HCPCS Range Above the Knee Prosthetics

• 1 Above knee, molded socket, single axis constant friction knee, shin, SACH foot ( L5200 )

• 2 Above knee, for proximal femoral focal deficiency, constant friction knee, shin, SACH foot ( L5230 )

• 3 Above knee, short prosthesis, no knee joint ('stubbies'), with foot blocks, no ankle joints, each ( L5210 )

• 4 Above knee, short prosthesis, no knee joint ('stubbies'), with articulated ankle/foot, dynamically aligned, each ( L5220 )