| A5113 | Leg strap; latex, replacement only, per set |
| A5114 | Leg strap; foam or fabric, replacement only, per set |
| A7031 | Face mask interface, replacement for full face mask, each |
| K0019 | Arm pad, replacement only, each |
| L4002 | Replacement strap, any orthosis, includes all components, any length, any type |
| K0609 | Replacement electrodes for use with automated external defibrillator, garment type only, each |
| K0607 | Replacement battery for automated external defibrillator, garment type only, each |
| E1620 | Blood pump for hemodialysis, replacement |
| A4284 | Breast shield and splash protector for use with breast pump, replacement |
| E1530 | Air bubble detector for hemodialysis, each, replacement |
| A4257 | Replacement lens shield cartridge for use with laser skin piercing device, each |
| E2225 | Manual wheelchair accessory, caster wheel excludes tire, any size, replacement only, each |
| E2395 | Power wheelchair accessory, caster wheel excludes tire, any size, replacement only, each |
| E2384 | Power wheelchair accessory, pneumatic caster tire, any size, replacement only, each |
| E2385 | Power wheelchair accessory, tube for pneumatic caster tire, any size, replacement only, each |
| E2387 | Power wheelchair accessory, foam filled caster tire, any size, replacement only, each |
| K0045 | Footrest, complete assembly, replacement only, each |
| L8628 | Cochlear implant, external controller component, replacement |
| K0052 | Swingaway, detachable footrests, replacement only, each |
| E1560 | Blood leak detector for hemodialysis, each, replacement |
| A4457 | Enema tube, with or without adapter, any type, replacement only, each |
| K1013 | Enema tube, with or without adapter, any type, replacement only, each |
| E2224 | Manual wheelchair accessory, propulsion wheel excludes tire, any size, replacement only, each |
| E2394 | Power wheelchair accessory, drive wheel excludes tire, any size, replacement only, each |
| E2376 | Power wheelchair accessory, expandable controller, including all related electronics and mounting hardware, replacement only |
| K0051 | Cam release assembly, footrest or legrest, replacement only, each |
| K0072 | Front caster assembly, complete, with semi-pneumatic tire, replacement only, each |
| K0071 | Front caster assembly, complete, with pneumatic tire, replacement only, each |
| K0017 | Detachable, adjustable height armrest, base, replacement only, each |
| L8615 | Headset/headpiece for use with cochlear implant device, replacement |
| C7537 | Insertion of new or replacement of permanent pacemaker with atrial transvenous electrode(s), with insertion of pacing electrode, cardiac venous system, for left ventricular pacing, at time of insertion of implantable defibrillator or pacemaker pulse generator (e.g., for upgrade to dual chamber system) |
| C7539 | Insertion of new or replacement of permanent pacemaker with atrial and ventricular transvenous electrode(s), with insertion of pacing electrode, cardiac venous system, for left ventricular pacing, at time of insertion of implantable defibrillator or pacemaker pulse generator (eg, for upgrade to dual chamber system) |
| C7538 | Insertion of new or replacement of permanent pacemaker with ventricular transvenous electrode(s), with insertion of pacing electrode, cardiac venous system, for left ventricular pacing, at time of insertion of implantable defibrillator or pacemaker pulse generator (e.g., for upgrade to dual chamber system) |
| A4602 | Replacement battery for external infusion pump owned by patient, lithium, 1.5 volt, each |
| K0603 | Replacement battery for external infusion pump owned by patient, alkaline, 1.5 volt, each |
| K0604 | Replacement battery for external infusion pump owned by patient, lithium, 3.6 volt, each |
| K0605 | Replacement battery for external infusion pump owned by patient, lithium, 4.5 volt, each |
| K0601 | Replacement battery for external infusion pump owned by patient, silver oxide, 1.5 volt, each |
| K0602 | Replacement battery for external infusion pump owned by patient, silver oxide, 3 volt, each |
| K1011 | Activation device for intraurethral drainage device with valve, replacement only, each |
