HCPCS Procedure & Supply Codes

Orthotic Devices & Services

section notes

Orthopedic Shoes

section notes

Orthopedic Footwear

section notes
L3201   Oxford w supinat/pronat inf
L3202   Oxford w/ supinat/pronator c
L3203   Oxford w/ supinator/pronator
L3204   Hightop w/ supp/pronator inf
L3206   Hightop w/ supp/pronator chi
L3207   Hightop w/ supp/pronator jun
L3208   Surgical boot each infant
L3209   Surgical boot each child
L3211   Surgical boot each junior
L3212   Benesch boot pair infant
L3213   Benesch boot pair child
L3214   Benesch boot pair junior
L3215   Orthopedic ftwear ladies oxf
L3216   Orthoped ladies shoes dpth i
L3217   Ladies shoes hightop depth i
L3219   Orthopedic mens shoes oxford
L3221   Orthopedic mens shoes dpth i
L3222   Mens shoes hightop depth inl
L3224   Woman's shoe oxford brace
L3225   Man's shoe oxford brace
L3230   Custom shoes depth inlay
L3250   Custom mold shoe remov prost
L3251   Shoe molded to pt silicone s
L3252   Shoe molded plastazote cust
L3253   Shoe molded plastazote cust
L3254   Orth foot non-stndard size/w
L3255   Orth foot non-standard size/
L3257   Orth foot add charge split s
L3260   Ambulatory surgical boot eac
L3265   Plastazote sandal each
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