L3450 HCPCS code: Heel, sach cushion type
L3450 is the HCPCS Level II code for heel, sach cushion type. The 2026 Medicare DMEPOS fee schedule pays $126.64 to $139.27 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 10 of 11 L34 codes (family range $41.98–$195.96).
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 L3450
| Modifier | Meaning | Lowest state fee | Highest state fee | Ceiling | Floor |
|---|---|---|---|---|---|
| — | base fee | $126.64 | $139.27 | $154.51 | $115.88 |
| State | Modifier | Fee | Rural fee |
|---|---|---|---|
| AK | — | $126.64 | — |
| AL | — | $130.40 | — |
| AR | — | $130.40 | — |
| AZ | — | $126.64 | — |
| CA | — | $126.64 | — |
| CO | — | $131.11 | — |
| CT | — | $126.64 | — |
| DC | — | $126.64 | — |
| DE | — | $126.64 | — |
| FL | — | $130.40 | — |
| GA | — | $130.40 | — |
| HI | — | $126.64 | — |
| IA | — | $129.09 | — |
| ID | — | $126.64 | — |
| IL | — | $129.69 | — |
| IN | — | $129.69 | — |
| KS | — | $129.09 | — |
| KY | — | $130.40 | — |
| LA | — | $130.40 | — |
| MA | — | $126.64 | — |
| MD | — | $126.64 | — |
| ME | — | $126.64 | — |
| MI | — | $129.69 | — |
| MN | — | $129.69 | — |
| MO | — | $129.09 | — |
| MS | — | $130.40 | — |
| MT | — | $131.11 | — |
| NC | — | $130.40 | — |
| ND | — | $131.11 | — |
| NE | — | $129.09 | — |
| NH | — | $126.64 | — |
| NJ | — | $126.64 | — |
| NM | — | $130.40 | — |
| NV | — | $126.64 | — |
| NY | — | $126.64 | — |
| OH | — | $129.69 | — |
| OK | — | $130.40 | — |
| OR | — | $126.64 | — |
| PA | — | $126.64 | — |
| PR | — | $139.27 | — |
| RI | — | $126.64 | — |
| SC | — | $130.40 | — |
| SD | — | $131.11 | — |
| TN | — | $130.40 | — |
| TX | — | $130.40 | — |
| UT | — | $131.11 | — |
| VA | — | $126.64 | — |
| VI | — | $139.27 | — |
| VT | — | $126.64 | — |
| WA | — | $126.64 | — |
| WI | — | $129.69 | — |
| WV | — | $126.64 | — |
| WY | — | $131.11 | — |
How the L3450 fee compares
| Measure | Value |
|---|---|
| Rank among 11 L34 codes (lowest = 1) | 10 |
| Family fee range (average of state fees) | $41.98–$195.96 |
| 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 L3450
- 2026-01-01: Average state fee rose 2.0%: $126.55 to $129.08
- 1984-01-01: L3450 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 L3450?
L3450 is the HCPCS Level II code for heel, sach cushion type. Short descriptor: "Shoe heel sach cushion type".
How much does Medicare pay for L3450?
Under the 2026 DMEPOS fee schedule, non-rural state fees are base (base fee): $126.64–$139.27. Rural fees can be higher.
Does Medicare cover L3450?
Coverage code D — Special coverage instructions apply. Medicare covers it when its national or local coverage criteria are met.
Did the Medicare fee for L3450 change in 2026?
The average non-rural state fee moved from $126.55 in 2025 to $129.08 in 2026 (+2.0%). CMS's next quarterly HCPCS and DMEPOS update takes effect January 1, 2027.
How many units of L3450 can be billed per day?
2 on DME suppliers; 2 on outpatient hospital claims (NCCI medically unlikely edits).
Related L34 codes
- L3400 — Metatarsal bar wedge, rocker ($48.83–$53.69)
- L3410 — Metatarsal bar wedge, between sole ($111.35–$122.47)
- L3420 — Full sole and heel wedge, between sole ($65.62–$72.12)
- L3430 — Heel, counter, plastic reinforced ($192.22–$211.48)
- L3440 — Heel, counter, leather reinforced ($91.55–$100.71)
- L3455 — Heel, new leather, standard ($48.83–$53.69)
- L3460 — Heel, new rubber, standard ($41.16–$45.31)
- L3465 — Heel, thomas with wedge ($70.16–$77.19)
- L3470 — Heel, thomas extended to ball ($74.74–$82.20)
- L3480 — Heel, pad and depression for spur ($74.74–$82.20)
- L3485 — Heel, pad, removable for spur
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Next steps
- Run a reimbursement report for a device billed under L3450
- Watch L3450 for fee, coverage and descriptor changes
- Build a full Medicare revenue model for L3450
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.