Code: L4396

Description:
Description: Static or dynamic ankle foot orthosis, including soft interface material, adjustable for fit, for positioning, may be used for minimal ambulation, prefabricated item that has been trimmed, bent, molded, assembled, or otherwise customized to fit a specific patient by an individual with expertise
HCPCS Category: Orthotic/prosthetic procedures
Other Descriptions:
BOOT PODUS STATIC AFL
BOOT MULTIPODUS X-LGE
ORTHOSIS ANK/FT STATIC
Yb Afo Static/dynamic Prefab
Ankle Contracture Splint
HC STAT ANK FT ORTHOS W/SFT INTERFCE MATL ADJ FIT
PRAFO
SPLNT ANK REG AIR GEL
BOOT SOF CARE HEEL LG LONG
Related codes:
Code: L4392
Description: Replacement, soft interface material, static afo
HCPCS Category: Orthotic/prosthetic procedures
Code: L4394
ORTHO REPLAC SOFT INTFCE
Code: L4397
SPLINT FOOT MPO2000 LRG
Code: L4398
BRACE ORTHO RT ANKL 4
Maine
Hospital Address Code Price Last Updated
Northern Light Maine Coast Hospital 50 Union St, Ellsworth L4396 $166 [source] 4 years ago
Sebasticook Valley Health 447 N Main St, Pittsfield L4396 $245 [source] 4 years ago
Northern Light Blue Hill Hospital 57 Water Street, Blue Hill L4396 $265 [source] 4 years ago
Eastern Maine Medical Center 489 State St, Bangor L4396 $379 [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.