| L4360 | Walking boot, pneumatic and/or vacuum, with or without joints, with or without interface material, prefabricated item that has been trimmed, bent, molded, assembled, or otherwise customized to fit a… | 1 | 10 | 1,900 | $190 | $370K |
| L4361 | Walking boot, pneumatic and/or vacuum, with or without joints, with or without interface material, prefabricated, off-the-shelf | 1 | 10 | 340 | $170 | $139.9K |
| E0114 | Crutches underarm, other than wood, adjustable or fixed, pair, with pads, tips and handgrips | 1 | 10 | 2,040 | $30 | $122.5K |
| L3908 | Wrist hand orthosis, wrist extension control cock-up, non molded, prefabricated, off-the-shelf | 1 | 10 | 890 | $30 | $58.3K |
| L1820 | Knee orthosis, elastic with condylar pads and joints, with or without patellar control, prefabricated item that has been trimmed, bent, molded, assembled, or otherwise customized to fit a specific… | 1 | 10 | 20 | $90 | $53.5K |
| L3809 | Wrist hand finger orthosis, without joint(s), prefabricated, off-the-shelf, any type | 1 | 10 | 160 | $80 | $52.8K |
| L4350 | Ankle control orthosis, stirrup style, rigid, includes any type interface (e.g., pneumatic, gel), prefabricated, off-the-shelf | 1 | 10 | 520 | $50 | $50.1K |
| 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… | 1 | 10 | 120 | $420 | $49.3K |
| L3650 | Shoulder orthosis, figure of eight design abduction restrainer, prefabricated, off-the-shelf | 1 | 10 | 1,660 | $30 | $44.2K |
| L1830 | Knee orthosis, immobilizer, canvas longitudinal, prefabricated, off-the-shelf | 1 | 10 | 70 | $60 | $31.5K |