| Code | Description | Price | Price Type | Last Updated |
|---|---|---|---|---|
| L5681 | 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) * | $2,536 [source] | — | 4 years ago |