| E0466 | Home ventilator, any type, used with non-invasive interface, (e.g., mask, chest shell) | 18 | 30 | 990 | $310 | $1.4M |
| E0601 | Continuous positive airway pressure (CPAP) device | 2 | 80 | 2,450 | $60 | $338.6K |
| E1390 | Oxygen concentrator, single delivery port, capable of delivering 85 percent or greater oxygen concentration at the prescribed flow rate | 1 | 80 | 3,570 | $40 | $316K |
| L3807 | Wrist hand finger orthosis, without joint(s), prefabricated item that has been trimmed, bent, molded, assembled, or otherwise customized to fit a specific patient by an individual with expertise | 1 | 10 | 2,790 | $110 | $303K |
| A7030 | Full face mask used with positive airway pressure device, each | 2 | 60 | 1,260 | $80 | $197.2K |
| E0471 | Respiratory assist device, bi-level pressure capability, with back-up rate feature, used with noninvasive interface, e.g., nasal or facial mask (intermittent assist device with continuous positive… | 2 | 10 | 620 | $310 | $191K |
| L4361 | Walking boot, pneumatic and/or vacuum, with or without joints, with or without interface material, prefabricated, off-the-shelf | 1 | 20 | 150 | $150 | $168.2K |
| E0470 | Respiratory assist device, bi-level pressure capability, without backup rate feature, used with noninvasive interface, e.g., nasal or facial mask (intermittent assist device with continuous positive… | 2 | 40 | 470 | $140 | $143.6K |
| L1833 | Knee orthosis, adjustable knee joints (unicentric or polycentric), positional orthosis, rigid support, prefabricated, off-the shelf | 4 | 10 | 190 | $350 | $124.5K |
| A7031 | Face mask interface, replacement for full face mask, each | 5 | 60 | 1,840 | $30 | $114.2K |