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
Oklahoma
Hospital Address Code Price Last Updated
St. John Owasso 12451 E 100Th St N, Owasso L1904 $320 [source] 4 years ago
St. John Medical Center 1923 S Utica Ave, Tulsa L1904 $320 [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.