L3050 — Foot, arch support, removable, premolded, metatarsal, each
L3050 is a HCPCS Level II code for foot, arch support, removable, premolded, metatarsal, each. It belongs to the Orthotic and Prosthetic Procedures and Devices section. Whether Medicare pays it depends on the coverage rule below.
Medicare coverage: Special coverage instructions apply
There are published conditions attached to this code. Check the applicable coverage policy before billing it: the code being valid is not the same as the service being covered.
From the coverage field of the CMS Alpha-Numeric HCPCS File, release 2026Q3-Jul. This states Medicare’s position on the code, not on your particular claim.
Medically Unlikely Edits — units per day
The most units of L3050 Medicare will pay on one date of service. Bill more on a single line and it is denied. The limit is not the same in every setting, so the row that matters is the one matching the claim you are building.
- practitioner
- 0 — never payable MAI 3 — Date of Service Edit: Clinical · CMS Policy
- outpatient
- 2 units MAI 3 — Date of Service Edit: Clinical · Anatomic Consideration
- DME supplier
- 2 units MAI 3 — Date of Service Edit: Clinical · Anatomic Consideration
The adjudication indicator decides whether exceeding the limit is worth appealing at all: MAI 1 is a line edit you can support with documentation, MAI 3 is a date-of-service edit that is also appealable, and MAI 2 is absolute — no documentation overrides it. CMS MUE 2026Q3.
The CMS record for L3050
- Long descriptor
- Foot, arch support, removable, premolded, metatarsal, each
- Short descriptor
- Foot arch supp premold metat
- Added
- January 1, 1982
- BETOS
- D1F
- Pricing indicator
- 00 — Not priced by Part B
The official wording. This is what the code means.
CMS's 28-character form, which is what shows up on a remittance advice.
When CMS introduced the code.
Berenson-Eggers Type of Service — CMS's own analytic grouping.
Service not separately priced by Part B — not covered, bundled into another service, or used by Part A only.
Codes adjacent to L3050
HCPCS has no hierarchy — related items simply sit next to each other in the numbering. If L3050 is not quite right, the correct code is very often within a few positions of it.
- L3001Foot, insert, removable, molded to patient model, spenco, each
- L3002Foot, insert, removable, molded to patient model, plastazote or equal, each
- L3003Foot, insert, removable, molded to patient model, silicone gel, each
- L3010Foot, insert, removable, molded to patient model, longitudinal arch support, each
- L3020Foot, insert, removable, molded to patient model, longitudinal/ metatarsal support, each
- L3030Foot, insert, removable, formed to patient foot, each
- L3031Foot, insert/plate, removable, addition to lower extremity orthosis, high strength, lightweight material, all hybrid lamination/prepreg composite, each
- L3040Foot, arch support, removable, premolded, longitudinal, each
- L3060Foot, arch support, removable, premolded, longitudinal/ metatarsal, each
- L3070Foot, arch support, non-removable attached to shoe, longitudinal, each
- L3080Foot, arch support, non-removable attached to shoe, metatarsal, each
- L3090Foot, arch support, non-removable attached to shoe, longitudinal/metatarsal, each
- L3100Hallus-valgus night dynamic splint, prefabricated, off-the-shelf
- L3140Foot, abduction rotation bar, including shoes
- L3150Foot, abduction rotation bar, without shoes
- L3160Foot, adjustable shoe-styled positioning device
Questions about L3050
What is HCPCS code L3050?
L3050 is a HCPCS Level II code for foot, arch support, removable, premolded, metatarsal, each. It sits in the Orthotic and Prosthetic Procedures and Devices section.
Does Medicare cover L3050?
The CMS HCPCS file marks L3050 as "Special coverage instructions apply". There are published conditions attached to this code. Check the applicable coverage policy before billing it: the code being valid is not the same as the service being covered.