| E0483 | High frequency chest wall oscillation system, with full anterior and/or posterior thoracic region receiving simultaneous external oscillation, includes all accessories and supplies, each | 2 | 10 | 370 | $500 | $656.2K |
| E2402 | Negative pressure wound therapy electrical pump, stationary or portable | 7 | 20 | 300 | $350 | $563.7K |
| E1390 | Oxygen concentrator, single delivery port, capable of delivering 85 percent or greater oxygen concentration at the prescribed flow rate | 37 | 150 | 8,400 | $30 | $342.7K |
| E0466 | Home ventilator, any type, used with non-invasive interface, (e.g., mask, chest shell) | 18 | 50 | 410 | $210 | $248.6K |
| L0650 | Lumbar-sacral orthosis, sagittal-coronal control, with rigid anterior and posterior frame/panel(s), posterior extends from sacrococcygeal junction to t-9 vertebra, lateral strength provided by rigid… | 4 | 30 | 120 | $480 | $132.6K |
| A6550 | Wound care set, for negative pressure wound therapy electrical pump, includes all supplies and accessories | 7 | 10 | 140 | $70 | $85K |
| A7030 | Full face mask used with positive airway pressure device, each | 4 | 110 | 1,270 | $30 | $79.4K |
| L1833 | Knee orthosis, adjustable knee joints (unicentric or polycentric), positional orthosis, rigid support, prefabricated, off-the shelf | 7 | 10 | 160 | $190 | $72.3K |
| K0823 | Power wheelchair, group 2 standard, captains chair, patient weight capacity up to and including 300 pounds | 14 | 40 | 550 | $60 | $69.5K |
| L4361 | Walking boot, pneumatic and/or vacuum, with or without joints, with or without interface material, prefabricated, off-the-shelf | 4 | 30 | 90 | $140 | $68.3K |