L3031 HCPCS code: Foot, insert/plate, removable, addition to lower extremity orthosis, high strength, lightweight material, all hybrid lamination/prepreg composite, each
L3031 is the HCPCS Level II code for foot, insert/plate, removable, addition to lower extremity orthosis, high strength, lightweight material, all hybrid lamination/prepreg composite, each. The 2026 Medicare DMEPOS fee schedule pays $146.92 to $161.61 depending on the state. Its Medicare coverage code is C (Carrier judgment): Coverage is decided by the Medicare contractor (MAC) case by case. The NCCI unit limit is 2 per day on DME suppliers. Medicare volume fell 64% from 2022 to 2024 (166 to 60 services). In 2024, 20 suppliers billed Medicare for L3031 (purchases), serving 48 beneficiaries. Its average fee ranks 8 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 | C — Carrier judgment |
| Pricing indicator | 00 — Not separately priced by Medicare |
| BETOS category | D1F — Prosthetic and orthotic devices |
| Added | 2004-01-01 |
| Last action effective | 2005-01-01 |
2026 Medicare DMEPOS fee schedule for L3031
| Modifier | Meaning | Lowest state fee | Highest state fee | Ceiling | Floor |
|---|---|---|---|---|---|
| — | base fee | $146.92 | $161.61 | $179.71 | $134.78 |
| State | Modifier | Fee | Rural fee |
|---|---|---|---|
| AK | — | $146.92 | — |
| AL | — | $151.32 | — |
| AR | — | $151.31 | — |
| AZ | — | $146.92 | — |
| CA | — | $146.92 | — |
| CO | — | $152.19 | — |
| CT | — | $146.92 | — |
| DC | — | $146.92 | — |
| DE | — | $146.92 | — |
| FL | — | $151.32 | — |
| GA | — | $151.32 | — |
| HI | — | $146.92 | — |
| IA | — | $149.78 | — |
| ID | — | $152.66 | — |
| IL | — | $150.51 | — |
| IN | — | $150.51 | — |
| KS | — | $149.78 | — |
| KY | — | $151.32 | — |
| LA | — | $151.31 | — |
| MA | — | $146.92 | — |
| MD | — | $146.92 | — |
| ME | — | $146.92 | — |
| MI | — | $150.51 | — |
| MN | — | $150.51 | — |
| MO | — | $149.78 | — |
| MS | — | $151.32 | — |
| MT | — | $152.19 | — |
| NC | — | $151.32 | — |
| ND | — | $152.19 | — |
| NE | — | $149.78 | — |
| NH | — | $146.92 | — |
| NJ | — | $146.92 | — |
| NM | — | $151.31 | — |
| NV | — | $146.92 | — |
| NY | — | $146.92 | — |
| OH | — | $150.51 | — |
| OK | — | $151.31 | — |
| OR | — | $152.66 | — |
| PA | — | $146.92 | — |
| PR | — | $161.61 | — |
| RI | — | $146.92 | — |
| SC | — | $151.32 | — |
| SD | — | $152.19 | — |
| TN | — | $151.32 | — |
| TX | — | $151.31 | — |
| UT | — | $152.19 | — |
| VA | — | $146.92 | — |
| VI | — | $154.24 | — |
| VT | — | $146.92 | — |
| WA | — | $152.66 | — |
| WI | — | $150.51 | — |
| WV | — | $146.92 | — |
| WY | — | $152.19 | — |
How the L3031 fee compares
| Measure | Value |
|---|---|
| Rank among 14 L30 codes (lowest = 1) | 8 |
| Family fee range (average of state fees) | $38.87–$384.13 |
| Rural fee uplift | — |
Who bills L3031 (2024)
| Measure | Value |
|---|---|
| Suppliers billing rentals | — |
| Suppliers billing purchases | 20 |
| Referring clinicians | 39 |
| Medicare beneficiaries | 48 |
| States with claims | 1 |
| Year | Suppliers | Beneficiaries |
|---|---|---|
| 2022 | 73 | 136 |
| 2023 | 33 | 65 |
| 2024 | 20 | 48 |
Counts only. Supplier and clinician names, contact lists and state-by-state detail are in Caduvo.
Medicare utilization for L3031, 2022–2024
| Year | Services | Beneficiaries | Avg. allowed | Avg. paid |
|---|---|---|---|---|
| 2022 | 166 | 136 | $106.14 | $74.21 |
| 2023 | 77 | 65 | $100.72 | $76.54 |
| 2024 | 60 | 48 | $127.36 | $97.37 |
States with the most L3031 services (2024)
| State | Services | Avg. paid |
|---|---|---|
| New Jersey | 26 | $107.20 |
NCCI unit limits (MUE)
| Claim type | Max units per day | Rationale |
|---|---|---|
| DME suppliers | 2 | Anatomic Consideration |
| outpatient hospital claims | 2 | Anatomic Consideration |
Medicare policy articles for this code
- A52481: Orthopedic Footwear - Policy Article (CGS Administrators, LLC (DME MAC) Noridian Healthcare Solutions, LLC (DME MAC)) — mentions this code in its coding guidance
Covered diagnoses (84 ICD-10-CM codes)
The diagnoses most often listed as covered in the policy articles above:
| ICD-10-CM | Diagnosis | Articles listing it |
|---|---|---|
| Q72.00 | Congenital complete absence of unspecified lower limb | 1 |
| Q72.01 | Congenital complete absence of right lower limb | 1 |
| Q72.02 | Congenital complete absence of left lower limb | 1 |
| Q72.03 | Congenital complete absence of lower limb, bilateral | 1 |
| Q72.30 | Congenital absence of unspecified foot and toe(s) | 1 |
| Q72.31 | Congenital absence of right foot and toe(s) | 1 |
| Q72.32 | Congenital absence of left foot and toe(s) | 1 |
| Q72.33 | Congenital absence of foot and toe(s), bilateral | 1 |
| Q72.70 | Split foot, unspecified lower limb | 1 |
| Q72.71 | Split foot, right lower limb | 1 |
Showing 10 of 84. The full list, non-covered diagnoses and CSV export are in Caduvo.
What changed for L3031
- 2026-01-01: Average state fee rose 2.0%: $147.02 to $149.96
- 2004-01-01: L3031 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 L3031?
L3031 is the HCPCS Level II code for foot, insert/plate, removable, addition to lower extremity orthosis, high strength, lightweight material, all hybrid lamination/prepreg composite, each. Short descriptor: "Foot lamin/prepreg composite".
How much does Medicare pay for L3031?
Under the 2026 DMEPOS fee schedule, non-rural state fees are base (base fee): $146.92–$161.61. Rural fees can be higher.
Does Medicare cover L3031?
Coverage code C — Carrier judgment. Coverage is decided by the Medicare contractor (MAC) case by case.
Which diagnoses support coverage for L3031?
Medicare policy articles that cite L3031 list 84 covered ICD-10-CM diagnosis codes across 1 article. The most cited include Q72.00 (Congenital complete absence of unspecified lower limb), Q72.01 (Congenital complete absence of right lower limb), Q72.02 (Congenital complete absence of left lower limb). A listed diagnosis is necessary but not sufficient; the policy's other criteria still apply.
Did the Medicare fee for L3031 change in 2026?
The average non-rural state fee moved from $147.02 in 2025 to $149.96 in 2026 (+2.0%). CMS's next quarterly HCPCS and DMEPOS update takes effect January 1, 2027.
How many units of L3031 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)
- L3003 — Foot, insert, removable, molded to patient model, silicone gel, each ($209.04–$229.91)
- 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)
- 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)
Building a device that would bill under a code like this? Caduvo matches a device description to HCPCS/CPT codes, Medicare coverage and payment, and the FDA pathway in one report.
Next steps
- Run a reimbursement report for a device billed under L3031
- Watch L3031 for fee, coverage and descriptor changes
- Build a full Medicare revenue model for L3031
Sources: CMS HCPCS Level II release October 2026; 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.