L3003 HCPCS code: Foot, insert, removable, molded to patient model, silicone gel, each
L3003 is the HCPCS Level II code for foot, insert, removable, molded to patient model, silicone gel, each. The 2026 Medicare DMEPOS fee schedule pays $209.04 to $229.91 depending on the state. Its Medicare coverage code is D (Special coverage instructions apply): Medicare covers it when its national or local coverage criteria are met. The NCCI unit limit is 2 per day on DME suppliers. Its average fee ranks 11 of 14 L30 codes (family range $38.87–$384.13).
Code details
| Field | Value |
|---|---|
| Section | L codes — Orthotic and prosthetic procedures and devices |
| Coverage code | D — Special coverage instructions apply |
| Pricing indicator | 00 — Not separately priced by Medicare |
| BETOS category | D1F — Prosthetic and orthotic devices |
| Added | 1984-01-01 |
| Last action effective | 1997-01-01 |
2026 Medicare DMEPOS fee schedule for L3003
| Modifier | Meaning | Lowest state fee | Highest state fee | Ceiling | Floor |
|---|---|---|---|---|---|
| — | base fee | $209.04 | $229.91 | $255.07 | $191.30 |
| State | Modifier | Fee | Rural fee |
|---|---|---|---|
| AK | — | $209.04 | — |
| AL | — | $215.29 | — |
| AR | — | $215.28 | — |
| AZ | — | $209.04 | — |
| CA | — | $209.04 | — |
| CO | — | $216.47 | — |
| CT | — | $209.04 | — |
| DC | — | $209.04 | — |
| DE | — | $209.04 | — |
| FL | — | $215.29 | — |
| GA | — | $215.29 | — |
| HI | — | $209.04 | — |
| IA | — | $213.12 | — |
| ID | — | $209.04 | — |
| IL | — | $214.11 | — |
| IN | — | $214.11 | — |
| KS | — | $213.12 | — |
| KY | — | $215.29 | — |
| LA | — | $215.28 | — |
| MA | — | $209.04 | — |
| MD | — | $209.04 | — |
| ME | — | $209.04 | — |
| MI | — | $214.11 | — |
| MN | — | $214.11 | — |
| MO | — | $213.12 | — |
| MS | — | $215.29 | — |
| MT | — | $216.47 | — |
| NC | — | $215.29 | — |
| ND | — | $216.47 | — |
| NE | — | $213.12 | — |
| NH | — | $209.04 | — |
| NJ | — | $209.04 | — |
| NM | — | $215.28 | — |
| NV | — | $209.04 | — |
| NY | — | $209.04 | — |
| OH | — | $214.11 | — |
| OK | — | $215.28 | — |
| OR | — | $209.04 | — |
| PA | — | $209.04 | — |
| PR | — | $229.91 | — |
| RI | — | $209.04 | — |
| SC | — | $215.29 | — |
| SD | — | $216.47 | — |
| TN | — | $215.29 | — |
| TX | — | $215.28 | — |
| UT | — | $216.47 | — |
| VA | — | $209.04 | — |
| VI | — | $229.91 | — |
| VT | — | $209.04 | — |
| WA | — | $209.04 | — |
| WI | — | $214.11 | — |
| WV | — | $209.04 | — |
| WY | — | $216.47 | — |
How the L3003 fee compares
| Measure | Value |
|---|---|
| Rank among 14 L30 codes (lowest = 1) | 11 |
| Family fee range (average of state fees) | $38.87–$384.13 |
| Rural fee uplift | — |
NCCI unit limits (MUE)
| Claim type | Max units per day | Rationale |
|---|---|---|
| DME suppliers | 2 | Anatomic Consideration |
| outpatient hospital claims | 2 | Anatomic Consideration |
What changed for L3003
- 2026-01-01: Average state fee rose 2.0%: $208.90 to $213.08
- 1984-01-01: L3003 added to HCPCS Level II
- Next scheduled CMS quarterly update (HCPCS and DMEPOS fee schedule): 2027-01-01
Frequently asked questions
What is HCPCS code L3003?
L3003 is the HCPCS Level II code for foot, insert, removable, molded to patient model, silicone gel, each. Short descriptor: "Foot insert silicone gel eac".
How much does Medicare pay for L3003?
Under the 2026 DMEPOS fee schedule, non-rural state fees are base (base fee): $209.04–$229.91. Rural fees can be higher.
Does Medicare cover L3003?
Coverage code D — Special coverage instructions apply. Medicare covers it when its national or local coverage criteria are met.
Did the Medicare fee for L3003 change in 2026?
The average non-rural state fee moved from $208.90 in 2025 to $213.08 in 2026 (+2.0%). CMS's next quarterly HCPCS and DMEPOS update takes effect January 1, 2027.
How many units of L3003 can be billed per day?
2 on DME suppliers; 2 on outpatient hospital claims (NCCI medically unlikely edits).
Related L30 codes
- L3000 — Foot, insert, removable, molded to patient model, 'ucb' type, berkeley shell, each ($376.80–$414.48)
- L3001 — Foot, insert, removable, molded to patient model, spenco, each ($158.66–$174.51)
- L3002 — Foot, insert, removable, molded to patient model, plastazote or equal, each ($193.73–$213.14)
- L3010 — Foot, insert, removable, molded to patient model, longitudinal arch support, each ($209.04–$229.91)
- L3020 — Foot, insert, removable, molded to patient model, longitudinal/ metatarsal support, each ($237.97–$261.73)
- L3030 — Foot, insert, removable, formed to patient foot, each ($91.55–$100.71)
- L3031 — Foot, insert/plate, removable, addition to lower extremity orthosis, high strength, lightweight material, all hybrid lamination/prepreg composite, each ($146.92–$161.61)
- L3040 — Foot, arch support, removable, premolded, longitudinal, each ($56.45–$62.11)
- L3050 — Foot, arch support, removable, premolded, metatarsal, each ($56.45–$62.11)
- L3060 — Foot, arch support, removable, premolded, longitudinal/ metatarsal, each ($88.45–$97.32)
- L3070 — Foot, arch support, non-removable attached to shoe, longitudinal, each ($38.11–$41.95)
- L3080 — Foot, arch support, non-removable attached to shoe, metatarsal, each ($38.11–$41.95)
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Next steps
- Run a reimbursement report for a device billed under L3003
- Watch L3003 for fee, coverage and descriptor changes
- Build a full Medicare revenue model for L3003
Sources: CMS HCPCS Level II release October 2025; CMS DMEPOS fee schedule 2026; CMS NCCI MUE tables; CMS Medicare utilization (physician and DME supplier files); CMS Medicare Coverage Database articles. Fees are Medicare allowables, not commercial rates. Not billing or legal advice.