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
Nebraska
Hospital Address Code Price Last Updated
Chi Health Good Samaritan 10 E 31St St, Kearney L4396 $142 [source] 4 years ago
Chi Health Schuyler 1721 Colfax St, Schuyler L4396 $142 [source] 4 years ago
Chi Health Plainview 704 N 3Rd St, Plainview L4396 $142 [source] 4 years ago
Chi Health St. Mary 1301 Grundman Blvd, Nebraska City L4396 $142 [source] 4 years ago
Chi Health St. Francis 2116 W Faidley Ave, Grand Island L4396 $142 [source] 4 years ago
Chi Health Lakeside 17201 Wright St, Omaha L4396 $285 [source] 4 years ago
Chi Health Midlands 11111 S 84Th St, Papillion L4396 $285 [source] 4 years ago
Chi Health Creighton University Medical Center - Bergan Mercy 7500 Mercy Rd, Omaha L4396 $285 [source] 4 years ago
Chi Health Immanuel 7101 Newport Ave, Omaha L4396 $285 [source] 4 years ago
Chi Health St. Elizabeth 555 S. 70Th St., Lincoln L4396 $425 [source] 4 years ago
Chi Health Nebraska Heart 7500 So. 91St St., Lincoln L4396 $425 [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.