Socket Insert, Suspensions, and Other Prosthetic Additions HCPCS Code range L5654-L5699

Addition to lower extremity, below knee, removable medial brim suspension

Addition to lower extremity, below knee/above knee, custom fabricated from existing mold or prefabricated, socket insert, silicone gel, elastomeric or equal, for use with locking mechanism

Additions to lower extremity, below knee, knee joints, single axis, pair

Additions to lower extremity, below knee, knee joints, polycentric, pair

Additions to lower extremity, below knee, joint covers, pair

Addition to lower extremity, below knee/above knee, custom fabricated from existing mold or prefabricated, socket insert, silicone gel, elastomeric or equal, not for use with locking mechanism

Addition to lower extremity, below knee, thigh lacer, nonmolded

Addition to lower extremity, below knee/above knee, custom fabricated socket insert for congenital or atypical traumatic amputee, silicone gel, elastomeric or equal, for use with or without locking mechanism, initial only (for other than initial, use code L5673 or L5679)

Addition to lower extremity, below knee, thigh lacer, gluteal/ischial, molded

Addition to lower extremity, below knee/above knee, custom fabricated socket insert for other than congenital or atypical traumatic amputee, silicone gel, elastomeric or equal, for use with or without locking mechanism, initial only (for other than initial, use code L5673 or L5679)