Cranial cervical orthosis, congenital torticollis type, with or without soft interface material, adjustable range of motion joint, custom fabricated

Cranial cervical orthosis, congenital torticollis type, with or without joint, with or without soft interface material, prefabricated, includes fitting and adjustment

TLSO, flexible, provides trunk support, upper thoracic region, produces intracavitary pressure to reduce load on the intervertebral disks with rigid stays or panels, includes shoulder straps and closures, prefabricated

TLSO, flexible, provides trunk support, upper thoracic region, produces intracavitary pressure to reduce load on the intervertebral disks with rigid stays or panels

TLSO, flexible, provides trunk support, extends from sacrococcygeal junction to above T9 vertebra, restricts gross trunk motion in the sagittal plane, produces intracavitary pressure to reduce load on the intervertebral disks

TLSO, flexible, provides trunk support, extends from sacrococcygeal junction to above T9 vertebra, restricts gross trunk motion in the sagittal plane, produces intracavitary pressure to reduce load on the intervertebral disks

TLSO, flexible, provides trunk support, thoracic region, rigid posterior panel and soft anterior apron, extends from the sacrococcygeal junction and terminates just inferior to the scapular spine, restricts gross trunk motion in the sagittal plane, produces intracavitary pressure to reduce load on the intervertebral disks, includes straps and closures, prefabricated

TLSO, flexible, provides trunk support, thoracic region, rigid posterior panel and soft anterior apron, extends from the sacrococcygeal junction and terminates just inferior to the scapular spine, restricts gross trunk motion in the sagittal plane, produces intracavitary pressure to reduce load on the intervertebral disks, includes straps and closures, prefabricated

TLSO, triplanar control, modular segmented spinal system, two rigid plastic shells, posterior extends from the sacrococcygeal junction and terminates just inferior to the scapular spine, anterior extends from the symphysis pubis to the xiphoid, soft liner, restricts gross trunk motion in the sagittal, coronal, and transverse planes, lateral strength is provided by overlapping plastic and stabilizing closures, includes straps and closures, prefabricated, includes fitting and adjustment

TLSO, triplanar control, modular segmented spinal system, two rigid plastic shells, posterior extends from the sacrococcygeal junction and terminates just inferior to the scapular spine, anterior extends from the symphysis pubis to the sternal notch, soft liner, restricts gross trunk motion in the sagittal, coronal, and transverse planes, lateral strength is provided by overlapping plastic and stabilizing closures, includes straps and closures, prefabricated

TLSO, triplanar control, modular segmented spinal system, three rigid plastic shells

TLSO, triplanar control, modular segmented spinal system, four rigid plastic shells

TLSO, sagittal control, rigid posterior frame and flexible soft anterior apron with straps, closures and padding, restricts gross trunk motion in sagittal plane, produces intracavitary pressure to reduce load on intervertebral disks, prefabricated

TLSO, sagittal control, rigid posterior frame and flexible soft anterior apron with straps, closures and padding, restricts gross trunk motion in sagittal plane, produces intracavitary pressure to reduce load on intervertebral disks, prefabricated

TLSO, sagittal-coronal control, rigid posterior frame and flexible soft anterior apron with straps, closures and padding, extends from sacrococcygeal junction over scapulae, lateral strength provided by pelvic, thoracic, and lateral frame pieces, restricts gross trunk motion in sagittal, and coronal planes, produces intracavitary pressure to reduce load on intervertebral disks, prefabricated

TLSO, sagittal-coronal control, rigid posterior frame and flexible soft anterior apron with straps, closures and padding, extends from sacrococcygeal junction over scapulae, lateral strength provided by pelvic, thoracic, and lateral frame pieces, restricts gross trunk motion in sagittal and coronal planes, produces intracavitary pressure to reduce load on intervertebral disks, prefabricated

TLSO, triplanar control, rigid posterior frame and flexible soft anterior apron with straps, closures and padding, extends from sacrococcygeal junction to scapula, lateral strength provided by pelvic, thoracic and lateral frame pieces, rotational strength provided by subclavicular extensions, restricts gross trunk motion in sagittal, coronal and transverse planes, provides intracavitary pressure to reduce load on the intervertebral disks, includes fitting and shaping the frame, prefabricated

TLSO, triplanar control, hyperextension, rigid anterior and lateral frame extends from symphysis pubis to sternal notch with two anterior components (one pubic and one sternal), posterior and lateral pads with straps

TLSO, triplanar control, one-piece rigid plastic shell without interface liner, with multiple straps and closures, posterior extends from sacrococcygeal junction and terminates just inferior to scapular spine

TLSO, triplanar control, one-piece rigid plastic shell without interface liner, multiple straps and closures, posterior extends from sacrococcygeal junction and terminates just inferior to scapular spine

TLSO, triplanar control, two-piece rigid plastic shell without interface liner, multiple straps and closures, posterior extends from sacrococcygeal junction and terminates just inferior to scapular spine

TLSO, triplanar control, two-piece rigid plastic shell without interface liner, multiple straps and closures, posterior extends from sacrococcygeal junction and terminates just inferior to scapular spine

TLSO, triplanar control, one-piece rigid plastic shell without interface liner, multiple straps and closures, posterior extends from sacrococcygeal junction and terminates just inferior to scapular spine

TLSO, sagittal-coronal control, one-piece rigid plastic shell with overlapping reinforced anterior, with multiple straps and closures, posterior extends from sacrococcygeal junction and terminates at or before the T9 vertebra, anterior extends from symphysis pubis to xiphoid, anterior opening, restricts gross trunk motion in sagittal and coronal planes, prefabricated

TLSO, sagittal-coronal control, modular segmented spinal system, two rigid plastic shells, posterior extends from the sacrococcygeal junction and terminates just inferior to the scapular spine, prefabricated

TLSO, sagittal-coronal control, modular segmented spinal system, three rigid plastic shells, posterior extends from the sacrococcygeal junction and terminates just inferior to the scapular spine, prefabricated

Sacroiliac orthosis, flexible, provides pelvic-sacral support, reduces motion about the sacroiliac joint, includes straps, closures, may include pendulous abdomen design, prefabricated

Sacroiliac orthosis, flexible, provides pelvic-sacral support, reduces motion about the sacroiliac joint, includes straps, closures, may include pendulous abdomen design, custom fabricated

Sacroiliac orthosis, provides pelvic-sacral support, with rigid or semi-rigid panels over the sacrum and abdomen, reduces motion about the sacroiliac joint, includes straps, closures, may include pendulous abdomen design, prefabricated, includes fitting and adjustment

Sacroiliac orthosis, flexible, provides pelvic-sacral support, with rigid or semi-rigid panels placed over the sacrum and abdomen, reduces motion about the sacroiliac joint, custom fabricated

Lumbar orthosis, flexible, provides lumbar support, posterior extends from L1 vertebra, produces intracavitary pressure to reduce load on the intervertebral discs, prefabricated, includes fitting and adjustment

Lumbar orthosis, sagittal control, with rigid posterior panels, posterior panels extend from L1 to below L5 vertebra, produces intracavitary pressure to reduce load on intervertebral discs, prefabricated

Lumbar orthosis, sagittal control, with rigid posterior panels, posterior panels, produces intracavitary pressure to reduce load on intervertebral discs, prefabricated

Lumbar-sacral orthosis, flexible, provides lumbo-sacral support, posterior extends from sacrococcygeal junction to T9 vertebra, produces intracavitary pressure to reduce load on the intervertebral discs, prefabricated

Lumbar-sacral orthosis, flexible, provides lumbo-sacral support, posterior cavitary pressure to reduce load on the intervertebral discs, prefabricated

Lumbar-sacral orthosis, sagittal control, with rigid posterior panels, intracavitary pressure to reduce load on the intervertebral discs, prefabricated

Lumbar-sacral orthosis, sagittal control, with rigid anterior and posterior panels, intracavitary pressure to reduce load on the intervertebral discs, prefabricated

Lumbar-sacral orthosis, sagittal control, with rigid anterior and posterior panels, posterior extends from sacrococcygeal junction to T9 vertebra, produces intracavitary pressure to reduce load on the intervertebral discs, custom fabricated

Lumbar-sacral orthosis, sagittal-coronal control, with rigid posterior strength provided by rigid lateral frame or panels, prefabricated

Lumbar-sacral orthosis, sagittal-coronal control, with rigid posterior frame or panels, posterior extends from sacrococcygeal junction to T9 vertebra, lateral strength provided by rigid lateral frame or panels, custom fabricated

Lumbar-sacral orthosis, sagittal-coronal control, lumbar flexion, rigid posterior frame or panels, lateral articulating design to flex the lumbar spine, posterior extends from sacrococcygeal junction to T9 vertebra, prefabricated

Lumbar-sacral orthosis, sagittal-coronal control, lumbar flexion, rigid posterior frame or panels, lateral articulating design to flex the lumbar spine, posterior extends from sacrococcygeal junction to T9 vertebra, custom fabricated

Lumbar-sacral orthosis, sagittal-coronal control, with rigid anterior and strength provided by rigid lateral frame or panels, prefabricated

Lumbar-sacral orthosis, sagittal-coronal control, with rigid anterior and posterior frame or panels, post extends from sacrococcygeal junction to T9 vertebra, lateral strength provided by rigid lateral frame or panels, custom fabricated

Lumbar-sacral orthosis, sagittal-coronal control, rigid shells or panels, from symphysis pubis to xyphoid, prefabricated

Lumbar-sacral orthosis, sagittal-coronal control, rigid shells or panels, posterior extends from sacrococcygeal junction to T9 vertebra, anterior extends from symphysis pubis to xyphoid, custom fabricated

Lumbar orthosis, sagittal control, with rigid posterior panels, posterior extends from L1 to below L5 vertebra, produces intracavitary pressure to reduce load on intervertebral discs, includes straps, closures

Lumbar orthosis, sagittal control, with rigid anterior and posterior panels, posterior extends from L1 to below L5 vertebra, produces intracavitary pressure to reduce load on the intervertebral discs

Lumbar-sacral orthosis, sagittal control, with rigid posterior panels

Lumbar-sacral orthosis, sagittal control, with rigid anterior and posterior panels, posterior extends from sacrococcygeal junction to T9 vertebra, produces intracavitary pressure to reduce load on the intervertebral discs

Lumbar-sacral orthosis, sagittal control, with rigid anterior and posterior panels, posterior extends from sacrococcygeal junction to T9 vertebra, produces intracavitary pressure to reduce load on the intervertebral discs

Lumbar-sacral orthosis, sagittal-coronal control, with rigid anterior and posterior frame or panels, posterior extends from sacrococcygeal junction to T9 vertebra, lateral strength provided by rigid lateral frame or panel

Lumbar-sacral orthosis, sagittal-coronal control, rigid shells or panels, posterior extends from sacrococcygeal junction to T9 vertebra, anterior extends from symphysis pubis to xyphoid, produces intracavitary pressure reduce load on the intervertebral discs

Cervical-thoracic-lumbar-sacral orthosis, anterior-posterior-lateral control, molded to patient model

Cervical-thoracic-lumbar-sacral orthosis, anterior-posterior-lateral control, molded to patient model, with interface material

Halo procedure, cervical halo incorporated into jacket vest

Halo procedure, cervical halo incorporated into plaster body jacket

Halo procedure, cervical halo incorporated into Milwaukee type orthosis

Addition to Halo procedure, magnetic resonance image compatible systems, rings and pins, any material

Addition to Halo procedure, replacement liner or interface material

TLSO, corset front

LSO, corset front

TLSO, full corset

LSO, full corset

HO, abduction control of hip joints, flexible, Frejka type with cover, prefabricated

HO, abduction control of hip joints, flexible, prefabricated, includes fitting and adjustment

HO, abduction control of hip joints, flexible, prefabricated, includes fitting and adjustment

HO, abduction control of hip joints, semi-flexible, custom fabricated

HO, abduction control of hip joints, static, pelvic band or spreader bar, thigh cuffs, custom fabricated

HO, abduction control of hip joints, static, adjustable, prefabricated, includes fitting and adjustment

HO, bilateral thigh cuffs with adjustable abductor spreader bar, adult size, prefabricated, includes fitting and adjustment, any type

HO, abduction control of hip joints, static, plastic, prefabricated, includes fitting and adjustment

HO, abduction control of hip joints, dynamic, pelvic control, adjustable hip motion control, thigh cuffs, custom fabricated

HO, bilateral hip joints and thigh cuffs, adjustable flexion, extension, abduction control of hip joint, postoperative hip abduction type, prefabricated

HO, abduction control of hip joint, postoperative hip abduction type, custom fabricated

HO, abduction control of hip joint, postoperative hip abduction type, prefabricated, includes fitting and adjustments

Combination, bilateral, lumbo-sacral, hip, femur orthosis providing adduction and internal rotation control, prefabricated, includes fitting and adjustment

Legg perthes othrosis (Toronto type), custom fabricated

Legg perthes orthosis (Newington type), custom fabricated

Legg perthes orthosis (Tachdijan type), custom fabricated

Legg perthes orthosis (Scottish Rite type), custom fabricated

Legg perthes orthosis (Patten Bottom type), custom fabricated

KO, elastic with joints, prefabricated, includes fitting and adjustment

KO, elastic with joints, prefabricated

KO, elastic with condylar pads and joints, with or without patellar control, prefabricated, includes fitting and adjustment

KO, immobilizer, canvas longitudinal, prefabricated, includes fitting and adjustment

KO, locking knee joints, positional orthosis, prefabricated, includes fitting and adjustment

KO, adjustable knee joints (unicentric or polycentric), positional orthosis, rigid support, prefabricated, includes fitting and adjustment

KO, adjustable knee joints (unicentric or polycentric), positional orthosis, rigid support, prefabricated

KO, without knee joint, rigid, custom fabricated

KO, rigid, without joints, includes soft interface material, prefabricated, includes fitting and adjustment

KO, derotation, medial-lateral, anterior cruciate ligament, custom fabricated

KO, single upright, thigh and calf, with adjustable flexion and extension joint (unicentric or polycentric), medial-lateral and rotation control, with or without varus or valgus adjustment, prefabricated, includes fitting and adjustment

KO, single upright, thigh and calf, with adjustable flexion and extension joint (unicentric or polycentric), medial-lateral and rotation control with or without varus or valgus adjustment, custom fabricated

KO, double upright, thigh and calf, with adjustable flexion and extension joint (unicentric or polycentric), medial-lateral and rotation control, with or without varus or valgus adjustment, prefabricated, includes fitting and adjustment

KO, double upright, thigh and calf, with adjustable flexion and extension joint (unicentric or polycentric), medial-lateral and rotation control, with or without varus or valgus adjustment, custom fabricated

KO, double upright with adjustable joint, with inflatable air support chambers, prefabricated, includes fitting and adjustment

KO, double upright with adjustable joint, with inflatable air support chambers, prefabricated

KO, Swedish type, prefabricated, includes fitting and adjustment

KO, single upright, thigh and calf, with adjustable flexion and extension joint (unicentric or polycentric), medial-lateral and rotation control, with or without varus or valgus adjustment, prefabricated

KO, double upright, thigh and calf, with adjustable flexion and extension joint (unicentric or polycentric), medial-lateral and rotation control, with or without varus or valgus adjustment, prefabricated

KO, modification of supracondylar prosthetic socket, custom fabricated

AFO, spring wire, dorsiflexion assist calf band, custom fabricated

AFO, ankle gauntlet, prefabricated, includes fitting and adjustment

AFO, ankle gauntlet or similar, with or without joints, custom fabricated

AFO, multipligamentus ankle support, prefabricated, includes fitting and adjustment

AFO, supramalleolar with straps, with or without interface or pads, custom fabricated

AFO, posterior, single bar, clasp attachment to shoe counter, prefabricated, includes fitting and adjustment

AFO, single upright with static or adjustable stops (Phelps or Perlstein type), custom fabricated

AFO, plastic or other material, prefabricated, includes fitting and adjustment

AFO, rigid anterior tibial section, total carbon fiber or equal material, prefabricated, includes fitting and adjustment

AFO, plastic or other material, custom fabricated

AFO, plastic, rigid anterior tibial section (floor reaction), custom fabricated

AFO, spiral (institute of rehabilitative medicine type), plastic, custom fabricated

AFO, spiral, plastic or other material, prefabricated, includes fitting and adjustment

AFO, posterior solid ankle, plastic, custom fabricated

AFO, plastic with ankle joint, custom fabricated

AFO, plastic or other material with ankle joint, prefabricated, includes fitting and adjustment

AFO, single upright free plantar dorsiflexion, solid stirrup, calf band or cuff, custom fabricated

AFO, double upright free plantar dorsiflexion, solid stirrup, calf band or cuff, custom fabricated

Knee-ankle-foot orthosis (KAFO), single upright, free knee, free ankle, solid stirrup, thigh and calf bands or cuffs, custom fabricated

KAFO, any material, single or double upright, stance control, automatic lock and swing phase release, mechanical activation, includes ankle joint, any type, custom fabricated

Knee ankle foot device, any material, single or double upright, swing and stance phase microprocessor control with adjustability, includes all components, any-type activation with or without ankle joints, custom fabricated

KAFO, single upright, free ankle, solid stirrup, thigh and calf bands or cuffs, without knee joint, custom fabricated

KAFO, double upright, free ankle, solid stirrup, thigh and calf bands or cuffs, custom fabricated

KAFO, double upright, free ankle, solid stirrup, thigh and calf bands or cuffs, without knee joint, custom fabricated

KAFO, full plastic, single upright, with or without free motion knee, medial lateral rotation control, with or without free motion ankle, custom fabricated

KAFO, full plastic, static (pediatric size), without free motion ankle, prefabricated, includes fitting and adjustment

KAFO, full plastic, double upright, with or without free motion knee, with or without free motion ankle, custom fabricated

KAFO, full plastic, single upright, with or without free motion knee, with or without free motion ankle, custom fabricated

KAFO, full plastic, with or without free motion knee, multi-axis ankle, custom fabricated

Hip-knee-ankle-foot orthotic (HKAFO), torsion control, bilateral rotation straps, pelvic band/belt, custom fabricated

HKAFO, torsion control, bilateral torsion cables, hip joint, pelvic band or belt, custom fabricated

HKAFO, torsion control, bilateral torsion cables, ball bearing hip joint, pelvic band or belt, custom fabricated

HKAFO, torsion control, unilateral rotation straps, pelvic band or belt, custom fabricated

HKAFO, torsion control, unilateral torsion cable, hip joint, pelvic band or belt, custom fabricated

HKAFO, torsion control, unilateral torsion cable, ball bearing hip joint, pelvic band or belt, custom fabricated

AFO, fracture orthosis, tibial fracture cast orthosis, thermoplastic type casting material, custom fabricated

AFO, fracture orthosis, tibial fracture cast orthosis, custom fabricated

AFO, fracture orthosis, tibial fracture orthosis, soft, prefabricated, includes fitting and adjustment

AFO, fracture orthosis, tibial fracture orthosis, semi-rigid, prefabricated, includes fitting and adjustment

AFO, fracture orthosis, tibial fracture orthosis, rigid, prefabricated, includes fitting and adjustment

KAFO, fracture orthosis, femoral fracture cast orthosis, thermoplastic type casting material, custom fabricated

KAFO, fracture orthosis, femoral fracture cast orthosis, custom fabricated

KAFO, fracture orthosis, femoral fracture cast orthosis, soft, prefabricated, includes fitting and adjustment

KAFO, fracture orthosis, femoral fracture cast orthosis, semi-rigid, prefabricated, includes fitting and adjustment

SO, figure of 8 design, prefabricated, includes fitting and adjustment

SO, figure of 8 design abduction restrainer, canvas and webbing prefabricated, includes fitting and adjustment

SO, acromio/clavicular (canvas and webbing type), prefabricated, includes fitting and adjustment

SO, shoulder cap design, without joints, may include soft interface, straps, custom fabricated includes fitting and adjustment

SO, abduction positioning (airplane design), thoracic component and support bar, with or without nontorsion joint/turnbuckle, may include soft interface, straps, custom fabricated, includes fitting and adjustment

SO, vest type abduction restrainer, canvas webbing type or equal, prefabricated includes fitting and adjustment

EO, without joints, may include soft interface, straps, custom fabricated, includes fitting and adjustment

EO, elastic with metal joints, prefab, includes fitting and adjustment

EO, double upright with forearm or arm cuffs, extension or flexion assist, custom fabricated

EO, double upright with forearm or arm cuffs, extension or flexion assist, custom fabricated

EO, double upright with forearm or arm cuffs, adjustable position lock with active control, custom fabricated

EO, with adjustable position locking joints, prefabricated, includes fitting and adjustments any type

EO, with adjustable position locking joints, prefabricated

EO, rigid, without joints includes soft interface material, prefabricated, includes fitting and adjustment

Elbow-wrist-hand orthotic (EWHO), rigid, without joints may include soft interface, straps, custom fabricated, includes fitting and adjustment

EWHO. Includes one or more nontorsion joints, elastic bands, turnbuckles, may include soft interface, straps, custom fabricated, includes fitting and adjustment

Elbow-wrist-hand-finger orthotic (EWHFO), rigid, without joints, may include soft interface, straps, custom fabricated, includes fitting and adjustment

WHFO, includes one of more nontorsion joints, turnbuckles, elastic bands or springs, may include soft interface material, straps, custom fabricated, includes fitting and adjustment

WHFO, without joints, prefabricated, includes fitting and adjustments, any type

WHFO, dynamic flexor hinge, reciprocal wrist extension/flexion, finger flexion;/extension, wrist or finger driven, custom fabricated

WHFO, external powered, electric, custom fabricated

WHO, without joints, may include soft interface, straps, custom fabricated, includes fitting and adjustment

WHO, wrist extension control cock-up, nonmolded, prefabricated, includes fitting and adjustment

Hand-finger orthotic (HFO), flexion glove with elastic finger control, prefabricated, includes fitting and adjustment

HFO, without joints, may include soft interface, straps, custom fabricated, includes fitting and adjustment

WHO, includes one or more nontorsion joints, elastic bands, turnbuckles, may include soft interface, straps prefabricated, includes fitting and adjustment

Hand orthotic (HO), metacarpal fracture orthotic, prefabricated, includes fitting and adjustment

HS, without joints, may include soft interface, straps, custom fabricated, includes fitting and adjustment

HFO, includes one or more nontorsion joints, elastic bands turnbuckles, may include soft interface, straps, custom fabricated includes fitting and adjustment

HFO, without joints, may include soft interface, straps, prefabricated, includes fitting and adjustment

HFO, without joints, may include soft interface, straps, prefabricated

Finger orthotic (FO), proximal interphalangeal (PIP)/distal interphalangeal (DIP), nontorsion joint or spring, extension or flexion, may include soft interface material, prefabricated, includes fitting and adjustment

FO, proximal interphalangeal (PIP)/distal interphalangeal (DIP), without joint or spring, extension or flexion (for example, static or ring type), may include soft interface material, prefabricated, includes fitting and adjustment

HFO, includes one or more nontorsion joints, turnbuckles, elastic bands or springs, may include soft interface material, straps, prefabricated, includes fitting and adjustment

WHFO, includes one or more nontorsion joints, turnbuckles, elastic band or springs, may include soft interface material, straps, prefabricated, includes fitting and adjustment

FO, without joints, may include soft interface, custom fabricated, includes fitting and adjustment

FO, nontorsion joint, may include soft interface, custom fabricated, includes fitting and adjustment

SEWHO, abduction positioning, airplane design, prefabricated, includes, fitting and adjustment

SEWHO, shoulder cap design, without joints, may include soft interface, straps, custom fabricated, includes fitting and adjustment

SEWHO, abduction positioning, Erb’s palsy design, prefabricated, includes fitting and adjustment

SEWHO, abduction positioning (airplane design), thoracic component and support bar, without joints, may include soft interface, straps, custom fabricated, includes fitting and adjustment

SEWHO, shoulder cap design, includes one or more nontorsion joints, elastic bands, turnbuckles, may include soft interface, straps, custom fabricated includes fitting and adjustment

SWEHO, abduction positioning (airplane design), thoracic component and support bar, includes one or more nontorsion joints, elastic bands, turnbuckles, may include soft interface, straps, custom fabricated, includes fitting and adjustment

SEWHO, shoulder cap design, without joints, may include soft interface, straps, custom fabricated, includes fitting and adjustment

SEWHO, abduction positioning (airplane design), thoracic component and support bar, without joints, may include soft interface, straps, custom fabricated, includes fitting and adjustment

SEWHO, shoulder cap design, include one or more nontorsion joints, elastic bands, turnbuckles, may include soft interface, straps, custom fabricated, includes fitting and adjustment

Upper extremity fracture orthotic, humeral, prefabricated, includes fitting and adjustment

Upper extremity fracture orthosis, humeral, prefabricated, includes shoulder cap design, with or without joints, forearm section, may include soft interface, straps, includes fitting and adjustments

Upper extremity fracture orthotic, radius or ulnar, prefabricated, includes fitting and adjustment

Upper extremity fracture orthotic, wrist, prefabricated, includes fitting and adjustment

Addition to upper extremity orthotic, sock, fracture or equal, each

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

Repair of orthotic device, labor component, per 15 minutes