HCPCS Service Codes - Lump sum purchase of DME, prosthetics, orthotics

HCPCS Service Code P for Lump sum purchase of DME, prosthetics, orthotics.

HCPCS Type of Service (TOS) code is an indicator that the contractor places on Form CMS-1500. The indicator is mainly used for data purposes, however in some instances, it affects payment. All HCPCS codes have a corresponding TOS indicator.

Below are all available HCPCS TOS codes. Find an HCPCS code based on the type of service.

HCPCS Codes for Lump sum purchase of DME, prosthetics, orthotics

  • L4000

    Replace girdle for spinal orthosis (ctlso or so)

  • L4002

    Replacement strap, any orthosis, includes all components, any length, any type

  • L4010

    Replace trilateral socket brim

  • L4020

    Replace quadrilateral socket brim, molded to patient model

  • L4030

    Replace quadrilateral socket brim, custom fitted

  • L4040

    Replace molded thigh lacer, for custom fabricated orthosis only

  • L4045

    Replace non-molded thigh lacer, for custom fabricated orthosis only

  • L4050

    Replace molded calf lacer, for custom fabricated orthosis only

  • L4055

    Replace non-molded calf lacer, for custom fabricated orthosis only

  • L4060

    Replace high roll cuff

  • L4070

    Replace proximal and distal upright for kafo

  • L4080

    Replace metal bands kafo, proximal thigh

  • L4090

    Replace metal bands kafo-afo, calf or distal thigh

  • L4100

    Replace leather cuff kafo, proximal thigh

  • L4110

    Replace leather cuff kafo-afo, calf or distal thigh

  • L4130

    Replace pretibial shell

  • L4205

    Repair of orthotic device, labor component, per 15 minutes

  • L4210

    Repair of orthotic device, repair or replace minor parts

  • L4350

    Ankle control orthosis, stirrup style, rigid, includes any type interface (e.g., pneumatic, gel), prefabricated, off-the-shelf

  • 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 specific patient by an individual with expertise

  • L4361

    Walking boot, pneumatic and/or vacuum, with or without joints, with or without interface material, prefabricated, off-the-shelf

  • L4370

    Pneumatic full leg splint, prefabricated, off-the-shelf

  • L4386

    Walking boot, non-pneumatic, with or without joints, with or without interface material, prefabricated item that has been trimmed, bent, molded, assembled, or otherwise customized to fit a specific patient by an individual with expertise

  • L4387

    Walking boot, non-pneumatic, with or without joints, with or without interface material, prefabricated, off-the-shelf

  • L4392

    Replacement, soft interface material, static afo

  • L4394

    Replace soft interface material, foot drop splint

  • L4396

    Static or dynamic ankle foot orthosis, including soft interface material, adjustable for fit, for positioning, may be used for minimal ambulation, prefabricated item that has been trimmed, bent, molded, assembled, or otherwise customized to fit a specific patient by an individual with expertise

  • L4397

    Static or dynamic ankle foot orthosis, including soft interface material, adjustable for fit, for positioning, may be used for minimal ambulation, prefabricated, off-the-shelf

  • L4398

    Foot drop splint, recumbent positioning device, prefabricated, off-the-shelf

  • L4631

    Ankle foot orthosis, walking boot type, varus/valgus correction, rocker bottom, anterior tibial shell, soft interface, custom arch support, plastic or other material, includes straps and closures, custom fabricated

  • L5000

    Partial foot, shoe insert with longitudinal arch, toe filler

  • L5010

    Partial foot, molded socket, ankle height, with toe filler

  • L5020

    Partial foot, molded socket, tibial tubercle height, with toe filler

  • L5050

    Ankle, symes, molded socket, sach foot

  • L5060

    Ankle, symes, metal frame, molded leather socket, articulated ankle/foot

  • L5100

    Below knee, molded socket, shin, sach foot

  • L5105

    Below knee, plastic socket, joints and thigh lacer, sach foot

  • L5150

    Knee disarticulation (or through knee), molded socket, external knee joints, shin, sach foot

  • L5160

    Knee disarticulation (or through knee), molded socket, bent knee configuration, external knee joints, shin, sach foot

  • L5200

    Above knee, molded socket, single axis constant friction knee, shin, sach foot

  • L5210

    Above knee, short prosthesis, no knee joint ('stubbies'), with foot blocks, no ankle joints, each

  • L5220

    Above knee, short prosthesis, no knee joint ('stubbies'), with articulated ankle/foot, dynamically aligned, each

  • L5230

    Above knee, for proximal femoral focal deficiency, constant friction knee, shin, sach foot

  • L5250

    Hip disarticulation, canadian type; molded socket, hip joint, single axis constant friction knee, shin, sach foot

  • L5270

    Hip disarticulation, tilt table type; molded socket, locking hip joint, single axis constant friction knee, shin, sach foot

  • L5280

    Hemipelvectomy, canadian type; molded socket, hip joint, single axis constant friction knee, shin, sach foot

  • L5301

    Below knee, molded socket, shin, sach foot, endoskeletal system

  • L5312

    Knee disarticulation (or through knee), molded socket, single axis knee, pylon, sach foot, endoskeletal system

  • L5321

    Above knee, molded socket, open end, sach foot, endoskeletal system, single axis knee

  • L5331

    Hip disarticulation, canadian type, molded socket, endoskeletal system, hip joint, single axis knee, sach foot