| L3919 | Hand orthosis, without joints, may include soft interface, straps, custom fabricated, includes fitting and adjustment |
| L3924 | Hand finger orthosis, without joints, may include soft interface, straps, prefabricated, off-the-shelf |
| C1887 | Catheter, guiding (may include infusion/perfusion capability) |
| C1725 | Catheter, transluminal angioplasty, non-laser (may include guidance, infusion/perfusion capability) |
| L3916 | Wrist hand orthosis, includes one or more nontorsion joint(s), elastic bands, turnbuckles, may include soft interface, straps, prefabricated, off-the-shelf |
| S5105 | Day care services, center-based; services not included in program fee, per diem |
| G9756 | Surgical procedures that included the use of silicone oil |
| G9757 | Surgical procedures that included the use of silicone oil |
