| V2629 | Prosthetic eye, other type |
| V2623 | Prosthetic eye, plastic, custom |
| L7600 | Prosthetic donning sleeve, any material, each |
| L6500 | Above elbow, molded socket, endoskeletal system, including soft prosthetic tissue shaping |
| L6450 | Elbow disarticulation, molded socket, endoskeletal system, including soft prosthetic tissue shaping |
| L6550 | Shoulder disarticulation, molded socket, endoskeletal system, including soft prosthetic tissue shaping |
| L8415 | Prosthetic sheath, upper limb, each |
| L8465 | Prosthetic shrinker, upper limb, each |
| L8485 | Prosthetic sock, single ply, fitting, upper limb, each |
