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HCPCS L3002 · Level II · orthotic and prosthetic code

L3002: Foot, insert, removable, molded to patient model, plastazote or equal, each, HCPCS Level II orthotic and prosthetic code

Compiled from CMS files by the QuickIntell RCM Editorial Team · Data effective · Method: reference methodology · Report a data correction

Data currency: HCPCS Level II file: October 2026 (effective October 1, 2026); DMEPOS fee schedule: DME26-D (October 2026) (effective October 1, 2026); NCCI MUE tables: 2026 Q4 (effective October 1, 2026); NCCI PTP edits: v323r0 (2026 Q4) (effective October 1, 2026); OPPS Addendum B: October 2026 (effective October 1, 2026); Medicare Coverage Database LCD export: MCD release October 8, 2026 (effective October 4, 2026). Next CMS release: January 1, 2027 (quarterly update) for the HCPCS Level II file and DMEPOS fee schedule and NCCI MUE tables and NCCI PTP edits and OPPS Addendum B; weekly, every Thursday for the Medicare Coverage Database LCD export.

Key facts for L3002

Medicare payment
$193.73 to $200.63
DMEPOS non-rural state fees
Coverage code
D
special coverage instructions apply
DME supplier MUE
2
MAI 3
OPPS status
SI A
Services not paid under OPPS; paid under fee schedule or other payment system
NCCI PTP pairs
0
practitioner file
LCDs and articles
1 / 0

TL;DR

L3002 is a Level II code from the L section (orthotic and prosthetic procedures and devices), in use since 1984: "Foot, insert, removable, molded to patient model, plastazote or equal, each". The October 2026 DMEPOS fee schedule (category PO, prosthetics and orthotics) sets L3002 at $193.73 in AZ, CA, CT and 17 more to $200.63 in CO, MT, ND and 3 more (floor $177.30, ceiling $236.41). CMS caps L3002 at practitioner 0 (MAI 3, CMS Policy); hospital outpatient 2 (MAI 3, Anatomic Consideration); DME supplier 2 (MAI 3, Anatomic Consideration) units per day in the 2026 Q4 MUE tables. 1 active LCD lists L3002: L33641 (Orthopedic Footwear). OPPS status indicator A: Services not paid under OPPS; paid under fee schedule or other payment system. HCPCS record: BETOS D1F (prosthetic/orthotic devices); pricing indicator 00; type of service P (lump-sum purchase of DME, prosthetics or orthotics). 21 other active codes open with "Foot"; related codes: L3001, L3003, L3000, L3010.

L3002 descriptor and code status

The October 2026 HCPCS Level II file describes L3002 as “Foot, insert, removable, molded to patient model, plastazote or equal, each”. It sits in the L section (orthotic and prosthetic procedures and devices), listed with the other L codes.

HCPCS file attributes of L3002
FieldValue
Short descriptorFoot insert plastazote or eq
Added to HCPCS1984-01-01
Last actionN (no maintenance), effective 1997-01-01
Coverage codeD: special coverage instructions apply
Pricing indicator00: not separately priced by Part B
BETOS categoryD1F: prosthetic/orthotic devices
Type of serviceP: lump-sum purchase of DME, prosthetics or orthotics

Medicare payment for L3002

The October 2026 DMEPOS fee schedule (category PO, prosthetics and orthotics) sets L3002 at $193.73 in AZ, CA, CT and 17 more to $200.63 in CO, MT, ND and 3 more (floor $177.30, ceiling $236.41). The amounts below are national figures from the October 2026 CMS files; the contractor applies the locality, rural or state adjustment and the beneficiary's cost sharing.

DMEPOS fee schedule (DME26-D)

Jurisdiction D (DME MAC), payment category PO (prosthetics and orthotics). Fees are set per state; AK, HI, PR and VI are not subject to the national ceiling and floor and are listed separately. A rural fee applies only in ZIP codes on the CMS rural ZIP list.

DMEPOS fees for L3002 by modifier
ModifierFloor / ceilingNon-rural state rangeRural rangeAK / HI / PR / VI
none$177.30 / $236.41$193.73 (AZ, CA, CT…) to $200.63 (CO, MT, ND…)—AK $193.73, HI $193.73, PR $213.14, VI $213.14

Hospital outpatient (OPPS Addendum B)

Status indicator A (Services not paid under OPPS; paid under fee schedule or other payment system), with no separate OPPS payment rate.

Medically Unlikely Edits for L3002

CMS caps L3002 at practitioner 0 (MAI 3, CMS Policy); hospital outpatient 2 (MAI 3, Anatomic Consideration); DME supplier 2 (MAI 3, Anatomic Consideration) units per day in the 2026 Q4 MUE tables. The DME supplier MUE is a date-of-service clinical edit: units above the limit deny but can be paid on appeal with documentation.

MUE values for L3002 by setting
SettingMUE (units/DOS)MAICMS rationale
Practitioner services03 Date of Service Edit: ClinicalCMS Policy
Facility outpatient hospital23 Date of Service Edit: ClinicalAnatomic Consideration
DME supplier23 Date of Service Edit: ClinicalAnatomic Consideration

The MUE lookup for L3002 shows every setting next to any other code on the same claim.

NCCI edits and add-on rules

No active practitioner PTP pair lists L3002 in v323r0.

L3002 is neither an add-on code nor a designated primary code in the 2026 Q4 NCCI add-on edit file.

Pair counts show exposure, not the answer for one claim. Check L3002 against a second code to see whether the pair bundles and whether a modifier can separate the services.

Medicare coverage policies for L3002

1 active Local Coverage Determination and 0 billing and coding articles list L3002. Each applies only in its contractor's jurisdiction, and the article carries the diagnosis codes that support the item or service.

Denials to expect on L3002

CARC 50 · N115

the diagnosis or documentation does not meet the LCD or billing article that lists L3002

CARC 151 · N362

units of L3002 exceed the DME supplier MUE of 2 per date of service

CARC 4

the modifier reported is inconsistent with the code

CARC 16

the claim lacks information needed to adjudicate the line, such as an order, NPI or required modifier

Where QuickIntell fits for L3002 claims

QuickAuth coordinates the requirement checks and documentation that DME claims for L3002 depend on, with human review of each case, and QuickRCM carries claim readiness and the CARC 50, 151 and modifier denials these items draw.

See QuickAuth for requirement checksSee QuickRCM for denial follow-upBook a meeting

Frequently asked questions: HCPCS L3002

What does HCPCS code L3002 describe?

"Foot, insert, removable, molded to patient model, plastazote or equal, each" (short descriptor "Foot insert plastazote or eq"), in the L section (orthotic and prosthetic procedures and devices). Added 1984-01-01; last action N (no maintenance) effective 1997-01-01.

Is L3002 a CPT code?

It is not. L3002 belongs to the L section (orthotic and prosthetic procedures and devices) of HCPCS Level II, the CMS code set, not to AMA CPT.

What does Medicare pay for L3002?

The October 2026 DMEPOS fee schedule (category PO, prosthetics and orthotics) sets L3002 at $193.73 in AZ, CA, CT and 17 more to $200.63 in CO, MT, ND and 3 more (floor $177.30, ceiling $236.41).

How many units of L3002 can be billed per day?

CMS caps L3002 at practitioner 0 (MAI 3, CMS Policy); hospital outpatient 2 (MAI 3, Anatomic Consideration); DME supplier 2 (MAI 3, Anatomic Consideration) units per day in the 2026 Q4 MUE tables. For the DME supplier MUE (MAI 3), units above 2 deny for the day but can be paid on appeal with documentation; denials arrive as CARC 151.

Does Medicare cover L3002?

Coverage code D (special coverage instructions apply). 1 active LCD lists L3002: L33641 (Orthopedic Footwear).

Sources

Every figure on this page is taken from the CMS publications below, as released by the Centers for Medicare & Medicaid Services. Projection built 2026-10-10. Verify against the primary file before billing or contracting decisions. The reference methodology explains how each figure is computed from these files.

Disclaimer

This page is an operational reference compiled from CMS publications: the HCPCS Level II file, the physician, DMEPOS and clinical laboratory fee schedules, OPPS and ASC addenda, NCCI MUE, PTP and add-on edit tables and the Medicare Coverage Database. Amounts are Medicare national figures before locality and state adjustment; Medicaid and commercial payers set their own. CPT codes are shown as numbers only; CPT descriptors are copyright AMA. Nothing here is legal, clinical or billing advice.

Found a figure that does not match the CMS file? Report a data correction with the CMS file and the value you expected; the request reaches the editorial team through the contact form.