Prosthetic implant, not otherwise specified

Prosthetic eye, other type

Prosthetic donning sleeve, any material, each

Unlisted procedure for miscellaneous prosthetic services

Operative report identifies the prosthetic implant specifications including the prosthetic implant manufacturer, the brand name of the prosthetic implant and the size of each prosthetic implant

Prosthetic sock, multiple ply, below knee, each

Prosthetic sock, multiple ply, above knee, each

Repair of prosthetic device, repair or replace minor parts

Operative report does not identify the prosthetic implant specifications including the prosthetic implant manufacturer, the brand name of the prosthetic implant and the size of each prosthetic implant, reason not given

Addition to lower extremity, prosthetic type, (bk) socket, molded to patient model, (used for 'ptb' 'afo' orthoses)

Prosthetic sheath, below knee, each

Prosthetic sheath, above knee, each

Prosthetic sheath, upper limb, each

Prosthetic shrinker, below knee, each

Prosthetic shrinker, above knee, each

Prosthetic shrinker, upper limb, each

Prosthetic eye, plastic, custom

Patients with mechanical prosthetic heart valve

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

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

All endoskeletal lower extremity prostheses, dynamic prosthetic pylon

Microprocessor control feature, addition to upper limb prosthetic terminal device

Repair prosthetic device, labor component, per 15 minutes

Prosthetic sock, multiple ply, upper limb, each

Prosthetic sock, single ply, fitting, below knee, each

Prosthetic sock, single ply, fitting, above knee, each

Lithium ion battery, rechargeable, for non-prosthetic use, replacement

Knee orthosis, modification of supracondylar prosthetic socket, custom fabricated (sk)

Addition to lower extremity prostheses, osseointegrated external prosthetic connector

Prosthetic sock, single ply, fitting, upper limb, each

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

Orthopedic footwear, custom molded shoe, removable inner mold, prosthetic shoe, each

Below elbow, molded socket, endoskeletal system, including soft prosthetic tissue shaping

Elbow disarticulation, molded socket, endoskeletal system, including soft prosthetic tissue shaping

Above elbow, molded socket, endoskeletal system, including soft prosthetic tissue shaping

Shoulder disarticulation, molded socket, endoskeletal system, including soft prosthetic tissue shaping

Interscapular thoracic, molded socket, endoskeletal system, including soft prosthetic tissue shaping

Automatic grasp feature, addition to upper limb electric prosthetic terminal device

Gasket or seal, for use with prosthetic socket insert, any type, each

Implanted prosthetic device, payable only for inpatients who do not have inpatient coverage

Orthotic and prosthetic supply, accessory, and/or service component of another hcpcs "l" code

Prosthetic sheath/sock, including a gel cushion layer, below knee or above knee, each

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, including palm, for use without external power and/or passive prosthetic digit/thumb, not including inserts described by l6692

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

External lower extremity sensory prosthetic device, cutaneous stimulation of mechanoreceptors proximal to the ankle, per leg

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

Patient has mitral stenosis or prosthetic heart valves or patient has transient or reversible cause of af (e.g., pneumonia, hyperthyroidism, pregnancy, cardiac surgery)