2010 HCPCS Schedule - DE Medical Assistance Program

L0510 LSO FLEXIBLE CUSTOM FABRICAT O $0.00
L0515 LSO FLEX ELAS W/ RIG POST PA O $0.00
L0520 LSO A-P-L CONTROL WITH APRON O $0.00
L0530 LSO ANT-POS CONTROL W APRON O $0.00
L0540 LSO LUMBAR FLEXION A-P-L O $0.00
L0550 LSO A-P-L CONTROL MOLDED O $0.00
L0560 LSO A-P-L W INTERFACE O $0.00
L0561 PREFAB LSO O $0.00
L0565 LSO A-P-L CONTROL CUSTOM O $0.00
L0600 SACROILIAC FLEX SURG SUPPORT O $0.00
L0610 SACROILIAC FLEXIBLE CUSTM FA O $0.00
L0620 SACROILIAC SEMI-RIG W APRON O $0.00
L0621 SIO FLEX PELVISACRAL PREFAB 6 $0.00
L0622 SIO FLEX PELVISACRAL CUSTOM 6 $0.00
L0623 SIO PANEL PREFAB 6 $0.00
L0624 SIO PANEL CUSTOM 6 $0.00
L0625 LO FLEXIBL L1-BELOW L5 PRE 6 $0.00
L0626 LO SAG STAYS/PANELS PRE-FAB 6 $0.00
L0627 LO SAGITT RIGID PANEL PREFAB 6 $0.00
L0628 LO FLEX W/O RIGID STAYS PRE 6 $0.00
L0629 LSO FLEX W/RIGID STAYS CUST 6 $0.00
L0630 LSO POST RIGID PANEL PRE 3 $127.26
L0631 LSO SAG-CORO RIGID FRAME PRE 6 $0.00
L0632 LSO SAG RIGID FRAME CUST 6 $0.00
L0633 LSO FLEXION CONTROL PREFAB 6 $0.00
L0634 LSO FLEXION CONTROL CUSTOM 6 $0.00
L0635 LSO SAGIT RIGID PANEL PREFAB 6 $0.00
L0636 LSO SAGITTAL RIGID PANEL CUS 6 $0.00
L0637 LSO SAG-CORONAL PANEL PREFAB 6 $0.00
L0638 LSO SAG-CORONAL PANEL CUSTOM 6 $0.00
L0639 LSO S/C SHELL/PANEL PREFAB 6 $0.00
L0640 LSO S/C SHELL/PANEL CUSTOM 6 $0.00
L0700 CTLSO A-P-L CONTROL MOLDED 3 $1,467.79
L0710 CTLSO A-P-L CONTROL W/ INTER 3 $1,499.54
L0810 HALO CERVICAL INTO JCKT VEST 3 $1,875.37
L0820 HALO CERVICAL INTO BODY JACK 3 $1,683.27
L0830 HALO CERV INTO MILWAUKEE TYP 3 $2,372.22
L0859 MRI COMPATIBLE SYSTEM 6 $0.00
L0860 MAGNETIC RESONANC IMAGE COMP O $0.00
L0861 HALO REPL LINER/INTERFACE 6 $0.00
L0900 TORSO/PTOSIS SUPPORT O $0.00
L0910 TORSO & PTOSIS SUPP CUSTM FA O $0.00
L0920 TORSO/PENDULOUS ABD SUPPORT O $0.00
L0930 PENDULOUS ABDOMEN SUPP CUSTM O $0.00
L0940 TORSO/POSTSURGICAL SUPPORT O $0.00
L0950 POST SURG SUPPORT CUSTOM FAB O $0.00
L0960 POST SURGICAL SUPPORT PADS O $0.00
L0970 TLSO CORSET FRONT 3 $96.55
L0972 LSO CORSET FRONT 3 $86.71