fee schedule 2009 new - DE Medical Assistance Program

L2670 3 THORAC CONT PARASPINAL UPRIG 129.79
L2680 3 THORAC CONT LAT SUPPORT UPRI 120.23
L2750 3 PLATING CHROME/NICKEL PR BAR 60.02
L2755 3 CARBON GRAPHITE LAMINATION 97.91
L2760 3 EXTENSION PER EXTENSION PER 43.62
L2768 5 ORTHO SIDEBAR DISCONNECT 0.00
L2770 3 LOW EXT ORTHOSIS PER BAR/JNT 44.33
L2780 3 NON-CORROSIVE FINISH 48.59
L2785 3 DROP LOCK RETAINER EACH 22.86
L2795 3 KNEE CONTROL FULL KNEECAP 61.97
L2800 3 KNEE CAP MEDIAL OR LATERAL P 95.24
L2810 3 KNEE CONTROL CONDYLAR PAD 74.77
L2820 3 SOFT INTERFACE BELOW KNEE SE 62.35
L2830 3 SOFT INTERFACE ABOVE KNEE SE 67.46
L2840 3 TIBIAL LENGTH SOCK FX OR EQU 39.88
L2850 3 FEMORAL LGTH SOCK FX OR EQUA 44.46
L2860 O TORSION MECHANISM KNEE/ANKLE 0.00
L2999 5 LOWER EXTREMITY ORTHOSIS NOS 0.00
L3000 3 FT INSERT UCB BERKELEY SHELL 80.00
L3001 5 FOOT INSERT REMOV MOLDED SPE 0.00
L3002 5 FOOT INSERT PLASTAZOTE OR EQ 0.00
L3003 5 FOOT INSERT SILICONE GEL EAC 0.00
L3010 5 FOOT LONGITUDINAL ARCH SUPPO 0.00
L3020 3 FOOT LONGITUD/METATARSAL SUP 155.91
L3030 5 FOOT ARCH SUPPORT REMOV PREM 0.00
L3031 6 FOOT LAMIN/PREPREG COMPOSITE 0.00
L3040 5 FT ARCH SUPRT PREMOLD LONGIT 0.00
L3050 5 FOOT ARCH SUPP PREMOLD METAT 0.00
L3060 5 FOOT ARCH SUPP LONGITUD/META 0.00
L3070 5 ARCH SUPRT ATT TO SHO LONGIT 0.00
L3080 5 ARCH SUPP ATT TO SHOE METATA 0.00
L3090 5 ARCH SUPP ATT TO SHOE LONG/M 0.00
L3100 5 HALLUS-VALGUS NGHT DYNAMIC S 0.00
L3140 5 ABDUCTION ROTATION BAR SHOE 0.00
L3150 5 ABDUCT ROTATION BAR W/O SHOE 0.00
L3160 5 SHOE STYLED POSITIONING DEV 0.00
L3170 5 FOOT PLASTIC HEEL STABILIZER 0.00
L3201 5 OXFORD W SUPINAT/PRONAT INF 0.00
L3202 5 OXFORD W/ SUPINAT/PRONATOR C 0.00
L3203 5 OXFORD W/ SUPINATOR/PRONATOR 0.00
L3204 5 HIGHTOP W/ SUPP/PRONATOR INF 0.00
L3206 5 HIGHTOP W/ SUPP/PRONATOR CHI 0.00
L3207 5 HIGHTOP W/ SUPP/PRONATOR JUN 0.00
L3208 5 SURGICAL BOOT EACH INFANT 0.00
L3209 5 SURGICAL BOOT EACH CHILD 0.00
L3211 5 SURGICAL BOOT EACH JUNIOR 0.00
L3212 5 BENESCH BOOT PAIR INFANT 0.00
L3213 5 BENESCH BOOT PAIR CHILD 0.00
L3214 5 BENESCH BOOT PAIR JUNIOR 0.00
L3215 3 ORTHOPEDIC FTWEAR LADIES OXF 86.72