L3216 — Orthopedic footwear, ladies shoe, depth inlay, each
L3216 is a HCPCS Level II code for orthopedic footwear, ladies shoe, depth inlay, each. It belongs to the Orthotic and Prosthetic Procedures and Devices section. Medicare does not pay it — see the coverage note below before you bill it.
Medicare coverage: Non-covered by statute
Excluded from coverage by the Social Security Act itself, not by a policy decision. No documentation and no appeal changes this one — an ABN is the relevant conversation.
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 L3216 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
- 0 — never payable MAI 3 — Date of Service Edit: Clinical · CMS Policy
- DME supplier
- 2 units MAI 2 — Date of Service Edit: Policy · Anatomic Consideration
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 L3216
- Long descriptor
- Orthopedic footwear, ladies shoe, depth inlay, each
- Short descriptor
- Orthoped ladies shoes dpth i
- 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 L3216
HCPCS has no hierarchy — related items simply sit next to each other in the numbering. If L3216 is not quite right, the correct code is very often within a few positions of it.
- L3207Orthopedic shoe, hightop with supinator or pronator, junior
- L3208Surgical boot, each, infant
- L3209Surgical boot, each, child
- L3211Surgical boot, each, junior
- L3212Benesch boot, pair, infant
- L3213Benesch boot, pair, child
- L3214Benesch boot, pair, junior
- L3215Orthopedic footwear, ladies shoe, oxford, 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)
- L3225Orthopedic footwear, man's shoe, oxford, used as an integral part of a brace (orthosis)
- L3230Orthopedic footwear, custom shoe, depth inlay, each
- L3250Orthopedic footwear, custom molded shoe, removable inner mold, prosthetic shoe, each
Questions about L3216
What is HCPCS code L3216?
L3216 is a HCPCS Level II code for orthopedic footwear, ladies shoe, depth inlay, each. It sits in the Orthotic and Prosthetic Procedures and Devices section.
Does Medicare cover L3216?
The CMS HCPCS file marks L3216 as "Non-covered by statute". Excluded from coverage by the Social Security Act itself, not by a policy decision. No documentation and no appeal changes this one — an ABN is the relevant conversation.