fee schedule 2009 new - DE Medical Assistance Program

L1630 3 ABDUCT CONTROL HIP SEMI-FLEX 121.67
L1640 3 PELV BAND/SPREAD BAR THIGH C 370.37
L1650 3 HO ABDUCTION HIP ADJUSTABLE 187.41
L1652 5 HO BI THIGHCUFFS W SPRDR BAR 0.00
L1660 3 HO ABDUCTION STATIC PLASTIC 122.87
L1680 3 PELVIC & HIP CONTROL THIGH C 874.83
L1685 3 POST-OP HIP ABDUCT CUSTOM FA 892.79
L1686 3 HO POST-OP HIP ABDUCTION 824.39
L1690 3 COMBINATION BILATERAL HO 1,449.30
L1700 3 LEG PERTHES ORTH TORONTO TYP 1,096.46
L1710 3 LEGG PERTHES ORTH NEWINGTON 1,283.53
L1720 3 LEGG PERTHES ORTHOSIS TRILAT 946.12
L1730 3 LEGG PERTHES ORTH SCOTTISH R 812.63
L1750 O LEGG PERTHES SLING 0.00
L1755 3 LEGG PERTHES PATTEN BOTTOM T 1,289.59
L1800 3 KNEE ORTHOSES ELAS W STAYS 52.19
L1810 3 KO ELASTIC WITH JOINTS 70.71
L1815 3 ELASTIC WITH CONDYLAR PADS 74.89
L1820 3 KO ELAS W/ CONDYLE PADS & JO 109.56
L1825 3 KO ELASTIC KNEE CAP 48.39
L1830 3 KO IMMOBILIZER CANVAS LONGIT 66.62
L1831 6 KNEE ORTH POS LOCKING JOINT 0.00
L1832 3 KO ADJ JNT POS RIGID SUPPORT 507.82
L1834 3 KO W/0 JOINT RIGID MOLDED TO 557.35
L1836 5 RIGID KO WO JOINTS 0.00
L1840 3 KO DEROT ANT CRUCIATE CUSTOM 742.41
L1843 3 KO SINGLE UPRIGHT CUSTOM FIT 672.48
L1844 3 KO W/ADJ JT ROT CNTRL MOLDED 1,165.61
L1845 3 KO W/ ADJ FLEX/EXT ROTAT CUS 697.85
L1846 3 KO W ADJ FLEX/EXT ROTAT MOLD 791.83
L1847 3 KO ADJUSTABLE W AIR CHAMBERS 431.07
L1850 3 KO SWEDISH TYPE 218.25
L1855 O KO PLAS DOUB UPRIGHT JNT MOL 0.00
L1858 O KO POLYCENTRIC PNEUMATIC PAD 0.00
L1860 3 KO SUPRACONDYLAR SOCKET MOLD 770.45
L1870 O KO DOUB UPRIGHT LACERS MOLDE 0.00
L1880 O KO DOUB UPRIGHT CUFFS/LACERS 0.00
L1885 O KNEE UPRIGHT W/RESISTANCE 0.00
L1900 3 AFO SPRNG WIR DRSFLX CALF BD 193.70
L1901 5 PREFAB ANKLE ORTHOSIS 0.00
L1902 3 AFO ANKLE GAUNTLET 66.93
L1904 3 AFO MOLDED ANKLE GAUNTLET 402.52
L1906 3 AFO MULTILIGAMENTUS ANKLE SU 86.35
L1907 6 AFO SUPRAMALLEOLAR CUSTOM 0.00
L1910 3 AFO SING BAR CLASP ATTACH SH 196.12
L1920 3 AFO SING UPRIGHT W/ ADJUST S 251.01
L1930 3 AFO PLASTIC 169.85
L1932 6 AFO RIG ANT TIB PREFAB TCF/= 0.00
L1940 3 AFO MOLDED TO PATIENT PLASTI 355.08
L1945 3 AFO MOLDED PLAS RIG ANT TIB 848.95