HCPCS Index 2017

Papaverine HCl,   J2440
Paraffin,   A4265
Paraffin bath unit,   E0235
administration kit,   B4224
pump,   B9004, B9006
solution,   B4164 - B5200
Parenteral nutrition solution carbohydrates (dextrose), 50 or less (500 ml 1 unit) - homemix   B4164
Parenteral nutrition solution amino acid, 35, (500 ml 1 unit) - homemix   B4168
Parenteral nutrition solution amino acid, 55 through 7, (500 ml 1 unit) NAME   B4172
Parenteral nutrition solution amino acid, 7 through 85, (500 ml 1 unit) NAME   B4176
Parenteral nutrition solution amino acid, greater than 85 (500 ml 1 unit) NAME   B4178
Parenteral nutrition solution carbohydrates (dextrose), greater than 50 (500 ml1 unit) - homemix   B4180
Parenteral nutrition solution, per 10 grams lipids   B4185
Parenteral nutrition solution compounded amino acid and carbohydrates with electrolytes, trace elements, and vitamins, including preparation, any strength, 10 to 51 grams of protein - premix   B4189
Parenteral nutrition solution compounded amino acid and carbohydrates with electrolytes, trace elements, and vitamins, including preparation, any strength, 52 to 73 grams of protein - premix   B4193
Parenteral nutrition solution compounded amino acid and carbohydrates with electrolytes, trace elements and vitamins, including preparation, any strength, 74 to 100 grams of protein - premix   B4197
Parenteral nutrition solution compounded amino acid and carbohydrates with electrolytes, trace elements and vitamins, including preparation, any strength, over 100 grams of protein - premix   B4199
Parenteral nutrition additives (vitamins, trace elements, heparin, electrolytes) homemix per day   B4216
Parenteral nutrition supply kit premix, per day   B4220
Parenteral nutrition supply kit home mix, per day   B4222
Parenteral nutrition administration kit, per day   B4224
Parenteral nutrition solution compounded amino acid and carbohydrates with electrolytes, trace elements, and vitamins, including preparation, any strength, renal - amirosyn rf, nephramine, renamine - premix   B5000
Parenteral nutrition solution compounded amino acid and carbohydrates with electrolytes, trace elements, and vitamins, including preparation, any strength, hepatic - freamine hbc, hepatamine - premix   B5100
Parenteral nutrition solution compounded amino acid and carbohydrates with electrolytes, trace elements, and vitamins, including preparation, any strength, stress - branch chain amino acids - premix   B5200
supply kit,   B4220, B4222
Pentostatin,   J9268
Percussor,   E0480
Papanicolaou (Pap) screening smear,   P3000, P3001, Q0091
Pacemaker monitor,   E0610, E0615
Paclitaxel,   J9267
Paclitaxel protein-bound particles,   J9264
gel pressure,   E0185, E0196
heat,   E0210, E0215, E0217, E0238, E0249
orthotic device interface,   E1820
sheepskin,   E0188, E0189
water circulating cold with pump,   E0218
water circulating heat with pump,   E0217
water circulating heat unit,   E0249
Pail, for use with commode chair,   E0167
Palate, prosthetic implant,   L8618
Palifermin,   J2425
Paliperidone palmitate,   J2426
Palonosetron HCl,   J2469
Pamidronate disodium,   J2430
Pan, for use with commode chair,   E0167
Panitumumab,   J9303
Paricalcitol,   J2501
Parking fee, nonemergency transport,   A0170
Paste, conductive,   A4558
Pathology and laboratory tests, miscellaneous,   P9010 - P9615
Blood (whole), for transfusion, per unit   P9010
Blood, split unit   P9011
Cryoprecipitate, each unit   P9012
Red blood cells, leukocytes reduced, each unit   P9016
Fresh frozen plasma (single donor), frozen within 8 hours of collection, each unit   P9017
Platelets, each unit   P9019
Platelets, leukocytes reduced, irradiated, each unit   P9033
Platelet rich plasma, each unit   P9020
Red blood cells, each unit   P9021
Red blood cells, washed, each unit   P9022
Plasma, pooled multiple donor, solventdetergent treated, frozen, each unit   P9023
Platelets, leukocytes reduced, each unit   P9031
Platelets, irradiated, each unit   P9032
Platelets, pheresis, each unit   P9034
Platelets, pheresis, leukocytes reduced, each unit   P9035
Platelets, pheresis, irradiated, each unit   P9036
Platelets, pheresis, leukocytes reduced, irradiated, each unit   P9037
Red blood cells, irradiated, each unit   P9038
Red blood cells, deglycerolized, each unit   P9039
Red blood cells, leukocytes reduced, irradiated, each unit   P9040
Infusion, albumin (human), 5, 50 ml   P9041
Infusion, plasma protein fraction (human), 5, 50 ml   P9043
Plasma, cryoprecipitate reduced, each unit   P9044
Infusion, albumin (human), 5, 250 ml   P9045
Infusion, albumin (human), 25, 20 ml   P9046
Infusion, albumin (human), 25, 50 ml   P9047
Infusion, plasma protein fraction (human), 5, 250ml   P9048
Granulocytes, pheresis, each unit   P9050
Whole blood or red blood cells, leukocytes reduced, cmv-negative, each unit   P9051
Platelets, hla-matched leukocytes reduced, apheresispheresis, each unit   P9052
Platelets, pheresis, leukocytes reduced, cmv-negative, irradiated, each unit   P9053
Whole blood or red blood cells, leukocytes reduced, frozen, deglycerol, washed, each unit   P9054
Platelets, leukocytes reduced, cmv-negative, apheresispheresis, each unit   P9055
Whole blood, leukocytes reduced, irradiated, each unit   P9056
Red blood cells, frozendeglycerolizedwashed, leukocytes reduced, irradiated, each unit   P9057
Red blood cells, leukocytes reduced, cmv-negative, irradiated, each unit   P9058
Fresh frozen plasma between 8-24 hours of collection, each unit   P9059
Fresh frozen plasma, donor retested, each unit   P9060
Travel allowance one way in connection with medically necessary laboratory specimen collection drawn from home bound or nursing home bound patient prorated miles actually travelled   P9603
Travel allowance one way in connection with medically necessary laboratory specimen collection drawn from home bound or nursing home bound patient prorated trip charge   P9604
Catheterization for collection of specimen, single patient, all places of service   P9612
Catheterization for collection of specimen (s) (multiple patients)   P9615
Patient support system,   E0636
Patient transfer system,   E1035 - E1036
Multi-positional patient transfer system, with integrated seat, operated by care giver, patient weight capacity up to and including 300 lbs   E1035
Multi-positional patient transfer system, extra-wide, with integrated seat, operated by caregiver, patient weight capacity greater than 300 lbs   E1036
PEFR, peak expiratory flow rate meter,   A4614
Pegademase bovine,   J2504
Pegaptanib,   J2503
Pegaspargase,   J9266
Pegfilgrastim,   J2505
Peginesatide,   J0890
Pegloticase,   J2507
Pelvic beltharnessboot,   E0944
Pemetrexed,   J9305
G benzathineG benzathine and penicillin G procaine,   J0558, J0561
G potassium,   J2540
G procaine, aqueous,   J2510
Pentamidine isethionate,   J2545, J7676
Pentastarch, 10 solution,   J2513
Pentazocine HCl,   J3070
Pentobarbital sodium,   J2515
Percutaneous access system,   A4301
Perflexane lipid microspheres,   Q9955
Perflutren lipid microspheres,   Q9957
Peroneal strap,   L0980
Peroxide,   A4244
Perphenazine,   J3310
Personal care services,   T1019 - T1021
Personal care services, per 15 minutes, not for an inpatient or resident of a hospital, nursing facility, icfmr or imd, part of the individualized plan of treatment (code may not be used to identify services provided by home health aide or certified nurse assistant)   T1019
Personal care services, per diem, not for an inpatient or resident of a hospital, nursing facility, icfmr or imd, part of the individualized plan of treatment (code may not be used to identify services provided by home health aide or certified nurse assistant)   T1020
Home health aide or certified nurse assistant, per visit   T1021
Pertuzumab,   J9306
Pessary,   A4561, A4562
Phenobarbital sodium,   J2560
Phentolamine mesylate,   J2760
Phenylephrine HCl,   J2370
Phenytoin sodium,   J1165
Phisohex solution,   A4246
Phototherapy light,   E0202
Phytonadione,   J3430
Pillow, cervical,   E094
Pinworm examination,   Q0113
single donor, fresh frozen,   P9017
multiple donor, pooled, frozen,   P9023
Plastazote,   L3002, L3252, L3253, L3265, L5654 - L5658
Addition to lower extremity, socket insert, symes, (kemblo, pelite, aliplast, plastazote or equal)   L5654
Addition to lower extremity, socket insert, below knee (kemblo, pelite, aliplast, plastazote or equal)   L5655
Addition to lower extremity, socket insert, knee disarticulation (kemblo, pelite, aliplast, plastazote or equal)   L5656
Addition to lower extremity, socket insert, above knee (kemblo, pelite, aliplast, plastazote or equal)   L5658
concentrate, each unit,   P9019
rich plasma, each unit,   P9020
forearm crutch,   E0153
walker,   E0154
Plerixafor,   J2562
Plicamycin,   J9270
Plumbing, for home ESRD equipment,   A4870
appliance,   E0655 - E0673 , L4350 - L4380
Non-segmental pneumatic appliance for use with pneumatic compressor, half arm   E0655
Segmental pneumatic appliance for use with pneumatic compressor, trunk   E0656
Segmental pneumatic appliance for use with pneumatic compressor, chest   E0657
Non-segmental pneumatic appliance for use with pneumatic compressor, full leg   E0660
Non-segmental pneumatic appliance for use with pneumatic compressor, full arm   E0665
Non-segmental pneumatic appliance for use with pneumatic compressor, half leg   E0666
Segmental pneumatic appliance for use with pneumatic compressor, full leg   E0667
Segmental pneumatic appliance for use with pneumatic compressor, full arm   E0668
Segmental pneumatic appliance for use with pneumatic compressor, half leg   E0669
Segmental pneumatic appliance for use with pneumatic compressor, integrated, 2 full legs and trunk   E0670
Segmental gradient pressure pneumatic appliance, full leg   E0671
Segmental gradient pressure pneumatic appliance, full arm   E0672
Segmental gradient pressure pneumatic appliance, half leg   E0673
Ankle control orthosis, stirrup style, rigid, includes any type interface (e G , pneumatic, gel), prefabricated, includes fitting and adjustment   L4350
Walking boot, pneumatic andor vacuum, with or without joints, with or without interface material, prefabricated, includes fitting and adjustment   L4360
Pneumatic full leg splint, prefabricated, includes fitting and adjustment   L4370
Walking boot, pneumatic andor vacuum, with or without joints, with or without interface material, prefabricated, off-the-shelf   L4361
compressor,   E0650 - E0652
Pneumatic compressor, non-segmental home model   E0650
Pneumatic compressor, segmental home model without calibrated gradient pressure   E0651
Pneumatic compressor, segmental home model with calibrated gradient pressure   E0652
splint,   L4350 - L4380
Ankle control orthosis, stirrup style, rigid, includes any type interface (e G , pneumatic, gel), prefabricated, includes fitting and adjustment   L4350
Walking boot, pneumatic andor vacuum, with or without joints, with or without interface material, prefabricated, includes fitting and adjustment   L4360
Pneumatic full leg splint, prefabricated, includes fitting and adjustment   L4370
Walking boot, pneumatic andor vacuum, with or without joints, with or without interface material, prefabricated, off-the-shelf   L4361
ventricular assist device,   Q0480 - Q0505
Driver for use with pneumatic ventricular assist device, replacement only   Q0480
Microprocessor control unit for use with electric ventricular assist device, replacement only   Q0481
Microprocessor control unit for use with electricpneumatic combination ventricular assist device, replacement only   Q0482
Monitordisplay module for use with electric ventricular assist device, replacement only   Q0483
Monitordisplay module for use with electric or electricpneumatic ventricular assist device, replacement only   Q0484
Monitor control cable for use with electric ventricular assist device, replacement only   Q0485
Monitor control cable for use with electricpneumatic ventricular assist device, replacement only   Q0486
Leads (pneumaticelectrical) for use with any type electricpneumatic ventricular assist device, replacement only   Q0487
Power pack base for use with electric ventricular assist device, replacement only   Q0488
Power pack base for use with electricpneumatic ventricular assist device, replacement only   Q0489
Emergency power source for use with electric ventricular assist device, replacement only   Q0490
Emergency power source for use with electricpneumatic ventricular assist device, replacement only   Q0491
Emergency power supply cable for use with electric ventricular assist device, replacement only   Q0492
Emergency power supply cable for use with electricpneumatic ventricular assist device, replacement only   Q0493
Emergency hand pump for use with electric or electricpneumatic ventricular assist device, replacement only   Q0494
Batterypower pack charger for use with electric or electricpneumatic ventricular assist device, replacement only   Q0495
Battery, other than lithium-ion, for use with electric or electricpneumatic ventricular assist device, replacement only   Q0496
Battery clips for use with electric or electricpneumatic ventricular assist device, replacement only   Q0497
Holster for use with electric or electricpneumatic ventricular assist device, replacement only   Q0498
Beltvestbag for use to carry external peripheral components of any type ventricular assist device, replacement only   Q0499
Filters for use with electric or electricpneumatic ventricular assist device, replacement only   Q0500
Shower cover for use with electric or electricpneumatic ventricular assist device, replacement only   Q0501
Mobility cart for pneumatic ventricular assist device, replacement only   Q0502
Battery for pneumatic ventricular assist device, replacement only, each   Q0503
Power adapter for pneumatic ventricular assist device, replacement only, vehicle type   Q0504
administration set, small volume, filtered,   A7006
administration set, small volume, nonfiltered,   A7003
administration set, small volume, nonfiltered, non-disposable,   A7005
small volume, disposable,   A7004
Porfimer,   J9600
equipment transfer,   R0070 - R0076
Transportation of portable x-ray equipment and personnel to home or nursing home, per trip to facility or location, one patient seen   R0070
Transportation of portable x-ray equipment and personnel to home or nursing home, per trip to facility or location, more than one patient seen   R0075
Transportation of portable ekg to facility or location, per patient   R0076
gaseous oxygen,   K0741, K0742
hemodialyzer system,   E1635
liquid oxygen system,   E0433
x-ray equipment,   Q0092
Positioning seat,   T5001
Positive airway pressure device, accessories,   A7030 - A7039 , E0561 - E0562
Full face mask used with positive airway pressure device, each   A7030
Face mask interface, replacement for full face mask, each   A7031
Cushion for use on nasal mask interface, replacement only, each   A7032
Pillow for use on nasal cannula type interface, replacement only, pair   A7033
Nasal interface (mask or cannula type) used with positive airway pressure device, with or without head strap   A7034
Headgear used with positive airway pressure device   A7035
Chinstrap used with positive airway pressure device   A7036
Tubing used with positive airway pressure device   A7037
Filter, disposable, used with positive airway pressure device   A7038
Filter, non disposable, used with positive airway pressure device   A7039
Humidifier, non-heated, used with positive airway pressure device   E0561
Humidifier, heated, used with positive airway pressure device   E0562
Positive expiratory pressure device,   E0484
Post-coital examination,   Q0115
Postural drainage board,   E0606
Potassium chloride,   J3480
Potassium hydroxide (KOH) preparation,   Q0112
fecal collection,   A4330
ostomy,   A4375 - A4378 , A5051 - A5054 , A5061 - A5065
Ostomy pouch, drainable, with faceplate attached, plastic, each   A4375
Ostomy pouch, drainable, with faceplate attached, rubber, each   A4376
Ostomy pouch, drainable, for use on faceplate, plastic, each   A4377
Ostomy pouch, drainable, for use on faceplate, rubber, each   A4378
Ostomy pouch, closed with barrier attached (1 piece), each   A5051
Ostomy pouch, closed without barrier attached (1 piece), each   A5052
Ostomy pouch, closed for use on faceplate, each   A5053
Ostomy pouch, closed for use on barrier with flange (2 piece), each   A5054
Ostomy pouch, drainable with barrier attached, (1 piece), each   A5061
Ostomy pouch, drainable without barrier attached (1 piece), each   A5062
Ostomy pouch, drainable for use on barrier with flange (2 piece system), each   A5063
urinary,   A4379 - A4383 , A5071 - A5075
Ostomy pouch, urinary, with faceplate attached, plastic, each   A4379
Ostomy pouch, urinary, with faceplate attached, rubber, each   A4380
Ostomy pouch, urinary, for use on faceplate, plastic, each   A4381
Ostomy pouch, urinary, for use on faceplate, heavy plastic, each   A4382
Ostomy pouch, urinary, for use on faceplate, rubber, each   A4383
Ostomy pouch, urinary with barrier attached (1 piece), each   A5071
Ostomy pouch, urinary without barrier attached (1 piece), each   A5072
Ostomy pouch, urinary for use on barrier with flange (2 piece), each   A5073
Pralatrexate,   J9307
Pralidoxime chloride,   J2730
acetate,   J2650
oral,   J7506, J7510
Prednisone,   J7506
Preparation kits, dialysis,   A491
Preparatory prosthesis,   L5510 - L5595
Preparatory, below knee 'ptb' type socket, non-alignable system, pylon, no cover, sach foot, plaster socket, molded to model   L5510
Preparatory, below knee 'ptb' type socket, non-alignable system, pylon, no cover, sach foot, thermoplastic or equal, direct formed   L5520
Preparatory, below knee 'ptb' type socket, non-alignable system, pylon, no cover, sach foot, thermoplastic or equal, molded to model   L5530
Preparatory, below knee 'ptb' type socket, non-alignable system, no cover, sach foot, prefabricated, adjustable open end socket   L5535
Preparatory, below knee 'ptb' type socket, non-alignable system, pylon, no cover, sach foot, laminated socket, molded to model   L5540
Preparatory, above knee- knee disarticulation, ischial level socket, non-alignable system, pylon, no cover, sach foot, plaster socket, molded to model   L5560
Preparatory, above knee - knee disarticulation, ischial level socket, non-alignable system, pylon, no cover, sach foot, thermoplastic or equal, direct formed   L5570
Preparatory, above knee - knee disarticulation ischial level socket, non-alignable system, pylon, no cover, sach foot, thermoplastic or equal, molded to model   L5580
Preparatory, above knee - knee disarticulation, ischial level socket, non-alignable system, pylon, no cover, sach foot, prefabricated adjustable open end socket   L5585
Preparatory, above knee - knee disarticulation ischial level socket, non-alignable system, pylon no cover, sach foot, laminated socket, molded to model   L5590
Preparatory, hip disarticulation-hemipelvectomy, pylon, no cover, sach foot, thermoplastic or equal, molded to patient model   L5595
chemotherapy,   J8999
nonchemotherapy,   J8499
alarm, dialysis,   E1540
pad,   A4640, E0180 - E0199
Powered pressure reducing mattress overlaypad, alternating, with pump, includes heavy duty   E0181
Pump for alternating pressure pad, for replacement only   E0182
Dry pressure mattress   E0184
Gel or gel-like pressure pad for mattress, standard mattress length and width   E0185
Air pressure mattress   E0186
Water pressure mattress   E0187
Synthetic sheepskin pad   E0188
Lambswool sheepskin pad, any size   E0189
Positioning cushionpillowwedge, any shape or size, includes all components and accessories   E0190
Heel or elbow protector, each   E0191
Powered air flotation bed (low air loss therapy)   E0193
Air fluidized bed   E0194
Gel pressure mattress   E0196
Air pressure pad for mattress, standard mattress length and width   E0197
Water pressure pad for mattress, standard mattress length and width   E0198
Dry pressure pad for mattress, standard mattress length and width   E0199
Privigen,   J1459
Procainamide HCl,   J2690
Prochlorperazine,   J0780
Prolotherapy,   M0076
Promazine HCl,   J2950
Promethazine HCl,   J2550
Promethazine and meperdine,   J2180
Propranolol HCl,   J1800
artificial larynx batteryaccessory,   L8505
breast,   L8000 - L8035 , L8600
Breast prosthesis, mastectomy bra, without integrated breast prosthesis form, any size, any type   L8000
Breast prosthesis, mastectomy bra, with integrated breast prosthesis form, unilateral, any size, any type   L8001
Breast prosthesis, mastectomy bra, with integrated breast prosthesis form, bilateral, any size, any type   L8002
Breast prosthesis, mastectomy sleeve   L8010
External breast prosthesis garment, with mastectomy form, post mastectomy   L8015
Breast prosthesis, mastectomy form   L8020
Breast prosthesis, silicone or equal, without integral adhesive   L8030
Breast prosthesis, silicone or equal, with integral adhesive   L8031
Nipple prosthesis, reusable, any type, each   L8032
Custom breast prosthesis, post mastectomy, molded to patient model   L8035
eye,   L8610, L8611, V2623 - V2629
Prosthetic eye, plastic, custom   V2623
Polishingresurfacing of ocular prosthesis   V2624
Enlargement of ocular prosthesis   V2625
Reduction of ocular prosthesis   V2626
Scleral cover shell   V2627
Fabrication and fitting of ocular conformer   V2628
Prosthetic eye, other type   V2629
fitting,   L5400 - L5460 , L6380 - L6388
Immediate post surgical or early fitting, application of initial rigid dressing, including fitting, alignment, suspension, and one cast change, below knee   L5400
Immediate post surgical or early fitting, application of initial rigid dressing, including fitting, alignment and suspension, below knee, each additional cast change and realignment   L5410
Immediate post surgical or early fitting, application of initial rigid dressing, including fitting, alignment and suspension and one cast change 'ak' or knee disarticulation   L5420
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   L5430
Immediate post surgical or early fitting, application of non-weight bearing rigid dressing, below knee   L5450
Immediate post surgical or early fitting, application of non-weight bearing rigid dressing, above knee   L5460
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   L6380
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   L6382
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   L6384
Immediate post surgical or early fitting, each additional cast change and realignment   L6386
Immediate post surgical or early fitting, application of rigid dressing only   L6388
footankle one piece system,   L5979
hand,   L6000 - L6020 , L6026
Partial hand, thumb remaining   L6000
Partial hand, little andor ring finger remaining   L6010
Partial hand, no finger remaining   L6020
implants,   L8600 - L8690
Implantable neurostimulator electrode, each   L8680
Metacarpophalangeal joint implant   L8630
Vascular graft material, synthetic, implant   L8670
Artificial cornea   L8609
Interphalangeal joint spacer, silicone or equal, each   L8658
Metatarsal joint implant   L8641
Injectable bulking agent, collagen implant, urinary tract, 25 ml syringe, includes shipping and necessary supplies   L8603
Metacarpal phalangeal joint replacement, two or more pieces, metal (eg stainless steel or cobalt chrome), ceramic-like material (eg pyrocarbon), for surgical implantation (all sizes, includes entire system)   L8631
Interphalangeal finger joint replacement, 2 or more pieces, metal (eg stainless steel or cobalt chrome), ceramic-like material (eg pyrocarbon) for surgical implantation, any size   L8659
Injectable bulking agent, dextranomerhyaluronic acid copolymer implant, urinary tract, 1 ml, includes shipping and necessary supplies   L8604
Ocular implant   L8610
Patient programmer (external) for use with implantable programmable neurostimulator pulse generator, replacement only   L8681
Hallux implant   L8642
Injectable bulking agent, dextranomerhyaluronic acid copolymer implant, anal canal, 1 ml, includes shipping and necessary supplies   L8605
Implantable neurostimulator radiofrequency receiver   L8682
Aqueous shunt   L8612
Injectable bulking agent, synthetic implant, urinary tract, 1 ml syringe, includes shipping and necessary supplies   L8606
Ossicula implant   L8613
Radiofrequency transmitter (external) for use with implantable neurostimulator radiofrequency receiver   L8683
Radiofrequency transmitter (external) for use with implantable sacral root neurostimulator receiver for bowel and bladder management, replacement   L8684
Cochlear device, includes all internal and external components   L8614
Headsetheadpiece for use with cochlear implant device, replacement   L8615
Implantable neurostimulator pulse generator, single array, rechargeable, includes extension   L8685
Microphone for use with cochlear implant device, replacement   L8616
Implantable neurostimulator pulse generator, single array, non-rechargeable, includes extension   L8686
Transmitting coil for use with cochlear implant device, replacement   L8617
Implantable neurostimulator pulse generator, dual array, rechargeable, includes extension   L8687
Transmitter cable for use with cochlear implant device, replacement   L8618
Implantable neurostimulator pulse generator, dual array, non-rechargeable, includes extension   L8688
Cochlear implant, external speech processor and controller, integrated system, replacement   L8619
External recharging system for battery (internal) for use with implantable neurostimulator, replacement only   L8689
Auditory osseointegrated device, includes all internal and external components   L8690
Zinc air battery for use with cochlear implant device, replacement, each   L8621
Implantable breast prosthesis, silicone or equal   L8600
Alkaline battery for use with cochlear implant device, any size, replacement, each   L8622
Lithium ion battery for use with cochlear implant device speech processor, other than ear level, replacement, each   L8623
Lithium ion battery for use with cochlear implant device speech processor, ear level, replacement, each   L8624
Cochlear implant, external speech processor, component, replacement   L8627
Cochlear implant, external controller component, replacement   L8628
Transmitting coil and cable, integrated, for use with cochlear implant device, replacement   L8629
Implantable neurostimulator, pulse generator, any type   L8679
larynx,   L8500
lower extremity,   L5700 - L5999 , L8640 - L8642
Addition, exoskeletal knee-shin system, single axis, manual lock   L5710
Addition, exoskeletal system, below knee, ultra-light material (titanium, carbon fiber or equal)   L5785
Replacement, socket, below knee, molded to patient model   L5700
Addition, endoskeletal knee-shin system, single axis, manual lock   L5810
Addition, endoskeletal knee-shin system, single axis, manual lock, ultra-light material   L5811
Replacement, socket, above kneeknee disarticulation, including attachment plate, molded to patient model   L5701
Additions exoskeletal knee-shin system, single axis, manual lock, ultra-light material   L5711
Addition, exoskeletal system, above knee, ultra-light material (titanium, carbon fiber or equal)   L5790
Addition, exoskeletal system, hip disarticulation, ultra-light material (titanium, carbon fiber or equal)   L5795
Addition, endoskeletal knee-shin system, single axis, friction swing and stance phase control (safety knee)   L5812
Replacement, socket, hip disarticulation, including hip joint, molded to patient model   L5702
Addition, exoskeletal knee-shin system, single axis, friction swing and stance phase control (safety knee)   L5712
Addition, endoskeletal knee-shin system, polycentric, hydraulic swing phase control, mechanical stance phase lock   L5814
Ankle, symes, molded to patient model, socket without solid ankle cushion heel (sach) foot, replacement only   L5703
Addition, exoskeletal knee-shin system, single axis, variable friction swing phase control   L5714
Addition, exoskeletal knee-shin system, polycentric, mechanical stance phase lock   L5716
Custom shaped protective cover, below knee   L5704
Addition, endoskeletal knee-shin system, polycentric, mechanical stance phase lock   L5816
Addition, endoskeletal knee-shin system, polycentric, friction swing, and stance phase control   L5818
Custom shaped protective cover, above knee   L5705
Addition, exoskeletal knee-shin system, polycentric, friction swing and stance phase control   L5718
Addition, exoskeletal knee-shin system, single axis, pneumatic swing, friction stance phase control   L5722
Addition, endoskeletal knee-shin system, single axis, pneumatic swing, friction stance phase control   L5822
Custom shaped protective cover, knee disarticulation   L5706
Addition, endoskeletal knee-shin system, single axis, fluid swing phase control   L5824
Addition, exoskeletal knee-shin system, single axis, fluid swing phase control   L5724
Custom shaped protective cover, hip disarticulation   L5707
Addition, endoskeletal knee-shin system, single axis, hydraulic swing phase control, with miniature high activity frame   L5826
Addition, exoskeletal knee-shin system, single axis, external joints fluid swing phase control   L5726
Addition, exoskeletal knee-shin system, single axis, fluid swing and stance phase control   L5728
Addition, endoskeletal knee-shin system, single axis, fluid swing and stance phase control   L5828
Addition, endoskeletal knee-shin system, single axis, pneumatic swing phase control   L5830
Addition, exoskeletal knee-shin system, single axis, pneumatichydra pneumatic swing phase control   L5780
Addition to lower limb prosthesis, vacuum pump, residual limb volume management and moisture evacuation system   L5781
Addition, endoskeletal kneeshin system, 4-bar linkage or multiaxial, pneumatic swing phase control   L5840
Addition, endoskeletal, knee-shin system, stance flexion feature, adjustable   L5845
Addition to lower limb prosthesis, vacuum pump, residual limb volume management and moisture evacuation system, heavy duty   L5782
Addition to endoskeletal knee-shin system, fluid stance extension, dampening feature, with or without adjustability   L5848
Addition, endoskeletal system, above knee or hip disarticulation, knee extension assist   L5850
Addition, endoskeletal system, hip disarticulation, mechanical hip extension assist   L5855
Addition to lower extremity prosthesis, endoskeletal knee-shin system, microprocessor control feature, swing and stance phase, includes electronic sensor(s), any type   L5856
Addition to lower extremity prosthesis, endoskeletal knee-shin system, microprocessor control feature, swing phase only, includes electronic sensor(s), any type   L5857
Addition to lower extremity prosthesis, endoskeletal knee shin system, microprocessor control feature, stance phase only, includes electronic sensor(s), any type   L5858
Addition to lower extremity prosthesis, endoskeletal knee-shin system, powered and programmable flexionextension assist control, includes any type motor(s)   L5859
Addition, endoskeletal system, below knee, alignable system   L5910
Addition, endoskeletal system, above knee or hip disarticulation, alignable system   L5920
Addition, endoskeletal ankle-foot or ankle system, power assist, includes any type motor(s)   L5969
Addition, endoskeletal system, above knee, knee disarticulation or hip disarticulation, manual lock   L5925
Addition, endoskeletal system, high activity knee control frame   L5930
Addition, endoskeletal system, below knee, ultra-light material (titanium, carbon fiber or equal)   L5940
Addition, endoskeletal system, above knee, ultra-light material (titanium, carbon fiber or equal)   L5950
Addition, endoskeletal system, hip disarticulation, ultra-light material (titanium, carbon fiber or equal)   L5960
Addition, endoskeletal system, polycentric hip joint, pneumatic or hydraulic control, rotation control, with or without flexion andor extension control   L5961
Addition, endoskeletal system, below knee, flexible protective outer surface covering system   L5962
Addition, endoskeletal system, above knee, flexible protective outer surface covering system   L5964
Addition, endoskeletal system, hip disarticulation, flexible protective outer surface covering system   L5966
Addition to lower limb prosthesis, multiaxial ankle with swing phase active dorsiflexion feature   L5968
All lower extremity prostheses, foot, external keel, sach foot   L5970
All lower extremity prosthesis, solid ankle cushion heel (sach) foot, replacement only   L5971
All lower extremity prostheses, foot, flexible keel   L5972
Endoskeletal ankle foot system, microprocessor controlled feature, dorsiflexion andor plantar flexion control, includes power source   L5973
All lower extremity prostheses, foot, single axis anklefoot   L5974
All lower extremity prosthesis, combination single axis ankle and flexible keel foot   L5975
All lower extremity prostheses, energy storing foot (seattle carbon copy ii or equal)   L5976
All lower extremity prostheses, foot, multiaxial anklefoot   L5978
All lower extremity prosthesis, multi-axial ankle, dynamic response foot, one piece system   L5979
All lower extremity prostheses, flex foot system   L5980
All lower extremity prostheses, flex-walk system or equal   L5981
All exoskeletal lower extremity prostheses, axial rotation unit   L5982
All endoskeletal lower extremity prosthesis, axial rotation unit, with or without adjustability   L5984
All endoskeletal lower extremity prostheses, dynamic prosthetic pylon   L5985
All lower extremity prostheses, multi-axial rotation unit ('mcp' or equal)   L5986
All lower extremity prosthesis, shank foot system with vertical loading pylon   L5987
Addition to lower limb prosthesis, vertical shock reducing pylon feature   L5988
Addition to lower extremity prosthesis, user adjustable heel height   L5990
Lower extremity prosthesis, not otherwise specified   L5999
Metatarsal joint implant   L8641
Hallux implant   L8642
mandible,   L8617
maxilla,   L8616
maxillofacial, provided by a non-physician,   L8040 - L8048
Nasal prosthesis, provided by a non-physician   L8040
Midfacial prosthesis, provided by a non-physician   L8041
Orbital prosthesis, provided by a non-physician   L8042
Upper facial prosthesis, provided by a non-physician   L8043
Hemi-facial prosthesis, provided by a non-physician   L8044
Auricular prosthesis, provided by a non-physician   L8045
Partial facial prosthesis, provided by a non-physician   L8046
Nasal septal prosthesis, provided by a non-physician   L8047
Unspecified maxillofacial prosthesis, by report, provided by a non-physician   L8048
miscellaneous service,   L8499
ocular,   V2623 - V2629
Prosthetic eye, plastic, custom   V2623
Polishingresurfacing of ocular prosthesis   V2624
Enlargement of ocular prosthesis   V2625
Reduction of ocular prosthesis   V2626
Scleral cover shell   V2627
Fabrication and fitting of ocular conformer   V2628
Prosthetic eye, other type   V2629
repair of,   L7520, L8049
socks (shrinker, sheath, stump sock),   L8400 - L8485
Prosthetic sock, multiple ply, below knee, each   L8420
Prosthetic sock, multiple ply, above knee, each   L8430
Prosthetic sheath, below knee, each   L8400
Prosthetic sheath, above knee, each   L8410
Prosthetic sheath, upper limb, each   L8415
Prosthetic sheathsock, including a gel cushion layer, below knee or above knee, each   L8417
Prosthetic sock, multiple ply, upper limb, each   L8435
Prosthetic shrinker, below knee, each   L8440
Prosthetic shrinker, above knee, each   L8460
Prosthetic shrinker, upper limb, each   L8465
Prosthetic sock, single ply, fitting, below knee, each   L8470
Prosthetic sock, single ply, fitting, above knee, each   L8480
Prosthetic sock, single ply, fitting, upper limb, each   L8485
taxes, orthoticprostheticother,   L999
tracheo-esophageal,   L8507 - L8509
Tracheo-esophageal voice prosthesis, patient inserted, any type, each   L8507
Tracheo-esophageal voice prosthesis, inserted by a licensed health care provider, any type   L8509
upper extremity,   L6000 - L6999
Shoulder disarticulation, molded socket, endoskeletal system, including soft prosthetic tissue shaping   L6550
Elbow disarticulation, molded socket, outside locking hinge, forearm   L6200
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   L6920
Wrist disarticulation, molded socket, flexible elbow hinges, triceps pad   L6050
Addition to upper extremity prosthesis, glove for terminal device, any material, prefabricated, includes fitting and adjustment   L6890
Partial hand, thumb remaining   L6000
Elbow disarticulation, molded socket, endoskeletal system, including soft prosthetic tissue shaping   L6450
Hand restoration (casts, shading and measurements included), partial hand, with glove, thumb or one finger remaining   L6900
Shoulder disarticulation, molded socket, shoulder bulkhead, humeral section, internal locking elbow, forearm   L6300
Interscapular thoracic, molded socket, endoskeletal system, including soft prosthetic tissue shaping   L6570
Above elbow, molded double wall socket, internal locking elbow, forearm   L6250
Below elbow, molded socket, flexible elbow hinge, triceps pad   L6100
Upper extremity additions, polycentric hinge, pair   L6600
Above elbow, molded socket, endoskeletal system, including soft prosthetic tissue shaping   L6500
Below elbow, molded socket, endoskeletal system, including soft prosthetic tissue shaping   L6400
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   L6380
Interscapular thoracic, molded socket, shoulder bulkhead, humeral section, internal locking elbow, forearm   L6350
Terminal device, passive handmitt, any material, any size   L6703
Elbow disarticulation, molded socket with expandable interface, outside locking hinges, forearm   L6205
Shoulder disarticulation, passive restoration (complete prosthesis)   L6310
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   L6580
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   L6382
Below elbow, molded socket, (muenster or northwestern suspension types)   L6110
Interscapular thoracic, passive restoration (complete prosthesis)   L6360
Terminal device, sportrecreationalwork attachment, any material, any size   L6704
Wrist disarticulation, molded socket with expandable interface, flexible elbow hinges, triceps pad   L6055
Partial hand, little andor ring finger remaining   L6010
Addition to upper extremity prosthesis, glove for terminal device, any material, custom fabricated   L6895
Upper extremity additions, single pivot hinge, pair   L6605
Hand restoration (casts, shading and measurements included), partial hand, with glove, multiple fingers remaining   L6905
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   L6925
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   L6582
Shoulder disarticulation, passive restoration (shoulder cap only)   L6320
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   L6930
Upper extremity additions, flexible metal hinge, pair   L6610
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   L6384
Hand restoration (casts, shading and measurements included), partial hand, with glove, no fingers remaining   L6910
Terminal device, hook, mechanical, voluntary opening, any material, any size, lined or unlined   L6706
Partial hand, no finger remaining   L6020
Interscapular thoracic, passive restoration (shoulder cap only)   L6370
Below elbow, molded double wall split socket, step-up hinges, half cuff   L6120
Immediate post surgical or early fitting, each additional cast change and realignment   L6386
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   L6584
Addition to upper extremity prosthesis, external powered, additional switch, any type   L6611
Terminal device, hook, mechanical, voluntary closing, any material, any size, lined or unlined   L6707
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   L6935
Hand restoration (shading, and measurements included), replacement glove for above   L6915
Transcarpalmetacarpal 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   L6025
Below elbow, molded double wall split socket, stump activated locking hinge, half cuff   L6130
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   L6586
Immediate post surgical or early fitting, application of rigid dressing only   L6388
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   L6940
Upper extremity addition, disconnect locking wrist unit   L6615
Terminal device, hand, mechanical, voluntary opening, any material, any size   L6708
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   L6588
Upper extremity addition, additional disconnect insert for locking wrist unit, each   L6616
Terminal device, hand, mechanical, voluntary closing, any material, any size   L6709
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   L6945
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   L6950
Upper extremity addition, flexionextension wrist unit, with or without friction   L6620
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   L6590
Terminal device, hook, mechanical, voluntary opening, any material, any size, lined or unlined, pediatric   L6711
Terminal device, hook, mechanical, voluntary closing, any material, any size, lined or unlined, pediatric   L6712
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   L6955
Upper extremity prosthesis addition, flexionextension wrist with or without friction, for use with external powered terminal device   L6621
Upper extremity addition, spring assisted rotational wrist unit with latch release   L6623
Terminal device, hand, mechanical, voluntary opening, any material, any size, pediatric   L6713
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   L6960
Terminal device, hand, mechanical, voluntary closing, any material, any size, pediatric   L6714
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   L6965
Upper extremity addition, flexionextension and rotation wrist unit   L6624
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   L6970
Terminal device, multiple articulating digit, includes motor(s), initial issue or replacement   L6715
Upper extremity addition, rotation wrist unit with cable lock   L6625
Upper extremity addition, quick disconnect hook adapter, otto bock or equal   L6628
Terminal device, hook or hand, heavy duty, mechanical, voluntary opening, any material, any size, lined or unlined   L6721
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   L6975
Upper extremity addition, quick disconnect lamination collar with coupling piece, otto bock or equal   L6629
Terminal device, hook or hand, heavy duty, mechanical, voluntary closing, any material, any size, lined or unlined   L6722
Upper extremity addition, stainless steel, any wrist   L6630
Addition to terminal device, modifier wrist unit   L6805
Addition to terminal device, precision pinch device   L6810
Upper extremity addition, latex suspension sleeve, each   L6632
Upper extremity addition, lift assist for elbow   L6635
Electric hand, switch or myolelectric controlled, independently articulating digits, any grasp pattern or combination of grasp patterns, includes motor(s)   L6880
Automatic grasp feature, addition to upper limb electric prosthetic terminal device   L6881
Upper extremity addition, nudge control elbow lock   L6637
Upper extremity addition to prosthesis, electric locking feature, only for use with manually powered elbow   L6638
Microprocessor control feature, addition to upper limb prosthetic terminal device   L6882
Upper extremity additions, shoulder abduction joint, pair   L6640
Replacement socket, below elbowwrist disarticulation, molded to patient model, for use with or without external power   L6883
Replacement socket, above elbowelbow disarticulation, molded to patient model, for use with or without external power   L6884
Upper extremity addition, excursion amplifier, pulley type   L6641
Upper extremity addition, excursion amplifier, lever type   L6642
Replacement socket, shoulder disarticulationinterscapular thoracic, molded to patient model, for use with or without external power   L6885
Upper extremity addition, shoulder flexion-abduction joint, each   L6645
Upper extremity addition, shoulder joint, multipositional locking, flexion, adjustable abduction friction control, for use with body powered or external powered system   L6646
Upper extremity addition, shoulder lock mechanism, body powered actuator   L6647
Upper extremity addition, shoulder lock mechanism, external powered actuator   L6648
Upper extremity addition, shoulder universal joint, each   L6650
Upper extremity addition, standard control cable, extra   L6655
Upper extremity addition, heavy duty control cable   L6660
Upper extremity addition, teflon, or equal, cable lining   L6665
Upper extremity addition, hook to hand, cable adapter   L6670
Upper extremity addition, harness, chest or shoulder, saddle type   L6672
Upper extremity addition, harness, (eg figure of eight type), single cable design   L6675
Upper extremity addition, harness, (eg figure of eight type), dual cable design   L6676
Upper extremity addition, harness, triple control, simultaneous operation of terminal device and elbow   L6677
Upper extremity addition, test socket, wrist disarticulation or below elbow   L6680
Upper extremity addition, test socket, elbow disarticulation or above elbow   L6682
Upper extremity addition, test socket, shoulder disarticulation or interscapular thoracic   L6684
Upper extremity addition, suction socket   L6686
Upper extremity addition, frame type socket, below elbow or wrist disarticulation   L6687
Upper extremity addition, frame type socket, above elbow or elbow disarticulation   L6688
Upper extremity addition, frame type socket, shoulder disarticulation   L6689
Upper extremity addition, frame type socket, interscapular-thoracic   L6690
Upper extremity addition, removable insert, each   L6691
Upper extremity addition, silicone gel insert or equal, each   L6692
Upper extremity addition, locking elbow, forearm counterbalance   L6693
Addition to upper extremity prosthesis, below elbowabove elbow, custom fabricated from existing mold or prefabricated, socket insert, silicone gel, elastomeric or equal, for use with locking mechanism   L6694
Addition to upper extremity prosthesis, below elbowabove elbow, custom fabricated from existing mold or prefabricated, socket insert, silicone gel, elastomeric or equal, not for use with locking mechanism   L6695
Addition to upper extremity prosthesis, below elbowabove 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)   L6696
Addition to upper extremity prosthesis, below elbowabove 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)   L6697
Addition to upper extremity prosthesis, below elbowabove elbow, lock mechanism, excludes socket insert   L6698
vacuum erection system,   L7900
lower extremity,   L5610 - L5999
Addition to lower extremity, socket insert, symes, (kemblo, pelite, aliplast, plastazote or equal)   L5654
Addition, exoskeletal system, below knee, ultra-light material (titanium, carbon fiber or equal)   L5785
Addition to lower extremity, test socket, symes   L5618
Addition, exoskeletal knee-shin system, single axis, manual lock   L5710
Addition to lower extremity, symes type, expandable wall socket   L5630
Replacement, socket, below knee, molded to patient model   L5700
Addition to lower extremity, endoskeletal system, above knee, hydracadence system   L5610
Addition, endoskeletal knee-shin system, single axis, manual lock   L5810
Addition, endoskeletal knee-shin system, single axis, manual lock, ultra-light material   L5811
Replacement, socket, above kneeknee disarticulation, including attachment plate, molded to patient model   L5701
Addition, exoskeletal system, above knee, ultra-light material (titanium, carbon fiber or equal)   L5790
Addition to lower extremity, socket insert, below knee (kemblo, pelite, aliplast, plastazote or equal)   L5655
Addition to lower extremity, test socket, below knee   L5620
Addition to lower extremity, endoskeletal system, above knee - knee disarticulation, 4 bar linkage, with friction swing phase control   L5611
Additions exoskeletal knee-shin system, single axis, manual lock, ultra-light material   L5711
Addition to lower extremity, above knee or knee disarticulation, acrylic socket   L5631
Addition, endoskeletal knee-shin system, single axis, friction swing and stance phase control (safety knee)   L5812
Replacement, socket, hip disarticulation, including hip joint, molded to patient model   L5702
Addition to lower extremity, socket insert, knee disarticulation (kemblo, pelite, aliplast, plastazote or equal)   L5656
Addition to lower extremity, test socket, knee disarticulation   L5622
Addition to lower extremity, endoskeletal system, above knee-knee disarticulation, 4 bar linkage, with hydraulic swing phase control   L5613
Addition, exoskeletal system, hip disarticulation, ultra-light material (titanium, carbon fiber or equal)   L5795
Addition to lower extremity, symes type, 'ptb' brim design socket   L5632
Addition, exoskeletal knee-shin system, single axis, friction swing and stance phase control (safety knee)   L5712
Addition to lower extremity, symes type, posterior opening (canadian) socket   L5634
Addition to lower extremity, test socket, above knee   L5624
Addition to lower extremity, exoskeletal system, above knee-knee disarticulation, 4 bar linkage, with pneumatic swing phase control   L5614
Ankle, symes, molded to patient model, socket without solid ankle cushion heel (sach) foot, replacement only   L5703
Addition, endoskeletal knee-shin system, polycentric, hydraulic swing phase control, mechanical stance phase lock   L5814
Addition to lower extremity, socket insert, above knee (kemblo, pelite, aliplast, plastazote or equal)   L5658
Addition, exoskeletal knee-shin system, single axis, variable friction swing phase control   L5714
Addition, exoskeletal knee-shin system, polycentric, mechanical stance phase lock   L5716
Addition to lower extremity, socket insert, multi-durometer symes   L5661
Addition, endoskeletal knee-shin system, polycentric, mechanical stance phase lock   L5816
Addition to lower extremity, test socket, hip disarticulation   L5626
Addition to lower extremity, endoskeletal system, above knee, universal multiplex system, friction swing phase control   L5616
Addition to lower extremity, symes type, medial opening socket   L5636
Custom shaped protective cover, below knee   L5704
Addition to lower extremity, below knee, total contact   L5637
Custom shaped protective cover, above knee   L5705
Addition to lower extremity, quick change self-aligning unit, above knee or below knee, each   L5617
Addition to lower extremity, socket insert, multi-durometer, below knee   L5665
Addition, exoskeletal knee-shin system, polycentric, friction swing and stance phase control   L5718
Addition, endoskeletal knee-shin system, polycentric, friction swing, and stance phase control   L5818
Addition to lower extremity, test socket, hemipelvectomy   L5628
Addition, exoskeletal knee-shin system, single axis, pneumatic swing, friction stance phase control   L5722
Custom shaped protective cover, knee disarticulation   L5706
Addition to lower extremity, below knee, leather socket   L5638
Addition to lower extremity, below knee, cuff suspension   L5666
Addition to lower extremity, below knee, acrylic socket   L5629
Addition, endoskeletal knee-shin system, single axis, pneumatic swing, friction stance phase control   L5822
Addition to lower extremity, below knee, molded distal cushion   L5668
Custom shaped protective cover, hip disarticulation   L5707
Addition, endoskeletal knee-shin system, single axis, fluid swing phase control   L5824
Addition to lower extremity, below knee, wood socket   L5639
Addition, exoskeletal knee-shin system, single axis, fluid swing phase control   L5724
Addition, endoskeletal knee-shin system, single axis, hydraulic swing phase control, with miniature high activity frame   L5826
Addition to lower extremity, knee disarticulation, leather socket   L5640
Addition to lower extremity, below knee, molded supracondylar suspension ('pts' or similar)   L5670
Addition, exoskeletal knee-shin system, single axis, external joints fluid swing phase control   L5726
Addition, endoskeletal knee-shin system, single axis, fluid swing and stance phase control   L5828
Addition, exoskeletal knee-shin system, single axis, fluid swing and stance phase control   L5728
Addition to lower extremity, above knee, leather socket   L5642
Addition to lower extremity, below knee above knee suspension locking mechanism (shuttle, lanyard or equal), excludes socket insert   L5671
Addition to lower extremity, hip disarticulation, flexible inner socket, external frame   L5643
Addition, endoskeletal knee-shin system, single axis, pneumatic swing phase control   L5830
Addition to lower extremity, below knee, removable medial brim suspension   L5672
Addition, exoskeletal knee-shin system, single axis, pneumatichydra pneumatic swing phase control   L5780
Addition to lower limb prosthesis, vacuum pump, residual limb volume management and moisture evacuation system   L5781
Addition to lower extremity, below kneeabove knee, custom fabricated from existing mold or prefabricated, socket insert, silicone gel, elastomeric or equal, for use with locking mechanism   L5673
Addition, endoskeletal kneeshin system, 4-bar linkage or multiaxial, pneumatic swing phase control   L5840
Addition to lower extremity, above knee, wood socket   L5644
Additions to lower extremity, below knee, knee joints, single axis, pair   L5676
Addition to lower limb prosthesis, vacuum pump, residual limb volume management and moisture evacuation system, heavy duty   L5782
Addition to lower extremity, below knee, flexible inner socket, external frame   L5645
Addition, endoskeletal, knee-shin system, stance flexion feature, adjustable   L5845
Additions to lower extremity, below knee, knee joints, polycentric, pair   L5677
Addition to endoskeletal knee-shin system, fluid stance extension, dampening feature, with or without adjustability   L5848
Addition to lower extremity, below knee, air, fluid, gel or equal, cushion socket   L5646
Addition to lower extremity, below knee suction socket   L5647
Addition, endoskeletal system, above knee or hip disarticulation, knee extension assist   L5850
Additions to lower extremity, below knee, joint covers, pair   L5678
Addition, endoskeletal system, hip disarticulation, mechanical hip extension assist   L5855
Addition to lower extremity, above knee, air, fluid, gel or equal, cushion socket   L5648
Addition to lower extremity, below kneeabove knee, custom fabricated from existing mold or prefabricated, socket insert, silicone gel, elastomeric or equal, not for use with locking mechanism   L5679
Addition to lower extremity, ischial containmentnarrow m-l socket   L5649
Addition to lower extremity prosthesis, endoskeletal knee-shin system, microprocessor control feature, swing and stance phase, includes electronic sensor(s), any type   L5856
Addition to lower extremity, below knee, thigh lacer, nonmolded   L5680
Addition to lower extremity prosthesis, endoskeletal knee-shin system, microprocessor control feature, swing phase only, includes electronic sensor(s), any type   L5857
Addition to lower extremity, below kneeabove 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)   L5681
Additions to lower extremity, total contact, above knee or knee disarticulation socket   L5650
Addition to lower extremity prosthesis, endoskeletal knee shin system, microprocessor control feature, stance phase only, includes electronic sensor(s), any type   L5858
Addition to lower extremity, below knee, thigh lacer, glutealischial, molded   L5682
Addition to lower extremity, above knee, flexible inner socket, external frame   L5651
Addition to lower extremity prosthesis, endoskeletal knee-shin system, powered and programmable flexionextension assist control, includes any type motor(s)   L5859
Addition to lower extremity, below kneeabove 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)   L5683
Addition to lower extremity, suction suspension, above knee or knee disarticulation socket   L5652
Addition to lower extremity, knee disarticulation, expandable wall socket   L5653
Addition, endoskeletal system, below knee, alignable system   L5910
Addition to lower extremity, below knee, fork strap   L5684
Addition to lower extremity prosthesis, below knee, suspensionsealing sleeve, with or without valve, any material, each   L5685
Addition, endoskeletal ankle-foot or ankle system, power assist, includes any type motor(s)   L5969
Addition, endoskeletal system, above knee or hip disarticulation, alignable system   L5920
Addition, endoskeletal system, above knee, knee disarticulation or hip disarticulation, manual lock   L5925
Addition to lower extremity, below knee, back check (extension control)   L5686
Addition to lower extremity, below knee, waist belt, webbing   L5688
Addition, endoskeletal system, high activity knee control frame   L5930
Addition to lower extremity, below knee, waist belt, padded and lined   L5690
Addition, endoskeletal system, below knee, ultra-light material (titanium, carbon fiber or equal)   L5940
Addition to lower extremity, above knee, pelvic control belt, light   L5692
Addition, endoskeletal system, above knee, ultra-light material (titanium, carbon fiber or equal)   L5950
Addition, endoskeletal system, hip disarticulation, ultra-light material (titanium, carbon fiber or equal)   L5960
Addition to lower extremity, above knee, pelvic control belt, padded and lined   L5694
Addition to lower extremity, above knee, pelvic control, sleeve suspension, neoprene or equal, each   L5695
Addition, endoskeletal system, polycentric hip joint, pneumatic or hydraulic control, rotation control, with or without flexion andor extension control   L5961
Addition to lower extremity, above knee or knee disarticulation, pelvic joint   L5696
Addition, endoskeletal system, below knee, flexible protective outer surface covering system   L5962
Addition to lower extremity, above knee or knee disarticulation, pelvic band   L5697
Addition, endoskeletal system, above knee, flexible protective outer surface covering system   L5964
Addition to lower extremity, above knee or knee disarticulation, silesian bandage   L5698
Addition, endoskeletal system, hip disarticulation, flexible protective outer surface covering system   L5966
Addition to lower limb prosthesis, multiaxial ankle with swing phase active dorsiflexion feature   L5968
All lower extremity prostheses, shoulder harness   L5699
All lower extremity prostheses, foot, external keel, sach foot   L5970
All lower extremity prosthesis, solid ankle cushion heel (sach) foot, replacement only   L5971
All lower extremity prostheses, foot, flexible keel   L5972
Endoskeletal ankle foot system, microprocessor controlled feature, dorsiflexion andor plantar flexion control, includes power source   L5973
All lower extremity prostheses, foot, single axis anklefoot   L5974
All lower extremity prosthesis, combination single axis ankle and flexible keel foot   L5975
All lower extremity prostheses, energy storing foot (seattle carbon copy ii or equal)   L5976
All lower extremity prostheses, foot, multiaxial anklefoot   L5978
All lower extremity prosthesis, multi-axial ankle, dynamic response foot, one piece system   L5979
All lower extremity prostheses, flex foot system   L5980
All lower extremity prostheses, flex-walk system or equal   L5981
All exoskeletal lower extremity prostheses, axial rotation unit   L5982
All endoskeletal lower extremity prosthesis, axial rotation unit, with or without adjustability   L5984
All endoskeletal lower extremity prostheses, dynamic prosthetic pylon   L5985
All lower extremity prostheses, multi-axial rotation unit ('mcp' or equal)   L5986
All lower extremity prosthesis, shank foot system with vertical loading pylon   L5987
Addition to lower limb prosthesis, vertical shock reducing pylon feature   L5988
Addition to lower extremity prosthesis, user adjustable heel height   L5990
Lower extremity prosthesis, not otherwise specified   L5999
upper extremity,   L6600 - L7405
Hand restoration (casts, shading and measurements included), partial hand, with glove, thumb or one finger remaining   L6900
Six volt battery, each   L7360
Terminal device, passive handmitt, any material, any size   L6703
Electronic elbow, hosmer or equal, switch controlled   L7170
Upper extremity additions, polycentric hinge, pair   L6600
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   L6920
Addition to upper extremity prosthesis, glove for terminal device, any material, prefabricated, includes fitting and adjustment   L6890
Hand restoration (casts, shading and measurements included), partial hand, with glove, multiple fingers remaining   L6905
Battery charger, six volt, each   L7362
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   L6925
Addition to upper extremity prosthesis, glove for terminal device, any material, custom fabricated   L6895
Terminal device, sportrecreationalwork attachment, any material, any size   L6704
Electronic elbow, microprocessor sequential control of elbow and terminal device   L7180
Upper extremity additions, single pivot hinge, pair   L6605
Upper extremity additions, flexible metal hinge, pair   L6610
Twelve volt battery, each   L7364
Terminal device, hook, mechanical, voluntary opening, any material, any size, lined or unlined   L6706
Electronic elbow, microprocessor simultaneous control of elbow and terminal device   L7181
Hand restoration (casts, shading and measurements included), partial hand, with glove, no fingers remaining   L6910
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   L6930
Terminal device, hook, mechanical, voluntary closing, any material, any size, lined or unlined   L6707
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   L6935
Addition to upper extremity prosthesis, external powered, additional switch, any type   L6611
Battery charger, twelve volt, each   L7366
Electronic elbow, adolescent, variety village or equal, switch controlled   L7185
Hand restoration (shading, and measurements included), replacement glove for above   L6915
Electronic elbow, child, variety village or equal, switch controlled   L7186
Lithium ion battery, replacement   L7367
Upper extremity addition, disconnect locking wrist unit   L6615
Terminal device, hand, mechanical, voluntary opening, any material, any size   L6708
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   L6940
Upper extremity addition, additional disconnect insert for locking wrist unit, each   L6616
Lithium ion battery charger, replacement only   L7368
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   L6945
Electronic elbow, adolescent, variety village or equal, myoelectronically controlled   L7190
Terminal device, hand, mechanical, voluntary closing, any material, any size   L6709
Electronic elbow, child, variety village or equal, myoelectronically controlled   L7191
Addition to upper extremity prosthesis, below elbowwrist disarticulation, ultralight material (titanium, carbon fiber or equal)   L7400
Upper extremity addition, flexionextension wrist unit, with or without friction   L6620
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   L6950
Terminal device, hook, mechanical, voluntary opening, any material, any size, lined or unlined, pediatric   L6711
Terminal device, hook, mechanical, voluntary closing, any material, any size, lined or unlined, pediatric   L6712
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   L6955
Addition to upper extremity prosthesis, above elbow disarticulation, ultralight material (titanium, carbon fiber or equal)   L7401
Electronic wrist rotator, otto bock or equal   L7260
Upper extremity prosthesis addition, flexionextension wrist with or without friction, for use with external powered terminal device   L6621
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   L6960
Upper extremity addition, spring assisted rotational wrist unit with latch release   L6623
Electronic wrist rotator, for utah arm   L7261
Terminal device, hand, mechanical, voluntary opening, any material, any size, pediatric   L6713
Addition to upper extremity prosthesis, shoulder disarticulationinterscapular thoracic, ultralight material (titanium, carbon fiber or equal)   L7402
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   L6965
Terminal device, hand, mechanical, voluntary closing, any material, any size, pediatric   L6714
Addition to upper extremity prosthesis, below elbowwrist disarticulation, acrylic material   L7403
Upper extremity addition, flexionextension and rotation wrist unit   L6624
Addition to upper extremity prosthesis, above elbow disarticulation, acrylic material   L7404
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   L6970
Upper extremity addition, rotation wrist unit with cable lock   L6625
Terminal device, multiple articulating digit, includes motor(s), initial issue or replacement   L6715
Upper extremity addition, quick disconnect hook adapter, otto bock or equal   L6628
Terminal device, hook or hand, heavy duty, mechanical, voluntary opening, any material, any size, lined or unlined   L6721
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   L6975
Addition to upper extremity prosthesis, shoulder disarticulationinterscapular thoracic, acrylic material   L7405
Electric hand, switch or myoelectric controlled, adult   L7007
Terminal device, hook or hand, heavy duty, mechanical, voluntary closing, any material, any size, lined or unlined   L6722
Upper extremity addition, quick disconnect lamination collar with coupling piece, otto bock or equal   L6629
Upper extremity addition, stainless steel, any wrist   L6630
Addition to terminal device, modifier wrist unit   L6805
Electric hand, switch or myoelectric, controlled, pediatric   L7008
Upper extremity addition, latex suspension sleeve, each   L6632
Electric hook, switch or myoelectric controlled, adult   L7009
Addition to terminal device, precision pinch device   L6810
Prehensile actuator, switch controlled   L7040
Upper extremity addition, lift assist for elbow   L6635
Electric hand, switch or myolelectric controlled, independently articulating digits, any grasp pattern or combination of grasp patterns, includes motor(s)   L6880
Electric hook, switch or myoelectric controlled, pediatric   L7045
Upper extremity addition, nudge control elbow lock   L6637
Automatic grasp feature, addition to upper limb electric prosthetic terminal device   L6881
Microprocessor control feature, addition to upper limb prosthetic terminal device   L6882
Upper extremity addition to prosthesis, electric locking feature, only for use with manually powered elbow   L6638
Upper extremity additions, shoulder abduction joint, pair   L6640
Replacement socket, below elbowwrist disarticulation, molded to patient model, for use with or without external power   L6883
Replacement socket, above elbowelbow disarticulation, molded to patient model, for use with or without external power   L6884
Upper extremity addition, excursion amplifier, pulley type   L6641
Upper extremity addition, excursion amplifier, lever type   L6642
Replacement socket, shoulder disarticulationinterscapular thoracic, molded to patient model, for use with or without external power   L6885
Upper extremity addition, shoulder flexion-abduction joint, each   L6645
Upper extremity addition, shoulder joint, multipositional locking, flexion, adjustable abduction friction control, for use with body powered or external powered system   L6646
Upper extremity addition, shoulder lock mechanism, body powered actuator   L6647
Upper extremity addition, shoulder lock mechanism, external powered actuator   L6648
Upper extremity addition, shoulder universal joint, each   L6650
Upper extremity addition, standard control cable, extra   L6655
Upper extremity addition, heavy duty control cable   L6660
Upper extremity addition, teflon, or equal, cable lining   L6665
Upper extremity addition, hook to hand, cable adapter   L6670
Upper extremity addition, harness, chest or shoulder, saddle type   L6672
Upper extremity addition, harness, (eg figure of eight type), single cable design   L6675
Upper extremity addition, harness, (eg figure of eight type), dual cable design   L6676
Upper extremity addition, harness, triple control, simultaneous operation of terminal device and elbow   L6677
Upper extremity addition, test socket, wrist disarticulation or below elbow   L6680
Upper extremity addition, test socket, elbow disarticulation or above elbow   L6682
Upper extremity addition, test socket, shoulder disarticulation or interscapular thoracic   L6684
Upper extremity addition, suction socket   L6686
Upper extremity addition, frame type socket, below elbow or wrist disarticulation   L6687
Upper extremity addition, frame type socket, above elbow or elbow disarticulation   L6688
Upper extremity addition, frame type socket, shoulder disarticulation   L6689
Upper extremity addition, frame type socket, interscapular-thoracic   L6690
Upper extremity addition, removable insert, each   L6691
Upper extremity addition, silicone gel insert or equal, each   L6692
Upper extremity addition, locking elbow, forearm counterbalance   L6693
Addition to upper extremity prosthesis, below elbowabove elbow, custom fabricated from existing mold or prefabricated, socket insert, silicone gel, elastomeric or equal, for use with locking mechanism   L6694
Addition to upper extremity prosthesis, below elbowabove elbow, custom fabricated from existing mold or prefabricated, socket insert, silicone gel, elastomeric or equal, not for use with locking mechanism   L6695
Addition to upper extremity prosthesis, below elbowabove 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)   L6696
Addition to upper extremity prosthesis, below elbowabove 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)   L6697
Addition to upper extremity prosthesis, below elbowabove elbow, lock mechanism, excludes socket insert   L6698
Protamine sulfate,   J2720
Protectant, skin,   A6250
Protector, heel or elbow,   E0191
Protein C Concentrate,   J2724
Protirelin,   J2725
Pulse generator,   E2120
alternating pressure pad,   E0182
ambulatory infusion,   E0781
ambulatory insulin,   E0784
blood, dialysis,   E1620
breast,   E0602 - E0604
Breast pump, manual, any type   E0602
Breast pump, electric (ac andor dc), any type   E0603
Breast pump, hospital grade, electric (ac and or dc), any type   E0604
enteral infusion,   B9000, B9002
external infusion,   E0779
heparin infusion,   E1520
implantable infusion,   E0782, E0783
implantable infusion, refill kit,   A4220
infusion, supplies,   A4230, A4232
negative pressure wound therapy,   E2402
parenteral infusion,   B9004, B9006
suction, portable,   E0600
water circulating pad,   E0236
Purification system,   E1610, E1615
Pyridoxine HCl,   J3415