Shoulder and Elbow Team
EPIC Orthoses
| Manufacturer | Part # | Description | Cash Pay Price | HCPCS Code | 
| Aircast | 01AL | Aircast Semi Pneumatic Boot Walker | $67.50 | L4360 | 
| Aircast | 01AM | Aircast Semi Pneumatic Boot Walker | $67.50 | L4360 | 
| Aircast | 01AS | Aircast Semi Pneumatic Boot Walker | $67.50 | L4360 | 
| Aircast | 01FL | Aircast Foam Boot Walker | $75.75 | L4386 | 
| Aircast | 01FM | Aircast Foam Boot Walker | $75.75 | L4386 | 
| Aircast | 01FS | Aircast Foam Boot Walker | $75.75 | L4386 | 
| Aircast | 01FXL | Aircast Foam Boot Walker | $75.75 | L4386 | 
| Aircast | 01PDL | Aircast Pneumatic Diabetic Boot | $173.13 | L4360 | 
| Aircast | 01PDM | Aircast Pneumatic Diabetic Boot | $173.13 | L4360 | 
| Aircast | 01PDS | Aircast Pneumatic Diabetic Boot | $173.13 | L4360 | 
| Aircast | 01PDXL | Aircast Pneumatic Diabetic Boot | $173.13 | L4360 | 
| Aircast | 02MLL | Aircast Airsport Ankle Brace | $35.75 | L4350 | 
| Aircast | 02MLR | Aircast Airsport Ankle Brace | $35.75 | L4350 | 
| Aircast | 02MML | Aircast Airsport Ankle Brace | $35.75 | L4350 | 
| Aircast | 02MMR | Aircast Airsport Ankle Brace | $35.75 | L4350 | 
| Aircast | 02MSL | Aircast Airsport Ankle Brace | $35.75 | L4350 | 
| Aircast | 02MSR | Aircast Airsport Ankle Brace | $35.75 | L4350 | 
| Aircast | 09AM | Aircast Air Heel | $32.50 | L1906 | 
| Aircast | 16A01 | Hand and Wrist Cryo Cuff | $56.25 | A9270 | 
| Alimed | 60404-L | Desc Uco Adjustable Heel Lift | $15.00 | L3350 | 
| Alimed | 60404-M | Desc Uco Adjustable Heel Lift | $15.00 | L3350 | 
| Alimed | 60404-S | Uco Adj Heel Lift | $15.00 | L3350 | 
| Alimed | 64321 | Dorsal Night Splint | $44.99 | L4396 | 
| Alimed | 64322 | Dorsal Night Splint | $44.99 | L4396 | 
| Bauerfeind | 11011101010705 | Malleotrain | $56.25 | L1906 | 
| Bauerfeind | 11011101010706 | Malleotrain | $56.25 | L1906 | 
| Bauerfeind | 11011101070605 | Malleotrain | $56.25 | L1906 | 
| Bauerfeind | 11011101070606 | Malleotrain | $56.25 | L1906 | 
| Bauerfeind | 13017001000003 | Visco Heel N (pair) | $28.75 | L3485 | 
| Bauerfeind | 13017301000001 | Visco Peds (pair) | $71.25 | L3485 | 
| Bauerfeind | 13017301000002 | Visco Peds (pair) | $71.25 | L3003 | 
| Bauerfeind | 13017301000003 | Visco Peds (pair) | $71.25 | L3003 | 
| Benik | E50003 | Tennis Elbow w/strap | $30.00 | L3700 | 
| Benik | E50005 | Tennis Elbow w/strap | $30.00 | L3700 | 
| Benik | E50007 | Tennis Elbow w/strap | $30.00 | L3700 | 
| Benik | W200 | Wrist Wrap | $15.31 | L3908 | 
| Benik | W201T-L | Wrist Wrap W/ Thumb | $17.49 | L3807 | 
| Benik | W201T-M | Wrist Wrap W/ Thumb | $17.49 | L3807 | 
| Benik | W201T-S | Wrist Wrap W/ Thumb | $17.49 | L3807 | 
| Breg | 07171 | Adj. Knee Support | $60.00 | L1825+L2795 | 
| Breg | 07172 | Adj. Knee Support | $60.00 | L1825+L2795 | 
| Breg | 07173 | Adj. Knee Support | $60.00 | L1825+L2795 | 
| Breg | 07174 | Adj. Knee Support | $60.00 | L1825+L2795 | 
| Breg | 07175 | Adj. Knee Support | $60.00 | L1825+L2795 | 
| Breg | 07176 | Adj. Knee Support | $60.00 | L1825+L2795 | 
| Breg | 07593 | Quick Fit Post-Op | $141.25 | L1832 | 
| Breg | 07594 | Quick Fit Post-Op | $141.25 | L1832 | 
| Breg | 08710 | Knee Support, Neo w/open pat | $30.00 | L1825 | 
| Breg | 08720 | Knee Support, Neo w/open pat | $30.00 | L1825 | 
| Breg | 08730 | Knee Support, Neo w/open pat | $30.00 | L1825 | 
| Breg | 08740 | Knee Support, Neo w/open pat | $30.00 | L1825 | 
| Breg | 08750 | Knee Support, Neo w/open pat | $30.00 | L1825 | 
| Breg | 08760 | Knee Support, Neo w/open pat | $30.00 | L1825 | 
| Breg | 14304 | PTO airmesh, Open Back | $148.75 | L1810 + L2795 | 
| Breg | 14305 | PTO airmesh, Open Back | $148.75 | L1810 + L2795 | 
| Breg | 14306 | PTO airmesh, Open Back | $148.75 | L1810 + L2795 | 
| Breg | 14312 | PTO airmesh, Open Back | $148.75 | L1810 + L2795 | 
| Breg | 14314 | PTO airmesh, Open Back | $148.75 | L1810 + L2795 | 
| Breg | 14315 | PTO airmesh, Open Back | $148.75 | L1810 + L2795 | 
| Breg | 14316 | PTO airmesh, Open Back | $148.75 | L1810 + L2795 | 
| Darco | OQ1B | Darco Ortho Wedge | $15.00 | L3260 | 
| Darco | OQ2B | Darco Ortho Wedge | $15.00 | L3260 | 
| Darco | OQ3B | Darco Ortho Wedge | $15.00 | L3260 | 
| DJ Ortho | 11-0180-2 | IROM Elbow Brace | $116.25 | L3760 | 
| DJ Ortho | 11-0180-4 | IROM Elbow Brace | $116.25 | L3760 | 
| DJ Ortho | 11-0181-2 | IROM Elbow Brace | $116.25 | L3760 | 
| DJ Ortho | 11-0181-4 | IROM Elbow Brace | $116.25 | L3760 | 
| DJ Ortho | 11-0467-9 | Forearm Support w/ Pad | $30.00 | L3701 | 
| DJ Ortho | 11-0666-1 | Drytex Playmaker Wraparound | $176.25 | L1832 | 
| DJ Ortho | 11-0966-9 | TROM Enhanced Bilateral Shells | $163.75 | L1832 | 
| hapad | HP2-1 | 2-1/2 x 1/2" Heel Pads (pair) | $15.00 | L3480 | 
| hapad | HP25 (PAIR) | 2 ½" x 5/16" Hapad heel pad (pair) | $15.83 | L3480 | 
| hely & weber | 304L | Webly Ankle Stabilizing Orthosis Ankle Brace | $16.80 | L1906 | 
| hely & weber | 304M | Webly Ankle Stabilizing Orthosis Ankle Brace | $16.80 | L1906 | 
| hely & weber | 304S | Webly Ankle Stabilizing Orthosis Ankle Brace | $16.80 | L1906 | 
| hely & weber | 3838-BLK-L | Tennis Elbow w/Compression Pad,Elastic Strap | $30.00 | L3701 | 
| hely & weber | 3838-BLK-M | Tennis Elbow w/Compression Pad,Elastic Strap | $30.00 | L3701 | 
| hely & weber | 3838-BLK-S | Tennis Elbow w/Compression Pad,Elastic Strap | $30.00 | L3701 | 
| hely & weber | 3838-BLK-XL | Tennis Elbow w/Compression Pad,Elastic Strap | $30.00 | L3701 | 
| hely & weber | 3838-BLK-XS | Tennis Elbow w/Compression Pad,Elastic Strap | $30.00 | L3701 | 
| Jim Hughes Co | 10385 | Silipos Achilles Heel Pad | $18.13 | L3350 | 
| Jim Hughes Co | 10395 | Silipos Achilles Heel Pad | $18.13 | L3350 | 
| Medical Ortho | 507-7 SZ 1 | Ankle Support | $46.19 | L1902 | 
| Medical Ortho | 507-7 SZ 2 | Ankle Support | $46.19 | L1902 | 
| Medical Ortho | 507-7 SZ 3 | Ankle Support | $46.19 | L1902 | 
| Medical Ortho | 507-7 SZ 4 | Ankle Support | $46.19 | L1902 | 
| Medical Ortho | 507-7 SZ 5 | Ankle Support | $46.19 | L1902 | 
| Medical Ortho | 507-7 SZ 6 | Ankle Support | $46.19 | L1902 | 
| Medical Ortho | 5115 SZ 1 | Achilles Support | $59.94 | L1902 | 
| Medical Ortho | 5115 SZ 3 | Achilles Support | $59.94 | L1902 | 
| Medical Ortho | 5115 SZ 4 | Achilles Support | $59.94 | L1902 | 
| Medical Ortho | 5115 SZ 5 | Achilles Support | $59.94 | L1902 | 
| Medical Ortho | 5115 SZ 6 | Achilles Support | $59.94 | L1902 | 
| Medical Ortho | 5115-SZ 2 | Achilles Support | $59.94 | L1902 | 
| Medline | MDS86420 | Aluminum Offset Cane | $15.00 | E0100 | 
| Medline | MDS86615 | Walker | $36.25 | E0135 | 
| Medline | mds86615w3 | 3" Wheels for Walkers | $24.44 | E0146 INCLUDES WALKER | 
| Medline | MDSV80534 | Crutches | $25.00 | E0114 | 
| Medline | MDSV80535 | Crutches | $25.00 | E0114 | 
| Medline | mdsv80536 | Crutches | $25.00 | E0114 | 
| Moore Medical | 76557 | Active Ankle Dorsal Night Splint | $39.85 | L4396 | 
| Moore Medical | 76558 | Active Ankle Dorsal Night Splint | $39.85 | L4396 | 
| North Coast Med | NC79556 | CMC Thumb Splint Plus | $18.71 | L3807 | 
| North Coast Med | NC79557 | CMC Thumb Splint Plus | $18.71 | L3807 | 
| North Coast Med | NC79558 | CMC Thumb Splint Plus | $18.71 | L3807 | 
| North Coast Med | NC79559 | CMC Thumb Splint Plus | $18.71 | L3807 | 
| North Coast Med | NC79560 | CMC Thumb Splint Plus | $18.71 | L3807 | 
| North Coast Med | NC79561 | CMC Thumb Splint Plus | $18.71 | L3807 | 
| North Coast Med | NC79562 | Comfort Cool Thumb | $18.71 | L3807 | 
| North Coast Med | NC79563 | Comfort Cool Thumb | $18.71 | L3807 | 
| North Coast Med | NC79564 | Comfort Cool Thumb | $18.71 | L3807 | 
| North Coast Med | NC79565 | Comfort Cool Thumb | $18.71 | L3807 | 
| North Coast Med | NC79566 | Comfort Cool Thumb | $18.71 | L3807 | 
| North Coast Med | NC79567 | Comfort Cool Thumb | $18.71 | L3807 | 
| Ortho America | 1089 | Humeral Fracture Brace | $115.00 | L3980 | 
| Ortho America | 1090 | Humeral Fracture Brace | $115.00 | L3980 | 
| Ortho America | 1091 | Humeral Fracture Brace | $115.00 | L3980 | 
| Ortho America | 1092 | Humeral Fracture Brace | $115.00 | L3980 | 
| Ortho America | 1093 | Humeral Fracture Brace | $115.00 | L3980 | 
| Ortho Outfitter | 264032 | Ankle Stabilizing Orthosis Ankle Brace w/ Stays | $29.94 | L1906 | 
| Ortho Outfitter | 264034 | Ankle Stabilizing Orthosis Ankle Brace w/ Stays | $29.94 | L1906 | 
| Ortho Outfitter | 264035 | Ankle Stabilizing Orthosis Ankle Brace w/ Stays | $29.94 | L1906 | 
| Ortho Outfitter | 264036 | Ankle Stabilizing Orthosis Ankle Brace w/ Stays | $29.94 | L1906 | 
| Orthomed | A21 | Half Arm | $15.00 | E1399 | 
| Orthomed | A31 | Full Arm | $15.00 | E1399 | 
| Orthomed | L25 | Half Leg | $15.00 | E1399 | 
| Orthomed | L44 | Full Leg | $20.31 | E1399 | 
| Ossur | 3030 | FormFit Thumb Spica | $20.00 | L3807 | 
| Ossur | 3050 | FormFit Thumb Spica | $20.00 | L3807 | 
| Ossur | 3070 | FormFit Thumb Spica | $20.00 | L3807 | 
| Ossur | 3080 | FormFit Thumb Spica | $20.00 | L3807 | 
| Ossur | 3130 | FormFit Thumb Spica | $20.00 | L3807 | 
| Ossur | 3150 | FormFit Thumb Spica | $20.00 | L3807 | 
| Ossur | 3170 | FormFit Thumb Spica | $20.00 | L3807 | 
| Ossur | 317072 | FormFit Thumb Spica | $20.00 | L3807 | 
| Ossur | 317073 | 8" Formfit Wrist Splint Brace | $15.00 | L3908 | 
| Ossur | 317075 | 8" Formfit Wrist Splint Brace | $15.00 | L3908 | 
| Ossur | 317077 | 8" Formfit Wrist Splint Brace | $15.00 | L3908 | 
| Ossur | 317078 | 8" Formfit Wrist Splint Brace | $15.00 | L3908 | 
| Ossur | 317082 | 8" Formfit Wrist Splint Brace | $15.00 | L3908 | 
| Ossur | 317083 | 8" Formfit Wrist Splint Brace | $15.00 | L3908 | 
| Ossur | 317085 | 8" Formfit Wrist Splint Brace | $15.00 | L3908 | 
| Ossur | 317087 | 8" Formfit Wrist Splint Brace | $15.00 | L3908 | 
| Ossur | 317088 | 8" Formfit Wrist Splint Brace | $15.00 | L3908 | 
| Ossur | 3180 | FormFit Thumb Spica | $20.00 | L3807 | 
| Ossur | 50007 | FormFit Night Splint | $30.00 | L4396 | 
| Ossur | S180WL | Darco Med-Surg Shoe | $15.00 | L3260 | 
| Ossur | S180WM | Darco Med-Surg Shoe | $15.00 | L3260 | 
| Ossur | S180WS | Darco Med-Surg Shoe | $15.00 | L3260 | 
| Ossur | S190ML | Darco Med-Surg Shoe | $15.00 | L3260 | 
| Ossur | S190MM | Darco Med-Surg Shoe | $15.00 | L3260 | 
| Ossur | S190MS | Darco Med-Surg Shoe | $15.00 | L3260 | 
| Procare | 72273 | Tuli's Pro Heel Cup Pair | $15.24 | L3332 | 
| Procare | 72275 | Tuli's Pro Heel Cup Pair | $15.24 | L3332 | 
| Procare | 72277 | Tuli's Pro Heel Cup Pair | $15.24 | L3332 | 
| Procare | 80020 | 20" 3 Panel Knee Splint | $37.25 | L1830 | 
| Procare | 80110 | 16" 3 Panel Knee Splint | $32.25 | L1830 | 
| Procare | 81113 | Rocker Cast Boot/Sandal | $15.00 | L3260 | 
| Procare | 81115 | Rocker Cast Boot/Sandal | $15.00 | L3260 | 
| Procare | 81117 | Rocker Cast Boot/Sandal | $15.00 | L3260 | 
| Procare | 81372 | Elastic Ankle Support w/ Figure 8 Strap | $17.81 | L1902 | 
| Procare | 81373 | Elastic Ankle Support w/ Figure 8 Strap | $17.81 | L1902 | 
| Procare | 81375 | Elastic Ankle Support w/ Figure 8 Strap | $17.81 | L1902 | 
| Procare | 81377 | Elastic Ankle Support w/ Figure 8 Strap | $17.81 | L1902 | 
| Procare | 82392 | Reddie Brace | $57.50 | L1810 | 
| Procare | 82393 | Reddie Brace | $57.50 | L1810 | 
| Procare | 82395 | Reddie Brace | $57.50 | L1810 | 
| Procare | 82397 | Reddie Brace | $57.50 | L1810 | 
| Procare | 82398 | Reddie Brace | $57.50 | L1810 | 
| Procare | 82399 | Reddie Brace | $57.50 | L1810 | 
| Procare | 82399 | Reddie Brace | $57.50 | L1810 | 
| Procare | 82702 | Sports Knee w/ Buttress | $30.00 | L1825 | 
| Procare | 82703 | Sports Knee w/ Buttress | $30.00 | L1825 | 
| Procare | 82705 | Sports Knee w/ Buttress | $30.00 | L1825 | 
| Procare | 82707 | Sports Knee w/ Buttress | $30.00 | L1825 | 
| Procare | 82708 | Sports Knee w/ Buttress | $30.00 | L1825 | 
| Procare | 84013 | Clinical Shoulder Immobilizer | $15.00 | L3650 | 
| Procare | 84015 | Clinical Shoulder Immobilizer | $15.00 | L3650 | 
| Procare | 84017 | Clinical Shoulder Immobilizer | $15.00 | L3650 | 
| Procare | 84153 | Arm Sling w/ Pad Strap | $17.50 | L3660 | 
| Procare | 84155 | Arm Sling w/ Pad Strap | $17.50 | L3660 | 
| Procare | 84157 | Arm Sling w/ Pad Strap | $17.50 | L3660 | 
| Procare | 85100 | Clavical Splint | $16.66 | L3650 | 
| Procare | 89070 | 9" 3-Pannel Binder (30"-45") | $30.00 | L0210 | 
| Procare | 89071 | 9" 3-Panel Binder (45"-62") | $30.00 | L0210 | 
| Procare | 92170 | Thumb Support | $15.00 | L3807 | 
| Procare | 92470 | Cuff & Collar | $15.00 | L3660 | 
| Procare | 92471 | Cuff & Collar | $15.00 | L3660 | 
| Procare | 95130 | Achilles Wedge | $21.35 | L3350 | 
| Procare | 96100 | Thumb Spica | $15.00 | L3807 | 
| Procare | 96820 | Shoulder Immobilizer - Deluxe | $18.23 | L3650 | 
| Procare | 97867 | Surround Gel Ankle Reg 10" | $33.69 | L4350 | 
| Sammons Preston | 55984302 | Back Sppt (Waist to Hip) | $50.00 | L0625 | 
| Sammons Preston | 55984303 | Back Sppt (Waist to Hip) | $50.00 | L0625 | 
| Sammons Preston | 564743 | Wrist Widget | $50.55 | L3908 | 
| Sammons Preston | C55984301 | Back Sppt (Waist to Hip) | $50.00 | L0625 | 
| Sammons Preston | C55984301 | Back support | $50.00 | L0625 | 
| Sammons Preston | C55984302 | Back support | $50.00 | L0625 | 
| Sammons Preston | C55984303 | Back support | $50.00 | L0625 | 
| Sammons Preston | C55984304 | Back Sppt (Waist to Hip) | $50.00 | L0625 | 
| Sammons Preston | C55984304 | Back support | $50.00 | L0625 | 
| Sammons Preston | C55984305 | Back Sppt (Waist to Hip) | $50.00 | L0625 | 
| Sammons Preston | C55984305 | Back support | $50.00 | L0625 | 
| Sammons Preston | C55984306 | Back Sppt (Waist to Hip) | $50.00 | L0625 | 
| Top Shelf | 501922 | Ankle Stabilizer | $26.25 | L1906 | 
| Top Shelf | 502023 | Arm Sling w/ Padded Strap | $15.00 | L3660 | 
| Top Shelf | 502024 | Arm Sling w/ Padded Strap | $15.00 | L3660 | 
| Top Shelf | 502025 | Arm Sling w/ Padded Strap | $15.00 | L3660 | 
| Top Shelf | 502026 | Arm Sling w/ Padded Strap | $15.00 | L3660 | 
| Top Shelf | 502054 | Stable Sling | $77.50 | L3670 | 
| Top Shelf | 502055 | Stable Sling | $77.50 | L3670 | 
| Top Shelf | 502070 | Stable Sling | $77.50 | L3670 | 
| Top Shelf | 502504 | Low-Profile Cast Shoe | $15.00 | L3260 | 
| Top Shelf | 502602 | Walk on Walker,Short | $47.50 | L4386 | 
| Top Shelf | 502603 | Walk on Walker,Short | $47.50 | L4386 | 
| Top Shelf | 502604 | Walk on Walker,Short | $47.50 | L4386 | 
| Top Shelf | 502605 | Walk on Walker,Short | $47.50 | L4386 | 
| Top Shelf | 502606 | Walk on Walker,Short | $47.50 | L4386 | 
| Top Shelf | 502612 | Walk on Walker,Tall | $48.75 | L4386 | 
| Top Shelf | 502613 | Walk on Walker,Tall | $48.75 | L4386 | 
| Top Shelf | 502614 | Walk on Walker,Tall | $48.75 | L4386 | 
| Top Shelf | 502615 | Walk on Walker,Tall | $48.75 | L4386 | 
| Top Shelf | 502616 | Walk on Walker,Tall | $48.75 | L4386 | 
| Top Shelf | 505202 | Lateral Patella Stabilizer,Kewl Mesh | $60.00 | L1800+L2795 | 
| Top Shelf | 505203 | Lateral Patella Stabilizer,Kewl Mesh | $60.00 | L1800+L2795 | 
| Top Shelf | 505204 | Lateral Patella Stabilizer,Kewl Mesh | $60.00 | L1800+L2795 | 
| Top Shelf | 505205 | Lateral Patella Stabilizer,Kewl Mesh | $60.00 | L1800+L2795 | 
| Top Shelf | 505206 | Lateral Patella Stabilizer,Kewl Mesh | $60.00 | L1800+L2795 | 
| Top Shelf | 505212 | Lateral Patella Stabilizer,Kewl Mesh | $60.00 | L1800+L2795 | 
| Top Shelf | 505213 | Lateral Patella Stabilizer,Kewl Mesh | $60.00 | L1800+L2795 | 
| Top Shelf | 505214 | Lateral Patella Stabilizer,Kewl Mesh | $60.00 | L1800+L2795 | 
| Top Shelf | 505215 | Lateral Patella Stabilizer,Kewl Mesh | $60.00 | L1800+L2795 | 
| Top Shelf | 505216 | Lateral Patella Stabilizer,Kewl Mesh | $60.00 | L1800+L2795 | 
| Top Shelf | 505217 | Lateral Patella Stabilizer,Kewl Mesh | $60.00 | L1800+L2795 | 
| Top Shelf | 505393 | Hinged Knee Plus,Wrprnd,w/ Open Pop,Kewl Mesh | $150.00 | L1832 | 
| Top Shelf | 505394 | Hinged Knee Plus,Wrprnd,w/ Open Pop,Kewl Mesh | $150.00 | L1832 | 
| Top Shelf | 505395 | Hinged Knee Plus,Wrprnd,w/ Open Pop,Kewl Mesh | $150.00 | L1832 | 
| Top Shelf | 505396 | Hinged Knee Plus,Wrprnd,w/ Open Pop,Kewl Mesh | $150.00 | L1832 | 
| Top Shelf | 505397 | Hinged Knee Plus,Wrprnd,w/ Open Pop,Kewl Mesh | $150.00 | L1832 | 
| Top Shelf | 505398 | Hinged Knee Plus,Wrprnd,w/ Open Pop,Kewl Mesh | $150.00 | L1832 |