2010 HCPCS Schedule - DE Medical Assistance Program

L8120 COMPRESSION STOCKING BK40-50 O $0.00
L8130 GC STOCKING THIGHLNGTH 18-30 O $0.00
L8140 GC STOCKING THIGHLNGTH 30-40 O $0.00
L8150 GC STOCKING THIGHLNGTH 40-50 O $0.00
L8160 GC STOCKING FULL LNGTH 18-30 O $0.00
L8170 GC STOCKING FULL LNGTH 30-40 O $0.00
L8180 GC STOCKING FULL LNGTH 40-50 O $0.00
L8190 GC STOCKING WAISTLNGTH 18-30 O $0.00
L8195 GC STOCKING WAISTLNGTH 30-40 O $0.00
L8200 GC STOCKING WAISTLNGTH 40-50 O $0.00
L8210 GC STOCKING CUSTOM MADE O $0.00
L8220 GC STOCKING LYMPHEDEMA O $0.00
L8230 GC STOCKING GARTER BELT O $0.00
L8239 G COMPRESSION STOCKING NOS O $0.00
L8300 TRUSS SINGLE W/ STANDARD PAD 3 $64.52
L8310 TRUSS DOUBLE W/ STANDARD PAD 3 $101.87
L8320 TRUSS ADDITION TO STD PAD WA 3 $45.67
L8330 TRUSS ADD TO STD PAD SCROTAL 3 $37.77
L8400 SHEATH BELOW KNEE 3 $13.28
L8410 SHEATH ABOVE KNEE 3 $17.75
L8415 SHEATH UPPER LIMB 3 $17.44
L8417 PROS SHEATH/SOCK W GEL CUSHN 3 $56.42
L8420 PROSTHETIC SOCK MULTI PLY BK 3 $15.68
L8430 PROSTHETIC SOCK MULTI PLY AK 3 $16.93
L8435 PROS SOCK MULTI PLY UPPER LM 3 $16.09
L8440 SHRINKER BELOW KNEE 3 $31.99
L8460 SHRINKER ABOVE KNEE 3 $50.98
L8465 SHRINKER UPPER LIMB 3 $45.15
L8470 PROS SOCK SINGLE PLY BK 3 $5.11
L8480 PROS SOCK SINGLE PLY AK 3 $7.04
L8485 PROS SOCK SINGLE PLY UPPER L 3 $8.84
L8490 AIR SEAL SUCTION RETEN SYSTM O $0.00
L8499 UNLISTED MISC PROSTHETIC SER 5 $0.00
L8500 ARTIFICIAL LARYNX 3 $673.10
L8501 TRACHEOSTOMY SPEAKING VALVE 3 $92.40
L8505 ARTIFICIAL LARYNX, ACCESSORY 5 $0.00
L8507 TRACH-ESOPH VOICE PROS PT IN 5 $0.00
L8509 TRACH-ESOPH VOICE PROS MD IN 5 $0.00
L8510 VOICE AMPLIFIER 5 $0.00
L8511 INDWELLING TRACH INSERT 6 $0.00
L8512 GEL CAP FOR TRACH VOICE PROS 6 $0.00
L8513 TRACH PROS CLEANING DEVICE 6 $0.00
L8514 REPL TRACH PUNCTURE DILATOR 6 $0.00
L8515 GEL CAP APP DEVICE FOR TRACH 6 $0.00
L8600 IMPLANT BREAST SILICONE/EQ 9 $0.00
L8603 COLLAGEN IMP URINARY 2.5 ML 9 $0.00
L8604 DEXTRANOMER/HYALURONIC ACID 9 $0.00
L8606 SYNTHETIC IMPLNT URINARY 1ML 3 $166.75
L8609 ARTIFICIAL CORNEA 6 $0.00