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
California
Hospital Address Code Price Last Updated
Santa Clara Medical Center 700 Lawrence Expy, Santa Clara L1904 $1,185 [source] 4 years ago
South San Francisco Medical Center 1200 El Camino Real, South San Francisco L1904 $1,185 [source] 4 years ago
Oakland Medical Center 3600 Broadway, Woodland Hills L1904 $1,185 [source] 4 years ago
Sacramento Medical Center 2025 Morse Ave, Sacramento L1904 $1,185 [source] 4 years ago
Kaiser Foundation Hospitals 4501 Sand Creek Road, Antioch L1904 $1,185 [source] 4 years ago
Modesto Medical Center 4601 Dale Rd, Modesto L1904 $1,185 [source] 4 years ago
Vacaville Medical Center 1 Quality Dr, Vacaville L1904 $1,185 [source] 4 years ago
San Leandro Medical Center 2500 Merced St, San Leandro L1904 $1,185 [source] 4 years ago
Walnut Creek Medical Center 1425 S Main St, Walnut Creek L1904 $1,185 [source] 4 years ago
San Jose Medical Center 250 Hospital Pkwy, San Jose L1904 $1,185 [source] 4 years ago
South Sacramento Medical Center 6600 Bruceville Rd, Sacramento L1904 $1,185 [source] 4 years ago
Richmond Medical Center 901 Nevin Ave, Richmond L1904 $1,185 [source] 4 years ago
Santa Rosa Medical Center 401 Bicentennial Way, American Canyon L1904 $1,185 [source] 4 years ago
Redwood City Medical Center 1100 Veterans Blvd, Redwood City L1904 $1,185 [source] 4 years ago
Vallejo Medical Center 975 Sereno Dr, Vallejo L1904 $1,185 [source] 4 years ago
San Rafael Medical Center 99 Montecillo Rd, San Rafael L1904 $1,185 [source] 4 years ago
San Francisco Medical Center 2525 Geary Blvd, San Francisco L1904 $1,185 [source] 4 years ago
Fresno Medical Center 39400 Paseo Padre Pkwy, Fresno L1904 $1,185 [source] 4 years ago
Roseville Medical Center 1600 Eureka Rd, Roseville L1904 $1,185 [source] 4 years ago
Encompass Health Rehabilitation Hospital Of Modesto 1303 Mable Avenue, Modesto L1904 $1,355 [source] 4 years ago

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.