L3257 — Orthopedic footwear, additional charge for split size
L3257 is a HCPCS Level II code for orthopedic footwear, additional charge for split size. 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 L3257 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 L3257
- Long descriptor
- Orthopedic footwear, additional charge for split size
- Short descriptor
- Orth foot add charge split s
- Added
- January 1, 1988
- 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 L3257
HCPCS has no hierarchy — related items simply sit next to each other in the numbering. If L3257 is not quite right, the correct code is very often within a few positions of it.
- 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
- L3251Foot, shoe molded to patient model, silicone shoe, each
- L3252Foot, shoe molded to patient model, plastazote (or similar), custom fabricated, each
- L3253Foot, molded shoe plastazote (or similar) custom fitted, each
- L3254Non-standard size or width
- L3255Non-standard size or length
- L3260Surgical boot/shoe, each
- L3265Plastazote sandal, each
- L3300Lift, elevation, heel, tapered to metatarsals, per inch
- L3310Lift, elevation, heel and sole, neoprene, per inch
- L3320Lift, elevation, heel and sole, cork, per inch
- L3330Lift, elevation, metal extension (skate)
- L3332Lift, elevation, inside shoe, tapered, up to one-half inch
- L3334Lift, elevation, heel, per inch
Questions about L3257
What is HCPCS code L3257?
L3257 is a HCPCS Level II code for orthopedic footwear, additional charge for split size. It sits in the Orthotic and Prosthetic Procedures and Devices section.
Does Medicare cover L3257?
The CMS HCPCS file marks L3257 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.