HCPCS 2018

L3201Orthopedic shoe, oxford with supinator or pronator, infant
L3202Orthopedic shoe, oxford with supinator or pronator, child
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
L3213Benesch boot, pair, child
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)
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
L3257Orthopedic footwear, additional charge for split size
L3260Surgical boot/shoe, each
L3265Plastazote sandal, each