L3216 HCPCS code: Orthopedic footwear, ladies shoe, depth inlay, each
L3216 is the HCPCS Level II code for orthopedic footwear, ladies shoe, depth inlay, each. Its Medicare coverage code is S (Non-covered by Medicare statute): Medicare is barred by law from covering it. The NCCI unit limit is 2 per day on DME suppliers.
Code details
| Field | Value |
|---|---|
| Section | L codes — Orthotic and prosthetic procedures and devices |
| Coverage code | S — Non-covered by Medicare statute |
| Pricing indicator | 00 — Not separately priced by Medicare |
| BETOS category | D1F — Prosthetic and orthotic devices |
| Added | 1984-01-01 |
| Last action effective | 2006-01-01 |
NCCI unit limits (MUE)
| Claim type | Max units per day | Rationale |
|---|---|---|
| DME suppliers | 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
- A52501: Therapeutic Shoes for Persons with Diabetes - Policy Article (CGS Administrators, LLC (DME MAC) Noridian Healthcare Solutions, LLC (DME MAC)) — mentions this code in its coding guidance
Covered diagnoses (512 ICD-10-CM codes)
The diagnoses most often listed as covered in the policy articles above:
| ICD-10-CM | Diagnosis | Articles listing it |
|---|---|---|
| E08.00 | Diabetes mellitus due to underlying condition with hyperosmolarity without nonketotic hyperglycemic-hyperosmolar coma (NKHHC) | 1 |
| E08.01 | Diabetes mellitus due to underlying condition with hyperosmolarity with coma | 1 |
| E08.10 | Diabetes mellitus due to underlying condition with ketoacidosis without coma | 1 |
| E08.11 | Diabetes mellitus due to underlying condition with ketoacidosis with coma | 1 |
| E08.21 | Diabetes mellitus due to underlying condition with diabetic nephropathy | 1 |
| E08.22 | Diabetes mellitus due to underlying condition with diabetic chronic kidney disease | 1 |
| E08.29 | Diabetes mellitus due to underlying condition with other diabetic kidney complication | 1 |
| E08.311 | Diabetes mellitus due to underlying condition with unspecified diabetic retinopathy with macular edema | 1 |
| E08.319 | Diabetes mellitus due to underlying condition with unspecified diabetic retinopathy without macular edema | 1 |
| E08.3211 | Diabetes mellitus due to underlying condition with mild nonproliferative diabetic retinopathy with macular edema, right eye | 1 |
Showing 10 of 512. The full list, non-covered diagnoses and CSV export are in Caduvo.
What changed for L3216
- 1984-01-01: L3216 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 L3216?
L3216 is the HCPCS Level II code for orthopedic footwear, ladies shoe, depth inlay, each. Short descriptor: "Orthoped ladies shoes dpth i".
Does Medicare cover L3216?
Coverage code S — Non-covered by Medicare statute. Medicare is barred by law from covering it.
Which diagnoses support coverage for L3216?
Medicare policy articles that cite L3216 list 512 covered ICD-10-CM diagnosis codes across 2 articles. The most cited include E08.00 (Diabetes mellitus due to underlying condition with hyperosmolarity without nonketotic hyperglycemic-hyperosmolar coma (NKHHC)), E08.01 (Diabetes mellitus due to underlying condition with hyperosmolarity with coma), E08.10 (Diabetes mellitus due to underlying condition with ketoacidosis without coma). A listed diagnosis is necessary but not sufficient; the policy's other criteria still apply.
How many units of L3216 can be billed per day?
2 on DME suppliers (NCCI medically unlikely edits).
Related L32 codes
- L3201 — Orthopedic shoe, oxford with supinator or pronator, infant
- L3202 — Orthopedic shoe, oxford with supinator or pronator, child
- L3203 — Orthopedic shoe, oxford with supinator or pronator, junior
- L3204 — Orthopedic shoe, hightop with supinator or pronator, infant
- L3206 — Orthopedic shoe, hightop with supinator or pronator, child
- L3207 — Orthopedic shoe, hightop with supinator or pronator, junior
- 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
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 L3216
- Watch L3216 for fee, coverage and descriptor changes
- Build a full Medicare revenue model for L3216
Sources: CMS HCPCS Level II release October 2026; CMS DMEPOS fee schedule; 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.