fee schedule 2009 new - DE Medical Assistance Program

L2240 3 ROUND CALIPER AND PLATE ATTA 68.19
L2250 3 FOOT PLATE MOLDED STIRRUP AT 276.47
L2260 3 REINFORCED SOLID STIRRUP 143.93
L2265 3 LONG TONGUE STIRRUP 84.55
L2270 3 VARUS/VALGUS STRAP PADDED/LI 39.65
L2275 3 PLASTIC MOD LOW EXT PAD/LINE 93.48
L2280 3 MOLDED INNER BOOT 326.87
L2300 3 ABDUCTION BAR JOINTED ADJUST 204.94
L2310 3 ABDUCTION BAR-STRAIGHT 102.64
L2320 3 NON-MOLDED LACER 147.73
L2330 3 LACER MOLDED TO PATIENT MODE 309.23
L2335 3 ANTERIOR SWING BAND 190.92
L2340 3 PRE-TIBIAL SHELL MOLDED TO P 413.33
L2350 3 PROSTHETIC TYPE SOCKET MOLDE 713.86
L2360 3 EXTENDED STEEL SHANK 37.15
L2370 3 PATTEN BOTTOM 240.71
L2375 3 TORSION ANK & HALF SOLID STI 101.69
L2380 3 TORSION STRAIGHT KNEE JOINT 88.39
L2385 3 STRAIGHT KNEE JOINT HEAVY DU 96.17
L2387 6 ADD LE POLY KNEE CUSTOM KAFO 0.00
L2390 3 OFFSET KNEE JOINT EACH 80.51
L2395 3 OFFSET KNEE JOINT HEAVY DUTY 112.34
L2397 3 SUSPENSION SLEEVE LOWER EXT 87.53
L2405 3 KNEE JOINT DROP LOCK EA JNT 65.34
L2415 3 KNEE JOINT CAM LOCK EACH JOI 91.03
L2425 3 KNEE DISC/DIAL LOCK/ADJ FLEX 107.43
L2430 3 KNEE JNT RATCHET LOCK EA JNT 107.43
L2435 O KNEE JOINT POLYCENTRIC JOINT 0.00
L2492 3 KNEE LIFT LOOP DROP LOCK RIN 97.54
L2500 3 THI/GLUT/ISCHIA WGT BEARING 233.34
L2510 3 TH/WGHT BEAR QUAD-LAT BRIM M 523.55
L2520 3 TH/WGHT BEAR QUAD-LAT BRIM C 345.37
L2525 3 TH/WGHT BEAR NAR M-L BRIM MO 931.80
L2526 3 TH/WGHT BEAR NAR M-L BRIM CU 531.72
L2530 3 THIGH/WGHT BEAR LACER NON-MO 168.70
L2540 3 THIGH/WGHT BEAR LACER MOLDED 303.55
L2550 3 THIGH/WGHT BEAR HIGH ROLL CU 206.21
L2570 3 HIP CLEVIS TYPE 2 POSIT JNT 341.99
L2580 3 PELVIC CONTROL PELVIC SLING 333.23
L2600 3 HIP CLEVIS/THRUST BEARING FR 182.48
L2610 3 HIP CLEVIS/THRUST BEARING LO 193.28
L2620 3 PELVIC CONTROL HIP HEAVY DUT 217.32
L2622 3 HIP JOINT ADJUSTABLE FLEXION 246.37
L2624 3 HIP ADJ FLEX EXT ABDUCT CONT 237.76
L2627 3 PLASTIC MOLD RECIPRO HIP & C 1,297.39
L2628 3 METAL FRAME RECIPRO HIP & CA 1,276.17
L2630 3 PELVIC CONTROL BAND & BELT U 177.79
L2640 3 PELVIC CONTROL BAND & BELT B 241.29
L2650 3 PELV & THOR CONTROL GLUTEAL 102.75
L2660 3 THORACIC CONTROL THORACIC BA 133.82