| L1833 | Knee orthosis, adjustable knee joints (unicentric or polycentric), positional orthosis, rigid support, prefabricated, off-the shelf | 1 | 10 | 1,240 | $390 | $487K |
| L4361 | Walking boot, pneumatic and/or vacuum, with or without joints, with or without interface material, prefabricated, off-the-shelf | 1 | 10 | 1,230 | $260 | $314.2K |
| L3809 | Wrist hand finger orthosis, without joint(s), prefabricated, off-the-shelf, any type | 1 | 10 | 1,190 | $160 | $186.7K |
| L3670 | Shoulder orthosis, acromio/clavicular (canvas and webbing type), prefabricated, off-the-shelf | 1 | 10 | 2,310 | $80 | $181.2K |
| L4387 | Walking boot, non-pneumatic, with or without joints, with or without interface material, prefabricated, off-the-shelf | 1 | 10 | 880 | $110 | $69.1K |
| E0114 | Crutches underarm, other than wood, adjustable or fixed, pair, with pads, tips and handgrips | 1 | 10 | 1,560 | $40 | $62.2K |
| 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 | 150 | $340 | $51.7K |
| L3908 | Wrist hand orthosis, wrist extension control cock-up, non molded, prefabricated, off-the-shelf | 1 | 10 | 140 | $50 | $40.3K |
| 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… | 2 | 10 | 100 | $90 | $40K |
| L3982 | Upper extremity fracture orthosis, radius/ulnar, prefabricated, includes fitting and adjustment | 1 | 10 | 120 | $220 | $26.8K |