818 – Addition, endoskeletal knee-shin system, polycentric, friction swing, and stance phase control
• L5822 – Addition, endoskeletal knee-shin system, single axis, pneumatic swing, friction stance phase control
• L5824 – Addition, endoskeletal knee-shin system, single axis, fluid swing phase control
• L5826 – Addition, endoskeletal knee-shin system, single axis, hydraulic swing phase control, with miniature high activity frame
• L5827 – Endoskeletal knee-shin system, single axis, electromechanical swing and stance phase control, with or without shock absorption and stance extension damping
• L5828 – Addition, endoskeletal knee-shin system, single axis, fluid swing and stance phase control
• L5830 – Addition, endoskeletal knee-shin system, single axis, pneumatic/ swing phase control
• L5840 – Addition, endoskeletal knee/shin system, 4-bar linkage or multiaxial, pneumatic swing phase control
• L5841 – Addition, endoskeletal knee-shin system, polycentric, pneumatic swing, and stance phase control
• L5845 – Addition, endoskeletal, knee-shin system, stance flexion feature, adjustable
• L5848 – Addition to endoskeletal knee-shin system, fluid stance extension, dampening feature, with or without adjustability
• L5850 – Addition, endoskeletal system, above knee or hip disarticulation, knee extension assist
• L5855 – Addition, endoskeletal system, hip disarticulation, mechanical hip extension assist
• L5856 – Addition to lower extremity prosthesis, endoskeletal knee-shin system, microprocessor control feature, swing and stance phase, includes electronic sensor(s), any type
• L5857 – Addition to lower extremity prosthesis, endoskeletal knee-shin system, microprocessor control feature, swing phase only, includes electronic sensor(s), any type
• L5858 – Addition to lower extremity prosthesis, endoskeletal knee shin system, microprocessor control feature, stance phase only, includes electronic sensor(s), any type
• L5859 – Addition to lower extremity prosthesis, endoskeletal knee-shin system, powered and programmable flexion/extension assist control, includes any type motor(s)
• L5910 – Addition, endoskeletal system, below knee, alignable system
• L5920 – Addition, endoskeletal system, above knee or hip disarticulation, alignable system
• L5925 – Addition, endoskeletal system, above knee, knee disarticulation or hip disarticulation, manual lock
• L5926 – Addition to lower extremity prosthesis, endoskeletal, knee disarticulation, above knee, hip disarticulation, positional rotation unit, any type
• L5930 – Addition, endoskeletal system, high activity knee control frame
• L5940 – Addition, endoskeletal system, below knee, ultra-light material (titanium, carbon fiber or equal)
• L5950 – Addition, endoskeletal system, above knee, ultra-light material (titanium, carbon fiber or equal)
• L5960 – Addition, endoskeletal system, hip disarticulation, ultra-light material (titanium, carbon fiber or equal)
• L5961 – Addition, endoskeletal system, polycentric hip joint, pneumatic or hydraulic control, rotation control, with or without flexion and/or extension control
• L5962 – Addition, endoskeletal system, below knee, flexible protective outer surface covering system
• L5964 – Addition, endoskeletal system, above knee, flexible protective outer surface covering system
• L5966 – Addition, endoskeletal system, hip disarticulation, flexible protective outer surface covering system
• L5968 – Addition to lower limb prosthesis, multiaxial ankle with swing phase active dorsiflexion feature
• L5969 – Addition, endoskeletal ankle-foot or ankle system, power assist, includes any type motor(s)
• L5970 – All lower extremity prostheses, foot, external keel, sach foot
• L5971 – All lower extremity prosthesis, solid ankle cushion heel (sach) foot, replacement only
• L5972 – All lower extremity prostheses, foot, flexible keel
• L5973 – Endoskeletal ankle foot system, microprocessor controlled feature, dorsiflexion and/or plantar flexion control, includes power source
• L5974 – All lower extremity prostheses, foot, single axis ankle/foot
• L5975 – All lower extremity prosthesis, combination single axis ankle and flexible keel foot
• L5976 – All lower extremity prostheses, energy storing foot (seattle carbon copy ii or equal)
• L5978 – All lower extremity prostheses, foot, multiaxial ankle/foot
• L5979 – All lower extremity prosthesis, multi-axial ankle, dynamic response foot, one piece system
• 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 – All endoskeletal lower extremity prosthesis, axial rotation unit, with or without adjustability
• 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 pylon
• L5988 – Addition to lower limb prosthesis, vertical shock reducing pylon feature
• L5990 – Addition to lower extremity prosthesis, user adjustable heel height
• L5991 – Addition to lower extremity prostheses, osseointegrated external prosthetic connector
• L5992 – All lower extremity prosthesis, foot shell for modular foot/non-solid ankle cushion heel (sach) replacement only
• L5999 – Lower extremity prosthesis, not otherwise specified
• L6026 – Transcarpal/metacarpal or partial hand disarticulation prosthesis, external power, self-suspended, inner socket with removable forearm section, electrodes and cables, two batteries, charger, myoelectric control of terminal device, excludes terminal device(s)
• L6028 – Partial hand, finger, and thumb prosthesis without prosthetic digit(s) /thumb, amputation at metacarpal level, including flexible or non-flexible interface, molded to patient model, for use without external power and/or passive prosthetic digit/thumb, not including inserts described by l6692
• L6029 – Upper extremity addition, test socket/interface, partial hand including fingers
• L6030 – Upper extremity addition, external frame, partial hand including fingers
• L6031 – Replacement socket/interface, partial hand including fingers, molded to patient model, for use with or without external power
• L6032 – Addition to upper extremity prosthesis, partial hand including fingers, ultralight material (titanium, carbon fiber or equal)
• L6033 – Addition to upper extremity prosthesis, partial hand including fingers, acrylic material
• L6034 – Partial hand, finger, and thumb prosthesis without prosthetic digit(s)/thumb, amputation at distal to metacarpal joint, including flexible or non-flexible interface, molded to patient model, for use without external power and/or passive prosthetic digit/thumb, not including inserts described by l6692
• L6035 – Single prosthetic digit, mechanical, can include metacarpophalangeal (mcp), proximal interphalangeal (pip), and/or distal interphalangeal (dip) joint(s), with or without locking mechanism, can include flexion or extension assist, any material, attachment, initial issue or replacement
• L6036 – Prosthetic thumb, mechanical, can include metacarpophalangeal (mcp), interphalangeal (ip) joint(s), with or without locking mechanism, can include flexion or extension assist, any material, attachment, initial issue or replacement
• L6037 – Immediate post-surgical or early fitting, application of initial rigid dressing, including fitting alignment and suspension of components, and one cast change, partial hand including fingers
• L6038 – Addition to single prosthetic digit or thumb, mechanical, attachment, multiaxial and/or internal/external rotation/abduction/adduction mechanism, with or without locking feature, any material
• L6039 – Passive prosthetic digit or thumb prosthesis not including hand restoration partial hand, full or partial, custom made, any material, initial or replacement, per single passive prosthetic digit or thumb
• L6050 – Wrist disarticulation, molded socket, flexible elbow hinges, triceps pad
• L6055 – Wrist disarticulation, molded socket with expandable interface, flexible elbow hinges, triceps pad
• 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 – Below elbow, molded double wall split socket, stump activated locking hinge, half cuff
• L6200 – Elbow disarticulation, molded socket, outside locking hinge, forearm
• L6205 – Elbow disarticulation, molded socket with expandable interface, outside locking hinges, forearm
• L6250 – Above elbow, molded double wall socket, internal locking elbow, forearm
• L6300 – Shoulder disarticulation, molded socket, shoulder bulkhead, humeral section, internal locking elbow, forearm
• L6310 – Shoulder disarticulation, passive restoration (complete prosthesis)
• L6320 – Shoulder disarticulation, passive restoration (shoulder cap only)
• L6350 – Interscapular thoracic, molded socket, shoulder bulkhead, humeral section, internal locking elbow, forearm
• 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 dressing, including fitting alignment and suspension of components, and one cast change, wrist disarticulation or below elbow
• L6382 – Immediate post surgical or early fitting, application of initial rigid dressing including fitting alignment and suspension of components, and one cast change, elbow disarticulation or above elbow
• L6384 – Immediate post surgical or early fitting, application of initial rigid dressing including fitting alignment and suspension of components, and one cast change, shoulder disarticulation or interscapular thoracic
• L6386 – Immediate post surgical or early fitting, each additional cast change and realignment
• L6388 – Immediate post surgical or early fitting, application of rigid dressing only
• L6400 – Below elbow, molded socket, endoskeletal system, including soft prosthetic tissue shaping
• L6450 – Elbow disarticulation, molded socket, endoskeletal system, including soft prosthetic tissue shaping
• L6500 – Above elbow, molded socket, endoskeletal system, including soft prosthetic tissue shaping
• L6550 – Shoulder disarticulation, molded socket, endoskeletal system, including soft prosthetic tissue shaping
• L6570 – Interscapular thoracic, molded socket, endoskeletal system, including soft prosthetic tissue shaping
• L6580 – Preparatory, wrist disarticulation or below elbow, single wall plastic socket, friction wrist, flexible elbow hinges, figure of eight harness, humeral cuff, bowden cable control, usmc or equal pylon, no cover, molded to patient model
• L6582 – Preparatory, wrist disarticulation or below elbow, single wall socket, friction wrist, flexible elbow hinges, figure of eight harness, humeral cuff, bowden cable control, usmc or equal pylon, no cover, direct formed
• L6584 – Preparatory, elbow disarticulation or above elbow, single wall plastic socket, friction wrist, locking elbow, figure of eight harness, fair lead cable control, usmc or equal pylon, no cover, molded to patient model
• L6586 – Preparatory, elbow disarticulation or above elbow, single wall socket, friction wrist, locking elbow, figure of eight harness, fair lead cable control, usmc or equal pylon, no cover, direct formed
• L6588 – Preparatory, shoulder disarticulation or interscapular thoracic, single wall plastic socket, shoulder joint, locking elbow, friction wrist, chest strap, fair lead cable control, usmc or equal pylon, no cover, molded to patient model
• L6590 – Preparatory, shoulder disarticulation or interscapular thoracic, single wall socket, shoulder joint, locking elbow, friction wrist, chest strap, fair lead cable control, usmc or equal pylon, no cover, direct formed
• 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, any type
• L6615 – Upper extremity addition, disconnect locking wrist unit
• L6616 – Upper extremity addition, additional disconnect insert for locking wrist unit, each
• L6620 – Upper extremity addition, flexion/extension wrist unit, with or without friction
• L6621 – Upper extremity prosthesis addition, flexion/extension wrist with or without friction, for use with external powered terminal device
• L6623 – Upper extremity addition, spring assisted rotational wrist unit with latch release
• 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 equal
• L6629 – Upper extremity addition, quick disconnect lamination collar with coupling piece, otto bock or equal
• 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 use with manually powered 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 – Upper extremity addition, shoulder joint, multipositional locking, flexion, adjustable abduction friction control, for use with body powered or external powered system
• L6647 – Upper extremity addition, shoulder lock mechanism, body powered actuator
• L6648 – Upper extremity addition, shoulder lock mechanism, external powered actuator
• 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 cable design
• L6676 – Upper extremity addition, harness, (e.g., figure of eight type), dual cable design
• L6677 – Upper extremity addition, harness, triple control, simultaneous operation of terminal device and elbow
• L6680 – Upper extremity addition, test socket, wrist disarticulation or below elbow
• L6682 – Upper extremity addition, test socket, elbow disarticulation or above elbow
• L6684 – Upper extremity addition, test socket, shoulder disarticulation or interscapular thoracic
• L6686 – Upper extremity addition, suction socket
• L6687 – Upper extremity addition, frame type socket, below elbow or wrist disarticulation
• L6688 – Upper extremity addition, frame type socket, above elbow or elbow disarticulation
• 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, with or without locking mechanism, each
• L6693 – Upper extremity addition, locking elbow, forearm counterbalance
• L6694 – Addition to upper extremity prosthesis, below elbow/above elbow, custom fabricated from existing mold or prefabricated, socket insert, silicone gel, elastomeric or equal, for use with locking mechanism
• L6695 – Addition to upper extremity prosthesis, below elbow/above elbow, custom fabricated from existing mold or prefabricated, socket insert, silicone gel, elastomeric or equal, not for use with locking mechanism
• L6696 – Addition to upper extremity prosthesis, below elbow/above elbow, custom fabricated socket insert for congenital or atypical traumatic amputee, silicone gel, elastomeric or equal, for use with or without locking mechanism, initial only (for other than initial, use code l6694 or l6695)
• L6697 – Addition to upper extremity prosthesis, below elbow/above elbow, custom fabricated socket insert for other than congenital or atypical traumatic amputee, silicone gel, elastomeric or equal, for use with or without locking mechanism, initial only (for other than initial, use code l6694 or l6695)
• L6698 – Addition to upper extremity prosthesis, lock mechanism, excludes socket insert
• L6700 – Upper extremity addition, external powered feature, myoelectronic control module, additional emg inputs, pattern-recognition decoding intent movement
• 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 size, lined or unlined
• L6707 – Terminal device, hook, mechanical, voluntary closing, any material, any size, lined or unlined
• L6708 – Terminal device, hand, mechanical, voluntary opening, any material, any size
• L6709 – Terminal device, hand, mechanical, voluntary closing, any material, any size
• L6711 – Terminal device, hook, mechanical, voluntary opening, any material, any size, lined or unlined, pediatric
• L6712 – Terminal device, hook, mechanical, voluntary closing, any material, any size, lined or unlined, pediatric
• L6713 – Terminal device, hand, mechanical, voluntary opening, any material, any size, pediatric
• L6714 – Terminal device, hand, mechanical, voluntary closing, any material, any size, pediatric
• L6715 – Terminal device, multiple articulating digit, includes motor(s), initial issue or replacement
• L6721 – Terminal device, hook or hand, heavy duty, mechanical, voluntary opening, any material, any size, lined or unlined
• L6722 – Terminal device, hook or hand, heavy duty, mechanical, voluntary closing, any material, any size, lined or unlined
• L6805 – Addition to terminal device, modifier wrist unit
• L6810 – Addition to terminal device, precision pinch device
• L6880 – Electric hand, switch or myoelectric controlled, independently articulating digits, any grasp pattern or combination of grasp patterns, includes motor(s)
• L6881 – Automatic grasp feature, addition to upper limb electric prosthetic terminal device
• L6882 – Microprocessor control feature, addition to upper limb prosthetic terminal device
• L6883 – Replacement socket, below elbow/wrist disarticulation, molded to patient model, for use with or without external power
• L6884 – Replacement socket, above elbow/elbow disarticulation, molded to patient model, for use with or without external power
• L6885 – Replacement socket, shoulder disarticulation/interscapular thoracic, molded to patient model, for use with or without external power
• L6890 – Addition to upper extremity prosthesis, glove for terminal device, any material, prefabricated, includes fitting and adjustment
• L6895 – Addition to upper extremity prosthesis, glove for terminal device, any material, custom fabricated
• L6900 – Hand restoration (casts, shading and measurements included), partial hand, with glove, thumb or one finger remaining
• L6905 – Hand restoration (casts, shading and measurements included), partial hand, with glove, multiple fingers remaining
• L6910 – Hand restoration (casts, shading and measurements included), partial hand, with glove, no fingers remaining
• L6915 – Hand restoration (shading, and measurements included), replacement glove for above
• L6920 – Wrist disarticulation, external power, self-suspended inner socket, removable forearm shell, otto bock or equal, switch, cables, two batteries and one charger, switch control of terminal device
• L6925 – Wrist disarticulation, external power, self-suspended inner socket, removable forearm shell, otto bock or equal electrodes, cables, two batteries and one charger, myoelectronic control of terminal device
• L6930 – Below elbow, external power, self-suspended inner socket, removable forearm shell, otto bock or equal switch, cables, two batteries and one charger, switch control of terminal device
• L6935 – Below elbow, external power, self-suspended inner socket, removable forearm shell, otto bock or equal electrodes, cables, two batteries and one charger, myoelectronic control of terminal device
• L6940 – Elbow disarticulation, external power, molded inner socket, removable humeral shell, outside locking hinges, forearm, otto bock or equal switch, cables, two batteries and one charger, switch control of terminal device
• L6945 – Elbow disarticulation, external power, molded inner socket, removable humeral shell, outside locking hinges, forearm, otto bock or equal electrodes, cables, two batteries and one charger, myoelectronic control of terminal device
• L6950 – Above elbow, external power, molded inner socket, removable humeral shell, internal locking elbow, forearm, otto bock or equal switch, cables, two batteries and one charger, switch control of terminal device
• L6955 – Above elbow, external power, molded inner socket, removable humeral shell, internal locking elbow, forearm, otto bock or equal electrodes, cables, two batteries and one charger, myoelectronic control of terminal device
• L6960 – Shoulder disarticulation, external power, molded inner socket, removable shoulder shell, shoulder bulkhead, humeral section, mechanical elbow, forearm, otto bock or equal switch, cables, two batteries and one charger, switch control of terminal device
• L6965 – Shoulder disarticulation, external power, molded inner socket, removable shoulder shell, shoulder bulkhead, humeral section, mechanical elbow, forearm, otto bock or equal electrodes, cables, two batteries and one charger, myoelectronic control of terminal device
• L6970 – Interscapular-thoracic, external power, molded inner socket, removable shoulder shell, shoulder bulkhead, humeral section, mechanical elbow, forearm, otto bock or equal switch, cables, two batteries and one charger, switch control of terminal device
• L6975 – Interscapular-thoracic, external power, molded inner socket, removable shoulder shell, shoulder bulkhead, humeral section, mechanical elbow, forearm, otto bock or equal electrodes, cables, two batteries and one charger, myoelectronic control of terminal device
• 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 device
• L7181 – Electronic elbow, microprocessor simultaneous control of elbow and terminal device
• 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 controlled
• L7191 – Electronic elbow, child, variety village or equal, myoelectronically controlled
• L7259 – Electronic wrist rotator, any type
• L7360 – Six volt battery, each
• L7362 – Battery charger, six volt, each
• L7364 – Twelve volt battery, each
• L7366 – Battery charger, twelve volt, each
• L7367 – Lithium ion battery, rechargeable, replacement
• L7368 – Lithium ion battery charger, replacement only
• L7400 – Addition to upper extremity prosthesis, below elbow/wrist disarticulation, ultralight material (titanium, carbon fiber or equal)
• L7401 – Addition to upper extremity prosthesis, above elbow disarticulation, ultralight material (titanium, carbon fiber or equal)
• L7402 – Addition to upper extremity prosthesis, shoulder disarticulation/interscapular thoracic, ultralight material (titanium, carbon fiber or equal)
• L7403 – Addition to upper extremity prosthesis, below elbow/wrist disarticulation, acrylic material
• L7404 – Addition to upper extremity prosthesis, above elbow disarticulation, acrylic material
• L7405 – Addition to upper extremity prosthesis, shoulder disarticulation/interscapular thoracic, acrylic material
• L7406 – Addition to upper extremity prosthesis, user adjustable, mechanical, residual limb volume management system (with or without lamination kit)
• L7499 – Upper extremity prosthesis, not otherwise specified
• 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
• L7700 – Gasket or seal, for use with prosthetic socket insert, any type, each
• L7900 – Male vacuum erection system
• L7902 – Tension ring, for vacuum erection device, any type, replacement only, each
• L8000 – Breast prosthesis, mastectomy bra, without integrated breast prosthesis form, any size, any type
• L8001 – Breast prosthesis, mastectomy bra, with integrated breast prosthesis form, unilateral, any size, any type
• L8002 – Breast prosthesis, mastectomy bra, with integrated breast prosthesis form, bilateral, any size, any type
• L8015 – External breast prosthesis garment, with mastectomy form, post mastectomy
• L8020 – Breast prosthesis, mastectomy form
• L8030 – Breast prosthesis, silicone or equal, without integral adhesive, any type
• L8031 – Breast prosthesis, silicone or equal, with integral adhesive, any type
• L8032 – Nipple prosthesis, prefabricated, reusable, any type, each
• L8033 – Nipple prosthesis, custom fabricated, reusable, any material, any type, each
• L8035 – Custom breast prosthesis, post mastectomy, molded to patient model, any type
• 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-physician
• L8049 – Repair or modification of maxillofacial prosthesis, labor component, 15 minute increments, provided by a non-physician
• 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 knee, each
• 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 – Tracheo-esophageal voice prosthesis, inserted by a licensed health care provider, any type
• L8510 – Voice amplifier
• L8511 – Insert for indwelling tracheoesophageal prosthesis, with or without valve, replacement only, each
• L8512 – Gelatin capsules or equivalent, for use with tracheoesophageal voice prosthesis, replacement only, per 10
• L8513 – Cleaning device used with tracheoesophageal voice prosthesis, pipet, brush, or equal, replacement only, each
• L8514 – Tracheoesophageal puncture dilator, replacement only, each
• L8515 – Gelatin capsule, application device for use with tracheoesophageal voice prosthesis, each
• L8600 – Implantable breast prosthesis, silicone or equal
• L8603 – Injectable bulking agent, collagen implant, urinary tract, 2.5 ml syringe, includes shipping and necessary supplies
• L8604 – Injectable bulking agent, dextranomer/hyaluronic acid copolymer implant, urinary tract, 1 ml, includes shipping and necessary supplies
• L8605 – Injectable bulking agent, dextranomer/hyaluronic acid copolymer implant, anal canal, 1 ml, includes shipping and necessary supplies
• L8606 – Injectable bulking agent, synthetic implant, urinary tract, 1 ml syringe, includes shipping and necessary supplies
• L8607 – Injectable bulking agent for vocal cord medialization, 0.1 ml, includes shipping and necessary supplies
• L8608 – Miscellaneous external component, supply or accessory for use with the argus ii retinal prosthesis system
• 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 or auditory osseointegrated device, replacement
• L8619 – Cochlear implant, external speech processor and controller, integrated system, replacement
• L8621 – Zinc air battery for use with cochlear implant device and auditory osseointegrated sound processors, replacement, each
• L8622 – Alkaline battery for use with cochlear implant device, any size, replacement, each
• L8623 – Lithium ion battery for use with cochlear implant device speech processor, other than ear level, replacement, each
• L8624 – Lithium ion battery for use with cochlear implant or auditory osseointegrated device speech processor, ear level, replacement, each
• L8625 – External recharging system for battery for use with cochlear implant or auditory osseointegrated device, replacement only, each
• L8627 – Cochlear implant, external speech processor, component, replacement
• L8628 – Cochlear implant, external controller component, replacement
• L8629 – Transmitting coil and cable, integrated, for use with cochlear implant device, replacement
• L8630 – Metacarpophalangeal joint implant
• L8631 – Metacarpal phalangeal joint replacement, two or more pieces, metal (e.g., stainless steel or cobalt chrome), ceramic-like material (e.g., pyrocarbon), for surgical implantation (all sizes, includes entire system)
• 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., stainless steel or cobalt chrome), ceramic-like material (e.g., pyrocarbon) for surgical implantation, any size
• L8670 – Vascular graft material, synthetic, implant
• L8678 – Electrical stimulator supplies (external) for use with implantable neurostimulator, per month
• L8679 – Implantable neurostimulator, pulse generator, any type
• L8680 – Implantable neurostimulator electrode, each
• L8681 – Patient programmer (external) for use with implantable programmable neurostimulator pulse generator, replacement only
• L8682 – Implantable neurostimulator radiofrequency receiver
• L8683 – Radiofrequency transmitter (external) for use with implantable neurostimulator radiofrequency receiver
• L8684 – Radiofrequency transmitter (external) for use with implantable sacral root neurostimulator receiver for bowel and bladder management, replacement
• L8685 – Implantable neurostimulator pulse generator, single array, rechargeable, includes extension
• L8686 – Implantable neurostimulator pulse generator, single array, non-rechargeable, includes extension
• L8687 – Implantable neurostimulator pulse generator, dual array, rechargeable, includes extension
• L8688 – Implantable neurostimulator pulse generator, dual array, non-rechargeable, includes extension
• L8689 – External recharging system for battery (internal) for use with implantable neurostimulator, replacement only
• L8690 – Auditory osseointegrated device, includes all internal and external components
• L8691 – Auditory osseointegrated device, external sound processor, excludes transducer/actuator, replacement only, each
• L8692 – Auditory osseointegrated device, external sound processor, used without osseointegration, body worn, includes headband or other means of external attachment
• L8693 – Auditory osseointegrated device abutment, any length, replacement only
• L8694 – Auditory osseointegrated device, transducer/actuator, replacement only, each
• L8695 – External recharging system for battery (external) for use with implantable neurostimulator, replacement only
• L8697 – External accessory for use with implantable phrenic nerve stimulation device, replacement, each
• L8698 – Miscellaneous component, supply or accessory for use with total artificial heart system
• L8699 – Prosthetic implant, not otherwise specified
• L8701 – Powered upper extremity range of motion assist device, elbow, wrist, hand with single or double upright(s), includes microprocessor, sensors, all components and accessories, custom fabricated
• L8702 – Powered upper extremity range of motion assist device, elbow, wrist, hand, finger, single or double upright(s), includes microprocessor, sensors, all components and accessories, custom fabricated
• L8720 – External lower extremity sensory prosthetic device, cutaneous stimulation of mechanoreceptors proximal to the ankle, per leg
• L8721 – Receptor sole for use with l8720, replacement, each
• L9900 – Orthotic and prosthetic supply, accessory, and/or service component of another hcpcs "l" code

Discontinued L codes

• L6000 – Partial hand, thumb remainingDiscontinued March 31, 2026
• L6010 – Partial hand, little and/or ring finger remainingDiscontinued March 31, 2026
• L6020 – Partial hand, no finger remainingDiscontinued March 31, 2026
• L6025 – Transcarpal/metacarpal or partial hand disarticulation prosthesis, external power, self-suspended, inner socket with removable forearm section, electrodes and cables, two batteries, charger, myoelectric control of terminal deviceDiscontinued December 31, 2014
• L7260 – Electronic wrist rotator, otto bock or equalDiscontinued December 31, 2014
• L7261 – Electronic wrist rotator, for utah armDiscontinued December 31, 2014
• L8010 – Breast prosthesis, mastectomy sleeveDiscontinued March 31, 2025
• L8696 – Antenna (external) for use with implantable diaphragmatic/phrenic nerve stimulation device, replacement, eachDiscontinued September 30, 2026