fee schedule 2009 new - DE Medical Assistance Program

L5999 5 LOWR EXTREMITY PROSTHES NOS 0.00
L6000 3 PAR HAND ROBIN-AIDS THUM REM 1,016.37
L6010 3 HAND ROBIN-AIDS LITTLE/RING 1,131.05
L6020 3 PART HAND ROBIN-AIDS NO FING 1,054.53
L6025 5 PART HAND DISART MYOELECTRIC 0.00
L6050 3 WRST MLD SCK FLX HNG TRI PAD 1,453.10
L6055 3 WRST MOLD SOCK W/EXP INTERFA 2,309.76
L6100 3 ELB MOLD SOCK FLEX HINGE PAD 1,472.21
L6110 3 ELBOW MOLD SOCK SUSPENSION T 1,561.53
L6120 3 ELBOW MOLD DOUB SPLT SOC STE 1,819.73
L6130 3 ELBOW STUMP ACTIVATED LOCK H 1,980.21
L6200 3 ELBOW MOLD OUTSID LOCK HINGE 2,086.82
L6205 3 ELBOW MOLDED W/ EXPAND INTER 3,477.47
L6250 3 ELBOW INTER LOC ELBOW FORARM 2,054.13
L6300 3 SHLDER DISART INT LOCK ELBOW 2,849.88
L6310 3 SHOULDER PASSIVE RESTOR COMP 2,343.65
L6320 3 SHOULDER PASSIVE RESTOR CAP 1,307.24
L6350 3 THORACIC INTERN LOCK ELBOW 2,996.21
L6360 3 THORACIC PASSIVE RESTOR COMP 2,459.71
L6370 3 THORACIC PASSIVE RESTOR CAP 1,851.78
L6380 3 POSTOP DSG CAST CHG WRST/ELB 1,000.12
L6382 3 POSTOP DSG CAST CHG ELB DIS/ 1,196.80
L6384 3 POSTOP DSG CAST CHG SHLDER/T 1,460.42
L6386 3 POSTOP EA CAST CHG & REALIGN 350.22
L6388 3 POSTOP APPLICAT RIGID DSG ON 336.28
L6400 3 BELOW ELBOW PROSTH TISS SHAP 1,778.70
L6450 3 ELB DISART PROSTH TISS SHAP 2,358.38
L6500 3 ABOVE ELBOW PROSTH TISS SHAP 2,360.31
L6550 3 SHLDR DISAR PROSTH TISS SHAP 2,916.91
L6570 3 SCAP THORAC PROSTH TISS SHAP 3,539.21
L6580 3 WRIST/ELBOW BOWDEN CABLE MOL 1,235.42
L6582 3 WRIST/ELBOW BOWDEN CBL DIR F 1,052.79
L6584 3 ELBOW FAIR LEAD CABLE MOLDED 1,705.33
L6586 3 ELBOW FAIR LEAD CABLE DIR FO 1,491.81
L6588 3 SHDR FAIR LEAD CABLE MOLDED 2,462.65
L6590 3 SHDR FAIR LEAD CABLE DIRECT 2,252.61
L6600 3 POLYCENTRIC HINGE PAIR 151.99
L6605 3 SINGLE PIVOT HINGE PAIR 141.87
L6610 3 FLEXIBLE METAL HINGE PAIR 127.35
L6611 6 ADDITIONAL SWITCH, EXT POWER 0.00
L6615 3 DISCONNECT LOCKING WRIST UNI 157.03
L6616 3 DISCONNECT INSERT LOCKING WR 66.15
L6620 3 FLEXION/EXTENSION WRIST UNIT 246.46
L6621 6 FLEX/EXT WRIST W/WO FRICTION 0.00
L6623 3 SPRING-ASS ROT WRST W/ LATCH 564.15
L6624 6 FLEX/EXT/ROTATION WRIST UNIT 0.00
L6625 3 ROTATION WRST W/ CABLE LOCK 410.51
L6628 3 QUICK DISCONN HOOK ADAPTER O 419.48
L6629 3 LAMINATION COLLAR W/ COUPLIN 111.91
L6630 3 STAINLESS STEEL ANY WRIST 164.86