L3100 HCPCS code: Hallus-valgus night dynamic splint, prefabricated, off-the-shelf
L3100 is the HCPCS Level II code for hallus-valgus night dynamic splint, prefabricated, off-the-shelf. The 2026 Medicare DMEPOS fee schedule pays $51.86 to $57.05 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. Medicare volume fell 83% from 2022 to 2024 (188 to 32 services). In 2024, 12 suppliers billed Medicare for L3100 (purchases), serving 30 beneficiaries. Its average fee ranks 1 of 4 L31 codes (family range $52.87–$108.88).
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 | 1985-01-01 |
| Last action effective | 2014-01-01 |
2026 Medicare DMEPOS fee schedule for L3100
| Modifier | Meaning | Lowest state fee | Highest state fee | Ceiling | Floor |
|---|---|---|---|---|---|
| — | base fee | $51.86 | $57.05 | $63.29 | $47.47 |
| State | Modifier | Fee | Rural fee |
|---|---|---|---|
| AK | — | $51.86 | — |
| AL | — | $53.41 | — |
| AR | — | $53.41 | — |
| AZ | — | $51.86 | — |
| CA | — | $51.86 | — |
| CO | — | $53.70 | — |
| CT | — | $51.86 | — |
| DC | — | $51.86 | — |
| DE | — | $51.86 | — |
| FL | — | $53.41 | — |
| GA | — | $53.41 | — |
| HI | — | $51.86 | — |
| IA | — | $52.89 | — |
| ID | — | $51.86 | — |
| IL | — | $53.16 | — |
| IN | — | $53.16 | — |
| KS | — | $52.89 | — |
| KY | — | $53.41 | — |
| LA | — | $53.41 | — |
| MA | — | $51.86 | — |
| MD | — | $51.86 | — |
| ME | — | $51.86 | — |
| MI | — | $53.16 | — |
| MN | — | $53.16 | — |
| MO | — | $52.89 | — |
| MS | — | $53.41 | — |
| MT | — | $53.70 | — |
| NC | — | $53.41 | — |
| ND | — | $53.70 | — |
| NE | — | $52.89 | — |
| NH | — | $51.86 | — |
| NJ | — | $51.86 | — |
| NM | — | $53.41 | — |
| NV | — | $51.86 | — |
| NY | — | $51.86 | — |
| OH | — | $53.16 | — |
| OK | — | $53.41 | — |
| OR | — | $51.86 | — |
| PA | — | $51.86 | — |
| PR | — | $57.05 | — |
| RI | — | $51.86 | — |
| SC | — | $53.41 | — |
| SD | — | $53.70 | — |
| TN | — | $53.41 | — |
| TX | — | $53.41 | — |
| UT | — | $53.70 | — |
| VA | — | $51.86 | — |
| VI | — | $57.05 | — |
| VT | — | $51.86 | — |
| WA | — | $51.86 | — |
| WI | — | $53.16 | — |
| WV | — | $51.86 | — |
| WY | — | $53.70 | — |
How the L3100 fee compares
| Measure | Value |
|---|---|
| Rank among 4 L31 codes (lowest = 1) | 1 |
| Family fee range (average of state fees) | $52.87–$108.88 |
| Rural fee uplift | — |
Who bills L3100 (2024)
| Measure | Value |
|---|---|
| Suppliers billing rentals | — |
| Suppliers billing purchases | 12 |
| Referring clinicians | 21 |
| Medicare beneficiaries | 30 |
| States with claims | 0 |
| Year | Suppliers | Beneficiaries |
|---|---|---|
| 2022 | 61 | 163 |
| 2023 | 19 | 72 |
| 2024 | 12 | 30 |
Counts only. Supplier and clinician names, contact lists and state-by-state detail are in Caduvo.
Medicare utilization for L3100, 2022–2024
| Year | Services | Beneficiaries | Avg. allowed | Avg. paid |
|---|---|---|---|---|
| 2022 | 188 | 163 | $42.46 | $27.75 |
| 2023 | 79 | 72 | $47.73 | $35.75 |
| 2024 | 32 | 30 | $47.09 | $34.54 |
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 L3100
- 2026-01-01: Average state fee rose 2.0%: $51.83 to $52.87
- 1985-01-01: L3100 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 L3100?
L3100 is the HCPCS Level II code for hallus-valgus night dynamic splint, prefabricated, off-the-shelf. Short descriptor: "Hallus-valgus nt dyn pre ots".
How much does Medicare pay for L3100?
Under the 2026 DMEPOS fee schedule, non-rural state fees are base (base fee): $51.86–$57.05. Rural fees can be higher.
Does Medicare cover L3100?
Coverage code D — Special coverage instructions apply. Medicare covers it when its national or local coverage criteria are met.
Which diagnoses support coverage for L3100?
Medicare policy articles that cite L3100 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 L3100 change in 2026?
The average non-rural state fee moved from $51.83 in 2025 to $52.87 in 2026 (+2.0%). CMS's next quarterly HCPCS and DMEPOS update takes effect January 1, 2027.
How many units of L3100 can be billed per day?
2 on DME suppliers; 2 on outpatient hospital claims (NCCI medically unlikely edits).
Related L31 codes
- L3140 — Foot, abduction rotation bar, including shoes ($106.80–$117.45)
- L3150 — Foot, abduction rotation bar, without shoes ($97.63–$107.44)
- L3160 — Foot, adjustable shoe-styled positioning device
- L3161 — Foot, adductus positioning device, adjustable
- L3170 — Foot, plastic, silicone or equal, heel stabilizer, prefabricated, off-the-shelf, each ($61.04–$67.13)
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 L3100
- Watch L3100 for fee, coverage and descriptor changes
- Build a full Medicare revenue model for L3100
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.