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
Illinois
Hospital Address Code Price Last Updated
Adventist Bolingbrook Hospital 500 Remington Blvd, Bolingbrook L1904 $532 [source] 4 years ago
Presence St. Mary's Hospital 500 W Court St, Kankakee L1904 $708 [source] 4 years ago
Alexian Brothers Medical Center 935 Beisner Rd, Elk Grove Village L1904 $928 [source] 4 years ago
Adventist Hinsdale Hospital 120 N Oak St, Hinsdale L1904 $953 [source] 4 years ago
Adventist Lagrange Memorial Hospital 5101 Willow Springs Rd, La Grange L1904 $961 [source] 4 years ago
Adventist Glenoaks Hospital 701 Winthrop Ave, Glendale Heights L1904 $961 [source] 4 years ago
St. Alexius Medical Center 1555 Barrington Road, L1904 $965 [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.