L3170 — Foot, plastic, silicone or equal, heel stabilizer, prefabricated, off-the-shelf, each
L3170 is a HCPCS Level II code for foot, plastic, silicone or equal, heel stabilizer, prefabricated, off-the-shelf, 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 L3170 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 2 — Date of Service Edit: Policy · Anatomic Consideration
- DME supplier
- 2 units MAI 2 — Date of Service Edit: Policy · 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 L3170
- Long descriptor
- Foot, plastic, silicone or equal, heel stabilizer, prefabricated, off-the-shelf, each
- Short descriptor
- Foot plas heel stabi pre ots
- Added
- January 1, 1984
- 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 L3170
HCPCS has no hierarchy — related items simply sit next to each other in the numbering. If L3170 is not quite right, the correct code is very often within a few positions of it.
- 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
- L3161Foot, adductus positioning device, adjustable
- L3201Orthopedic shoe, oxford with supinator or pronator, infant
- L3202Orthopedic shoe, oxford with supinator or pronator, child
- L3203Orthopedic shoe, oxford with supinator or pronator, junior
- L3204Orthopedic shoe, hightop with supinator or pronator, infant
- L3206Orthopedic shoe, hightop with supinator or pronator, child
- L3207Orthopedic shoe, hightop with supinator or pronator, junior
- L3208Surgical boot, each, infant
- L3209Surgical boot, each, child
Questions about L3170
What is HCPCS code L3170?
L3170 is a HCPCS Level II code for foot, plastic, silicone or equal, heel stabilizer, prefabricated, off-the-shelf, each. It sits in the Orthotic and Prosthetic Procedures and Devices section.
Does Medicare cover L3170?
The CMS HCPCS file marks L3170 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.