Code: L1904

Description:
Description: Ankle orthosis, ankle gauntlet or similar, with or without joints, custom fabricated
HCPCS Category: Orthotic/prosthetic procedures
Other Descriptions:
ANKLE ORTHOSIS ANKLE GAUNTLET CUSTOM FABRICATED
Afo molded ankle gauntlet
Related codes:
Code: L1900
Description: Ankle foot orthosis, spring wire, dorsiflexion assist calf band, custom fabricated
HCPCS Category: Orthotic/prosthetic procedures
Code: L1901
ANK ORTHOTIC ELASTIC PREFAB INCLUDES FIT & ADJ
Code: L1902
BRACE LG ANKL DRBLE
Code: L1906
BRACE ANKLE RT AIRCAST
Code: L1907
BRACE ORTH ANKL FT GNTLT
State Average # Hospitals In Database
West Virginia (WV) $252 1
Alabama (AL) $295 1
Tennessee (TN) $300 1
Minnesota (MN) $315 13
Oklahoma (OK) $320 2
Virginia (VA) $332 1
Kansas (KS) $338 3
Wisconsin (WI) $375 2
Hawaii (HI) $505 4
Florida (FL) $537 2
Kentucky (KY) $591 1
Pennsylvania (PA) $594 3
Georgia (GA) $697 1
Texas (TX) $747 10
New York (NY) $807 3
Delaware (DE) $830 1
Louisiana (LA) $843 1
Illinois (IL) $858 7
Massachusetts (MA) $939 3
Washington (WA) $1,045 2
California (CA) $1,193 21
Maine (ME) $1,238 1
Rhode Island (RI) $1,403 2
Indiana (IN) $1,556 14

ChargemasterDB by Joseph Paul Cohen
A database of US hospital prices based on data made available by the Centers for Medicare & Medicaid Services (CMS), HHS price transparancy rule 45 CFR ยง180.