| L2275 | Addition to lower extremity, varus/valgus correction, plastic modification, padded/lined | 2 | 20 | 220 | $80 | $1.4M |
| S1040 | Cranial remolding orthosis, pediatric, rigid, with soft interface material, custom fabricated, includes fitting and adjustment(s) | 5 | 10 | 830 | $1,460 | $1.4M |
| L1833 | Knee orthosis, adjustable knee joints (unicentric or polycentric), positional orthosis, rigid support, prefabricated, off-the shelf | 5 | 10 | 270 | $370 | $794.3K |
| L1832 | Knee orthosis, adjustable knee joints (unicentric or polycentric), positional orthosis, rigid support, prefabricated item that has been trimmed, bent, molded, assembled, or otherwise customized to… | 4 | 10 | 1,200 | $430 | $689.2K |
| L1970 | Ankle foot orthosis, plastic with ankle joint, custom fabricated | 4 | 10 | 520 | $520 | $404.6K |
| L0642 | Lumbar orthosis, sagittal control, with rigid anterior and posterior panels, posterior extends from l-1 to below l-5 vertebra, produces intracavitary pressure to reduce load on the intervertebral… | 4 | 10 | 20 | $200 | $377.5K |
| L3020 | Foot, insert, removable, molded to patient model, longitudinal/ metatarsal support, each | 3 | 20 | 180 | $130 | $354.4K |
| L2280 | Addition to lower extremity, molded inner boot | 4 | 10 | 920 | $360 | $315.1K |
| L0627 | Lumbar orthosis, sagittal control, with rigid anterior and posterior panels, posterior extends from l-1 to below l-5 vertebra, produces intracavitary pressure to reduce load on the intervertebral… | 4 | 10 | 200 | $230 | $296.9K |
| L1960 | Ankle foot orthosis, posterior solid ankle, plastic, custom fabricated | 5 | 10 | 370 | $490 | $287.8K |