Item

Code

Cat

Description

COIDA 2019

GPA

GENERAL PROSTHETIC ACCESSORIES

LA230

A22730

Patella buttons replaced

ea

240.37

LA235

A22735

Re-alignment (dynamic) of AK/TK modular prosthesis

ea

1092.68

LA236

A22736

Re-alignment (dynamic) of BK modular prosthesis

ea

1034.42

LA440

A22940

Stump care - Cleani-stump

box

1027.06

LA450

A22950

Stump care - Ampu-aid

tube

205.84

LA460

A22960

Stump care - talc

tin

278.65

LA461

A22961

Stump/skin lotion

ea

537.57

LA462

A22962

Stump lubricant

ea

426.08

LA463

A22963

Stump cleaner

ea

493.50

LA464

A22964

Stump moisturiser

ea

493.50

LA465

A22965

Stump ointment

ea

610.15

LA466

A22966

Stump moisturiser derma clean

ea

419.47

LA470

A22970

Stump care - balm

tin

493.48

LA480

A22980

Stump coning bandage 6cm

ea

402.51

LA481

A22981

Stump coning bandage 8cm

ea

508.04

LA482

A22982

Stump coning bandage 10cm

ea

681.16

LA483

A22983

Prosthetic sheath albert andre per pair

ea

743.02

LA484

A22984

Prosthetic sheath merit

ea

105.94

LA485

A22985

Fix prosthetic local 601 kneebrace

ea

440.96

LA486

A22986

Stump sock with hole for pin local

ea

317.43

LA487

A22987

Stump sock with pin imported

ea

425.42

LA488

A22988

Dermaseal residual limb stock 453D7

ea

2057.42

LA490

A22990

Stump coning bandage 15cm

ea

743.02

ADAPTORS

AD001

A24001

2R2 tube adaptor stainless steel

ea

1965.79

AD002

A24002

Bibr-003 hawk tube adaptor short E05S-BOSS

ea

895.95

AD003

A24003

2R3 tube adaptor stainless steel

ea

2086.35

AD004

A24004

Tube with adaptor 1907-13

ea

1412.08

AD005

A24005

2R38 tube adaptor titanium

ea

4140.89

AD006

A24006

A-712010 tube adaptor aluminium short

ea

541.84

AD007

A24007

S-712020 tube adaptor aluminium long

ea

684.14

AD008

A24008

Bibr-004 hawk tube adaptor E05S-A SS

ea

1131.98

FOOT ADAPTORS

AD009

A24009

2R8=10 sach foot adaptor 1907-14

ea

1190.87

AD010

A24010

Sach foot adaptor 1907-14

ea

1276.96

AD011

A24011

2R8=8 sach foot adaptor stainless

ea

1190.87

AD012

A24012

2R31 sach foot adaptor titanium

ea

2749.99

AD013

A24013

2R54 sach foot adaptor aluminium

ea

2265.17

AD014

A24014

Bibr-001 hawk sach foot adaptor E01S-M10SS

ea

534.68

AD015

A24015

2R10 single axis foot adaptor stainless steel

ea

2960.62

AD016

A24016

2R51 single axis foot adaptor titanium

ea

6489.51

AD017

A24017

2R33 single axis foot adaptor titanium

ea

8618.23

AD018

A24018

2R14 connection plate for each foot

ea

161.60

AD019

A24019

Sach foam connector

ea

161.60

AD020

A24020

2R22 connection cap for single axis foot

ea

337.78

TUBE CLAMP ADAPTORS

AD021

A24021

4R21 tube clamp adaptor stainless

ea

1854.52

AD022

A24022

Tube clamp connector 1907-22

ea

1291.55

AD023

A24023

4R82 tube clamp adaptor titanium

ea

5052.26

AD024

A24024

A-342100 tube clamp adaptor female pyramid

ea

1364.10

AD025

A24025

409054-BI tube clamp adaptor

ea

1981.03

SOCKET ADAPTORS

AD026

A24026

Bibr-005 hawk clamp adaptor EO7S SS

ea

1004.34

AD027

A24027

4G70 TK lamination anchor

ea

5085.41

AD028

A24028

4R116 lamination anchor

ea

4193.88

AD029

A24029

4R41 lamination anchor/socket with rotate

ea

4024.32

AD030

A24030

4R43 lamination anchor

ea

2344.64

AD031

A24031

Rotating socket adaptor 1907-40

ea

3469.29

AD032

A24032

4R51 socket adaptor with rotation

ea

4845.60

AD033

A24033

4R37 socket adaptor with rotation

ea

2466.52

AD034

A24034

4R89 socket adaptor with rotation

ea

3946.16

AD035

A24035

Bibr-006 hawk 3 prong socket adaptor with rotation

ea

1423.40

AD036

A24036

Bibr-007 hawk 3 pyramid adaptor with rotation

ea

1327.06

AD037

A24037

4R100 socket adaptor titanium Bk

ea

3772.63

AD038

A24038

4R68 socket adaptor titanium Bk

ea

2592.36

AD039

A24039

4R55 socket adaptor titanium

ea

3218.93

AD040

A24040

4R95 socket adaptor aluminium

ea

1865.12

AD041

A24041

4R22 socket adaptor stainless steel

ea

1376.33

AD042

A24042

2R63 socket adaptor stainless

ea

1675.68

AD043

A24043

BK socket adaptor with pyramid

ea

1453.14

AD044

A24044

4R42 socket adaptor stainless

ea

2302.25

AD045

A24045

3 prong socket adaptor

ea

1870.29

AD046

A24046

A-1104040 4 prong socket adaptor

ea

2047.92

AD047

A24047

Bibr-008 3 prong fixed pyramid adaptor E11S SS

ea

1391.94

AD048

A24048

Bibr-009 4 prong socket adaptor E12S SS

ea

818.88

AD249

A24049

5R1 socket attachment block

ea

1659.80

AD250

A24050

6PC599 socket lamination platform

ea

5023.32

AD251

A24051

Boww-037 laminating socket attachment Block 70020

ea

1071.78

AD252

A24052

Boww-240 laminating socket attachment block

ea

1119.95

AD253

A24053

4R98 Sliding adaptor

ea

4646.91

AD254

A24054

Boww-200 pyramid sliding adaptor

ea

5975.43

SILICONE SLEEVE

SS001

A24001

6Y42 silicone sleeve without pin

ea

5936.50

SS002

A25002

6Y70 silicone gel liner

ea

8551.50

SS003

A25003

6Y80 sleeve transfemoral

ea

9622.83

SS004

A25004

14Y1 silicone arm liner

ea

10800.95

SS006

A25006

I-0104 original icecross sleeve without cover

ea

6723.46

SS008

A25008

I-4013 derma lock in sleeve

ea

9121.39

SS009

A25009

I-5006 icecross comfort locking/Cushion liner

ea

8690.76

SS010

A25010

I-6003 icecross synergy locking

ea

10407.03

SS011

A25011

I-7132 icecross transfemoral locking/cushion liner

ea

11510.42

SS014

A25014

GPDT general purpose liner

ea

12106.40

SS015

A25015

GPFR general purpose liner

ea

12106.40

SS016

A25016

AKDT alps locking liner

ea

12133.61

SS017

A25017

AKFR alps cushion liner

ea

12133.61

SS018

A25018

Boww-016 alpha spirit cushion liner SP ALC5366

ea

9706.14

SS019

A25019

Boww-006 alpha original lock liner

ea

11681.09

SS020

A25020

Boww-221 alpha AK Lock in liner

ea

11909.90

SS021

A25021

Boww 225 alpha AK cushion AKL

ea

9706.14

SEAL IN SLEEVES

SS022

A25022

I-4613 icecross dermo seal in sleeve

ea

10243.63

SS023

A25023

I-7532 icecross transfemoral seal in sleeve

ea

13033.54

SS024

A25024

I-7632 icecross transfemoral seal in conical

ea

13033.54

SEAL IN SOCKS

SS025

A25025

K5313 seal in liner socks 3 ply

ea

307.76

SS026

A25026

K5311 seal in liner sock 1 ply

ea

204.30

KNEE SLEEVES

SS027

A25027

453A2=1-4 derma comfort ORT knee sleeve

ea

2769.71

SS028

A25028

453A3=1-3 profelex knee sleeve

ea

3359.34

SS029

A25029

453A-4=1-3 profelex knee sleeve short

ea

2986.08

SS030

A25030

F-2011 icecross knee sleeve = 35-62

ea

2754.68

SS031

A25031

BDAW-301 daw G-sleeve

ea

1546.24

SS032

A25032

BDMI-182 medi genu sleeve Mk00203000

ea

1890.66

DISTAL CUPS

SS033

A25033

I-3000 distal cup

ea

2441.47

SS034

A25034

Boww-042 gel cups

ea

1168.12

VOLUME MANAGE PADS

SS035

A25035

Boww-045 volume manage pads X3

ea

826.45

SS036

A25036

BPRO-002 1K10 protector pad

ea

4400.27

PINS

SS037

A25037

6Y13=3 long pin only

ea

1749.87

SS038

A25038

L-192000 attachment pin standard

ea

783.95

SS039

A25039

Boww-074 alpha lock pin

ea

903.18

SHUTTLE LOCKS

SL651

A36651

Shuttle lock fit

ea

3318.11

SL040

A25040

6A20 shuttle lock with distal adjustment pyramid

ea

12166.01

SL041

A25041

6A30=20 and 10 shuttle lock

ea

9961.44

SL042

A25042

14A1 shuttle lock to attach 14Y1 Silicone liner

ea

9443.49

SL043

A25043

L-621000 ice ratchet

ea

2826.72

SL044

A25044

109108 blatchfordshuttle lock

ea

9012.98

SL045

A25045

Alps shuttle lock with pyramid S498-P

ea

7049.64

SL047

A25047

Boww-061 alpha lock kit

ea

5977.83

SL048

A25048

Boww-062 lanyard lock kit

ea

6358.37

SL049

A25049

Bibr-040 hawk shuttle lock E70

ea

5539.49

VALVES

VL050

A25050

21Y12 screw valve kit

ea

3963.38

VL051

A25051

21Y40 suction valve

ea

573.57

VL052

A25052

21Y41 seat ring for 21Y40 valve

ea

164.25

VL053

A25053

21Y105 valve kit for flexible sockets

ea

2055.87

VL054

A25054

4R140 one way valve for knee sleeves

ea

1649.20

VL055

A25055

L-552000 ice lock expulsion valve TF AK valve

ea

1653.04

VL056

A25056

L-551002 ice lock expulsion valve TF BK valve

ea

1483.94

VL057

A25057

BMDI-240 medi vacu valve-1810723000

ea

696.06

VL058

A25058

BUSN-001 green dot valve plastic

ea

1507.29

VL059

A25059

BUSN-002 green dot valve stainless steel

ea

1111.00

LA510

A25060

Suction valve standard

ea

786.19

LA520

A25061

Suction valve total contact

ea

1438.20

LA530

A25062

Suction valve Green dot standard

ea

1438.20

LA540

A25063

Suction valve Green dot total contact

ea

1438.20

REPAIR KITS

RK001

A26001

2D2 single component pack for 1A6 and 1A29

ea

1250.97

RK002

A26002

2D3 for 1A20 foot

ea

764.87

RK003

A26003

2D5 service pack for 2R10 ankle

ea

392.18

RK004

A26004

3D4 service kit for 3P23 knee

ea

1861.89

RK005

A26005

2D1 Service for 3R15/3R46/3R42 knees

ea

883.31

RK006

A26006

4D13 service kit for 3R36/R20

ea

1534.79

RK007

A26007

4D18 service kit for 3R46 knee

ea

1328.62

RK008

A26008

4D19 repair kit for 3R55

ea

1114.21

RK009

A26009

4V34 declaration bumper

ea

516.79

RK010

A26010

4H5=26 knee extension stop rubber

ea

125.78

RK011

A26011

4H21 shin extension stop rubber

ea

104.37

RK012

A26012

7U25 joint bearing 509K 11X5X16X5

ea

215.33

RK013

A26013

7U25 joint big screw 501A22

ea

109.95

RK014

A26014

7U25 small joint screw 501S6X8XM3.5

ea

33.67

RK015

A26015

4B52 swinging block

ea

1874.04

RK016

A26016

4D7 repair kit for 3R21/3R30

ea

3038.42

RK017

A26017

4F34 lock control unit AK (3R17/3R33/3R40/3R41) KNEE

ea

1119.73

PARTIAL HAND PROSTHESIS

PH010

A30010

Partial hand passive

ea

24016.95

PH020

A30020

Partial hand functional

ea

33973.08

PH030

A30030

Partial opposition post

ea

16754.36

PARTIAL HAND REPAIRS

PH050

A30050

Partial new silicone socket

ea

7672.46

PH060

A30060

Partial hand - cosmetic glove replaced

ea

5776.56

PH070

A30070

Partial hand - replace zip to glove

ea

5 339.51

WD

WRIST DISARTICULATION PROSTHESIS

WD010

A30510

Wrist disarticulation - passive

ea

46748.29

WD020

A30520

Wrist disarticulation - functional

ea

61692.50

WD021

A30521

Refit Wrist Disarticulation

ea

13961.17

BE

BELOW ELBOW PROSTHESIS

BE010

A31010

Below elbow prosthesis - passive hand & cosmetic cover

ea

46748.29

BE020

A31020

Below elbow prosthesis - functional hand & cosmetic cover

ea

61692.50

BE040

A31040

BE test socket - diagnostic

ea

2622.39

ED

ELBOW DISARTICULATION PROSTHESIS

ED010

A31510

Elbow disarticulation prosthesis - passive hand and cosmetic cover

ea

69654.38

ED020

A31520

Elbow disarticulation prosthesis - functional hand and cosmetic cover

ea

90777.65

ED030

A31530

ED test socket - diagnostic

ea

2622.39

ED031

A31531

Refit ED

ea

28594.95

ABOVE ELBOW PROSTHESIS

AE010

A32010

Above elbow prosthesis - passive hand & cosmetic cover incl

54795.93

AE020

A32020

Above elbow prosthesis - functional hand & cosmetic cover incl

72424.36

AE040

A32040

AE test socket - diagnostic

2622.39

ADDITIONAL CHARGES

AE060

A32060

Automatic locking elbow 12K4

ea

25506.73

AE065

A32065

Elbow joint with cable lock

ea

17896.28

AE067

A32067

Step-up joints for short BE or TE

ea

20132.53

Notes

Manual locking elbows 12K5 are supplied as standard. Prosthetist may supply an automatic elbow on request and adjust the fee accordingly.

The cost of the standard elbow must be deducted and the automatic elbow added.

Prosthetic hooks are not included with upper extremity prosthesis as standard.

SD

SHOULDER DISARTICULATION PROSTHESIS

SD010

A32510/1

Shoulder disarticulation prosthesis manual elbow (incl. passive hand & cosmetic cover)

ea

75871.74

A32510/2

Shoulder disarticulation prosthesis electric elbow (incl. passive hand & cosmetic cover)

ea

92094.33

SD020

A32520

Shoulder disarticulation - with electric elbow functional hand & cosmetic cover incl

ea

93498.38

A33155

Refit Shoulder disarticulation

ea

32724.42

AA

ACCESSORIES

AA010

A33010

Cable - AE

ea

2625.98

AA020

A33020

Cable - BE

ea

2400.15

AA030

A33030

Corset - BE

ea

2393.00

AA040

A33040

Passive hand

ea

11258.25

AA050

A33050

Felt hand

ea

11258.25

AA060

A33060

Functional hand

ea

14133.77

AA070

A33070

Harness - AE

ea

2400.20

AA080

A33080

Harness - BE

ea

2400.18

AA090

A33090

Hook elastics

ea

63.81

AA100

A33100

Prosthetic glove - cosmetic

ea

5731.08

AA110

A33110

Prosthetic glove - leather

ea

1198.38

AA120

A33120

Prosthetic hook - aluminium

ea

16437.42

AA130

A33130

Prosthetic hook - steel

ea

21032.14

AA140

A33140

Refit AE

ea

21289.03

AA150

A33150

Refit BE

ea

13283.25

AA160

A33160

Wrist insert - Only with repairs or when hook is required

ea

1546.07

AA165

A33165

Wrist Unit inclusive of wrist insert

ea

6013.32

AA170

A33170

Manual locking elbow 12K5 inclusive with new. Only charge separate with repairs

ea

9284.15

AA175

A33175

Re laminate BE

ea

1898.06

AA180

A33180

C708 Base Plate

ea

102.47

AA185

133185

21A29=25 Auxila Loop

ea

786.13

AA190

A33190

C711HD Hanger

ea

207.74

AA195

A33195

C711 Standard Hanger

ea

166.99

AA196

A33196

C713HD Ball Receiver

ea

314.36

AA197

A33197

C713 Standard Ball Receiver

ea

269.75

AA198

A33198

C703HD Ball Terminal

ea

107.04

AA199

A33199

C703 Standard Ball Terminal

ea

139.16

AA200

A33200

C701HD Triple Swivel

ea

309.49

AA201

A33201

C703 Standard Triple Swivel

309.49

AA202

A33202

C709HD Retainer

ea

175.55

AA203

A33203

C709 Standard Retainer

ea

150.40

AA204

A33204

C710HD Cross Bar

ea

278.31

AA205

A33205

C710 Standard Cross Bar

ea

268.95

SS

PROSTHETIC SOCKS

SS010

A35010

Stump sock - BK local

ea

429.84

SS020

A35020

Stump sock - AK local

ea

480.73

SS030

A35030

Stump sock - Arm local

ea

309.57

SS040

A35040

Stump sock - Symes local

ea

797.66

SS050

A35050

Stump sock - BK 5 ply - imported

ea

850.52

SS055

A35055

Stump sock - BK 3 ply - imported

ea

797.66

SS060

A35060

Stump sock - AK 5 ply - imported

ea

850.52

SS065

A35065

Stump sock AK 3 ply - imported

ea

797.67

SS070

A35070

Stump sock Arm 3 ply - imported

ea

429.84

SS075

A35075

Stump sock Arm 5 ply - imported

ea

509.85

SS080

A35080

Stump sock - Symes 3 ply - imported

ea

1178.26

SS085

A35085

Stump sock - Symes 5 ply - imported

ea

1283.95

SS090

A35090

Prosthetic sheath - imported

ea

482.52

SS096

A35096

Prosthetic sheath - Local

ea

105.94

SS093

A35093

Prosthetic sheath with hole for pin - local

ea

109.31

SS097

A35097

Stump sock with hole for pin - local

ea

317.43

SS095

A35095

Stump sock with hole for pin imported

ea

425.42

SS100

A35100

Protective sheath - American

2385.63

SS105

A35105

Protective sheath - European (Derma seal)

4022.84

SS106

A35106

Dermaseal residual limb sock 453D7

ea

2163.16

SS110

A35110

Fix Prosthesis - European (Daw)

ea

1145.53

SS120

A35120

Fix Prosthesis - American (silicone suspension liner)

ea

564.50

SS121

A35121

Fix prosthesis local 601 kneebrace

ea

440.96

SS130

A35130

Stump shrinker BK

ea

910.22

SS140

A35140

Stump shrinker AK

ea

1209.73

SUSPENSION SYSTEMS

AK150

A21650

AK - hip-joint and pelvic band to prosthesis

ea

10373.05

AK700

A21700

AK - shoulder belt

ea

1050.74

AK701

A21701

AK - silesion belt

ea

962.35

AK704

A21704

AK - silesion strap

ea

291.77

AK708

A21708

AK - waist belt

ea

1011.90

AK712

A21712

AK - neoprene suspension belt

ea

2660.95

BK132

A20632

BK joints and thigh corset

ea

18641.80

BK133

A20633

BK joints and weightbearing corset

ea

20923.01

BK192

A20692

BK back check strap

ea

583.63

BK193

A20693

BK backlift

ea

605.03

BK194

A20694

BK crutch strap

ea

653.15

BK197

A20697

BK ptb strap

ea

1131.06

BK198

A20698

Front Control strap

ea

721.57

BK200

A20700

BK thigh corset

ea

3136.22

BK201

A20701

BK waistbelt leather

ea

1214.06

BK202

A20702

BK waistbelt webbing

ea

795.06

OCULAR PROSTHESIS

OCU

A53015

Prosthesis Consultation (Not payable with A56000)

701.90

OCU

A53115

Impression for Ocular Prosthesis

2833.59

OCU

A53215

Iris Colour

1171.36

OCU

A53315

Model fitting

5762.09

OCU

A53415

Prosthetic manufacture and moulding

6656.35

OCU

A53515

Follow-up (Within 6 months of new or replacement prosthesis but included in item 56000)

388.41

OCU

A53715

Glass eye complete with consultation and fitting (attached motivation)

5260.41

OCU

A53815

Drill ball and socket (pegging to coral) "attached motivation"

1136.19

OCU

A53915

Trimming and Reshaping

568.86

OCU

A54015

Build up

1683.64

OCU

A54115

Veining

793.65

OCU

A54215

Polishing

351.71

OCU

A54315

Materials for custom eye

2211.21

OCU

A54415

Stock eye (every 5 years)

1579.65

OCU

A54515

Haptic Lens (every 5 years)

3478.90

OCU

A56000

Complete eye (includes consultation A53015)

22067.72