HCPCS Range Shoulder Orthotics

• 1 Shoulder orthosis (SO), figure of eight design abduction restrainer, prefabricated, off-the-shelf ( L3650 )

• 2 Shoulder orthosis (SO), figure of eight design abduction restrainer, canvas and webbing, prefabricated, off-the-shelf ( L3660 )

• 3 Shoulder orthosis (SO), acromio/clavicular (canvas and webbing type), prefabricated, off-the-shelf ( L3670 )

• 4 Shoulder orthosis (SO), shoulder joint design, without joints, may include soft interface, straps, custom fabricated, includes fitting and adjustment ( L3671 )

• 5 Shoulder orthosis (SO), abduction positioning (airplane design), thoracic component and support bar, with or without nontorsion joint/turnbuckle, may include soft interface, straps, custom fabricated, includes fitting and adjustment ( L3674 )

• 6 Shoulder orthosis (SO), vest type abduction restrainer, canvas webbing type or equal, prefabricated, off-the-shelf ( L3675 )

• 7 Shoulder orthosis (SO), shoulder joint design, without joints, may include soft interface, straps, prefabricated item that has been trimmed, bent, molded, assembled, or otherwise customized to fit a specific patient by an individual with expertise ( L3677 )

• 8 Shoulder orthosis (SO), shoulder joint design, without joints, may include soft interface, straps, prefabricated, off-the-shelf ( L3678 )