| L4361 | Walking boot, pneumatic and/or vacuum, with or without joints, with or without interface material, prefabricated, off-the-shelf | 1 | 10 | 1,880 | $230 | $436.7K |
| L3809 | Wrist hand finger orthosis, without joint(s), prefabricated, off-the-shelf, any type | 1 | 10 | 1,380 | $100 | $140.4K |
| L3984 | Upper extremity fracture orthosis, wrist, prefabricated, includes fitting and adjustment | 1 | 10 | 450 | $220 | $96.3K |
| L1833 | Knee orthosis, adjustable knee joints (unicentric or polycentric), positional orthosis, rigid support, prefabricated, off-the shelf | 1 | 10 | 230 | $350 | $80.1K |
| L3908 | Wrist hand orthosis, wrist extension control cock-up, non molded, prefabricated, off-the-shelf | 1 | 10 | 460 | $50 | $58.8K |
| L4350 | Ankle control orthosis, stirrup style, rigid, includes any type interface (e.g., pneumatic, gel), prefabricated, off-the-shelf | 1 | 10 | 710 | $60 | $41.1K |
| L1902 | Ankle orthosis, ankle gauntlet or similar, with or without joints, prefabricated, off-the-shelf | 1 | 10 | 740 | $50 | $39.4K |
| L3660 | Shoulder orthosis, figure of eight design abduction restrainer, canvas and webbing, prefabricated, off-the-shelf | 1 | 10 | 680 | $50 | $36.2K |
| E0114 | Crutches underarm, other than wood, adjustable or fixed, pair, with pads, tips and handgrips | 1 | 10 | 160 | $30 | $34.4K |
| 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 | 330 | $100 | $33.1K |