L3213 — Benesch boot, pair, child
L3213 is a HCPCS Level II code for benesch boot, pair, child. It belongs to the Orthotic and Prosthetic Procedures and Devices section. Whether Medicare pays it depends on the coverage rule below.
Medicare coverage: Special coverage instructions apply
There are published conditions attached to this code. Check the applicable coverage policy before billing it: the code being valid is not the same as the service being covered.
From the coverage field of the CMS Alpha-Numeric HCPCS File, release 2026Q3-Jul. This states Medicare’s position on the code, not on your particular claim.
Medically Unlikely Edits — units per day
The most units of L3213 Medicare will pay on one date of service. Bill more on a single line and it is denied. The limit is not the same in every setting, so the row that matters is the one matching the claim you are building.
- practitioner
- 0 — never payable MAI 3 — Date of Service Edit: Clinical · CMS Policy
- outpatient
- 1 unit MAI 3 — Date of Service Edit: Clinical · Clinical: CMS Workgroup
- DME supplier
- 1 unit MAI 3 — Date of Service Edit: Clinical · Clinical: CMS Workgroup
The adjudication indicator decides whether exceeding the limit is worth appealing at all: MAI 1 is a line edit you can support with documentation, MAI 3 is a date-of-service edit that is also appealable, and MAI 2 is absolute — no documentation overrides it. CMS MUE 2026Q3.
The CMS record for L3213
- Long descriptor
- Benesch boot, pair, child
- Short descriptor
- Benesch boot pair child
- Added
- January 1, 1984
- BETOS
- D1F
- Pricing indicator
- 00 — Not priced by Part B
The official wording. This is what the code means.
CMS's 28-character form, which is what shows up on a remittance advice.
When CMS introduced the code.
Berenson-Eggers Type of Service — CMS's own analytic grouping.
Service not separately priced by Part B — not covered, bundled into another service, or used by Part A only.
Codes adjacent to L3213
HCPCS has no hierarchy — related items simply sit next to each other in the numbering. If L3213 is not quite right, the correct code is very often within a few positions of it.
- L3203Orthopedic shoe, oxford with supinator or pronator, junior
- L3204Orthopedic shoe, hightop with supinator or pronator, infant
- L3206Orthopedic shoe, hightop with supinator or pronator, child
- L3207Orthopedic shoe, hightop with supinator or pronator, junior
- L3208Surgical boot, each, infant
- L3209Surgical boot, each, child
- L3211Surgical boot, each, junior
- L3212Benesch boot, pair, infant
- L3214Benesch boot, pair, junior
- L3215Orthopedic footwear, ladies shoe, oxford, each
- L3216Orthopedic footwear, ladies shoe, depth inlay, each
- L3217Orthopedic footwear, ladies shoe, hightop, depth inlay, each
- L3219Orthopedic footwear, mens shoe, oxford, each
- L3221Orthopedic footwear, mens shoe, depth inlay, each
- L3222Orthopedic footwear, mens shoe, hightop, depth inlay, each
- L3224Orthopedic footwear, woman's shoe, oxford, used as an integral part of a brace (orthosis)
Questions about L3213
What is HCPCS code L3213?
L3213 is a HCPCS Level II code for benesch boot, pair, child. It sits in the Orthotic and Prosthetic Procedures and Devices section.
Does Medicare cover L3213?
The CMS HCPCS file marks L3213 as "Special coverage instructions apply". There are published conditions attached to this code. Check the applicable coverage policy before billing it: the code being valid is not the same as the service being covered.