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HCPCS Range Endoskeletal Prosthetics, Lower Limbs

• 1 Hemipelvectomy, Canadian type; molded socket, hip joint, single axis constant friction knee, shin, SACH foot ( L5280 )

• 2 Below knee, molded socket, shin, SACH foot, endoskeletal system ( L5301 )

• 3 Knee disarticulation (or through knee), molded socket, single axis knee, pylon, SACH foot, endoskeletal system ( L5312 )

• 4 Above knee, molded socket, open end, SACH foot, endoskeletal system, single axis knee ( L5321 )

• 5 Hip disarticulation, Canadian type, molded socket, endoskeletal system, hip joint, single axis knee, SACH foot ( L5331 )

• 6 Hemipelvectomy, Canadian type, molded socket, endoskeletal system, hip joint, single axis knee, SACH foot ( L5341 )