Code: L3764

Description:
Description: Elbow wrist hand orthosis, includes one or more nontorsion joints, elastic bands, turnbuckles, may include soft interface, straps, custom fabricated, includes fitting and adjustment
HCPCS Category: Orthotic/prosthetic procedures
Other Descriptions:
HC EWHO INCL 1/MORE NONTORSION JOINTS CSTM FAB
EWHO INCL 1/MORE NONTORSION JOINTS CSTM FAB
SUPLINATION SPLINT
Hc Pt Ewho W/joint(s)cf
Hc Ot Ewho W/joint(s)cf
Related codes:
Code: L3760
BRACE ELBOW ROM NON
Code: L3761
ORTHS ELB ADJ POSLOCK JT
Code: L3762
IMOB ORTH ELB 11.5X9IN
Code: L3763
ELB/WRST/HND WO JTS CF
Code: L3765
ORTHOSIS ELB WRIST HAND
Code: L3766
ELB/WRST/HND/FNGR JTS CF
Indiana
Hospital Address Code Price Last Updated
Encompass Health Deaconess Rehabilitation Hospital 9355 Warrick Trl, Newburgh L3764 $1,805 [source] 3 years ago
Franciscan Health Lafayette East , Lafayette L3764 $2,452 [source] 3 years ago
Ascension St. Vincent Warrick 1116 Millis Ave, Boonville L3764 $2,686 [source] 3 years ago
Ascension St. Vincent Hospital 2001 W 86Th St, Indianapolis L3764 $2,686 [source] 3 years ago
Ascension Medical Group St. Vincent 301 Henry St, North Vernon L3764 $2,686 [source] 3 years ago
Ascension St. Vincent Evansville 3700 Washington Ave, Evansville L3764 $2,686 [source] 3 years ago
Ascension St. Vincent Williamsport 412 N Monroe St, Williamsport L3764 $2,686 [source] 3 years ago
St Vincent Salem Hospital Inc 911 N Shelby St, Salem L3764 $2,686 [source] 3 years ago
St. Vincent Mercy Hospital 1331 S A St, Elwood L3764 $2,686 [source] 3 years ago
Ascension St. Vincent Dunn 1600 23Rd St, Bedford L3764 $2,686 [source] 3 years ago
Ascension St. Vincent Randolph 473 E Greenville Ave, Winchester L3764 $2,686 [source] 3 years ago
Ascension St. Vincent Carmel 13500 N Meridian St, Carmel L3764 $2,686 [source] 3 years ago
Ascension St. Vincent Anderson 2015 Jackson St, Anderson L3764 $2,686 [source] 3 years ago
Ascension St. Vincent Heart Center 10580 N Meridian St, Indianapolis L3764 $2,686 [source] 3 years ago
St. Vincent Clay Hospital, Inc 1206 E National Ave, Brazil L3764 $6,012 [source] 3 years ago
Ascension St Vincent Fishers 13861 Olio Road, L3764 $6,012 [source] 3 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.