HCPCS Service Codes - Lump sum purchase of DME, prosthetics, orthotics

HCPCS Codes for Lump sum purchase of DME, prosthetics, orthotics

• L3020

  Foot, insert, removable, molded to patient model, longitudinal/ metatarsal support, each

• L3030

  Foot, insert, removable, formed to patient foot, each

• L3031

  Foot, insert/plate, removable, addition to lower extremity orthosis, high strength, lightweight material, all hybrid lamination/prepreg composite, each

• L3040

  Foot, arch support, removable, premolded, longitudinal, each

• L3050

  Foot, arch support, removable, premolded, metatarsal, each

• L3060

  Foot, arch support, removable, premolded, longitudinal/ metatarsal, each

• L3070

  Foot, arch support, non-removable attached to shoe, longitudinal, each

• L3080

  Foot, arch support, non-removable attached to shoe, metatarsal, each

• L3090

  Foot, arch support, non-removable attached to shoe, longitudinal/metatarsal, each

• L3100

  Hallus-valgus night dynamic splint, prefabricated, off-the-shelf

• L3140

  Foot, abduction rotation bar, including shoes

• L3150

  Foot, abduction rotation bar, without shoes

• L3160

  Foot, adjustable shoe-styled positioning device

• L3170

  Foot, plastic, silicone or equal, heel stabilizer, prefabricated, off-the-shelf, each

• L3201

  Orthopedic shoe, oxford with supinator or pronator, infant

• L3202

  Orthopedic shoe, oxford with supinator or pronator, child

• L3203

  Orthopedic shoe, oxford with supinator or pronator, junior

• L3204

  Orthopedic shoe, hightop with supinator or pronator, infant

• L3206

  Orthopedic shoe, hightop with supinator or pronator, child

• L3207

  Orthopedic shoe, hightop with supinator or pronator, junior

• L3208

  Surgical boot, each, infant

• L3209

  Surgical boot, each, child

• L3211

  Surgical boot, each, junior

• L3212

  Benesch boot, pair, infant

• L3213

  Benesch boot, pair, child

• L3214

  Benesch boot, pair, junior

• L3215

  Orthopedic footwear, ladies shoe, oxford, each

• L3216

  Orthopedic footwear, ladies shoe, depth inlay, each

• L3217

  Orthopedic footwear, ladies shoe, hightop, depth inlay, each

• L3219

  Orthopedic footwear, mens shoe, oxford, each

• L3221

  Orthopedic footwear, mens shoe, depth inlay, each

• L3222

  Orthopedic footwear, mens shoe, hightop, depth inlay, each

• L3224

  Orthopedic footwear, woman's shoe, oxford, used as an integral part of a brace (orthosis)

• L3225

  Orthopedic footwear, man's shoe, oxford, used as an integral part of a brace (orthosis)

• L3230

  Orthopedic footwear, custom shoe, depth inlay, each

• L3250

  Orthopedic footwear, custom molded shoe, removable inner mold, prosthetic shoe, each

• L3251

  Foot, shoe molded to patient model, silicone shoe, each

• L3252

  Foot, shoe molded to patient model, plastazote (or similar), custom fabricated, each

• L3253

  Foot, molded shoe plastazote (or similar) custom fitted, each

• L3254

  Non-standard size or width

• L3255

  Non-standard size or length

• L3257

  Orthopedic footwear, additional charge for split size

• L3260

  Surgical boot/shoe, each

• L3265

  Plastazote sandal, each

• L3300

  Lift, elevation, heel, tapered to metatarsals, per inch

• L3310

  Lift, elevation, heel and sole, neoprene, per inch

• L3320

  Lift, elevation, heel and sole, cork, per inch

• L3330

  Lift, elevation, metal extension (skate)

• L3332

  Lift, elevation, inside shoe, tapered, up to one-half inch

• L3334

  Lift, elevation, heel, per inch