HCPCS Code L1904
Ankle orthosis, ankle gauntlet or similar, with or without joints, custom fabricated
| Short Description | Afo molded ankle gauntlet |
|---|---|
| Year | 2026 |
| Coverage Code | C = Carrier judgment |
| Action Code | N = No maintenance for this code |
| Action Effective Date | January 01, 2016 |
| Code Added Date | January 01, 1988 |
| Pricing Indicator | 38 = Orthotics, prosthetics, prosthetic devices & vision services (price subject to floors and ceilings) |
| Type of Service | P = Lump sum purchase of DME, prosthetics, orthotics |