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See a sample rate comparisonHCPCS L3213 Fee Schedule
Last Verified: September 2026
Healthcare providers use this code to document and receive reimbursement for visits that address moderate-level medical decision-making, often including multiple diagnoses or prescription management.
Benesch boot, pair, child
| Key Fact | Detail |
|---|---|
| Service Type | Orthotic Procedures and services Benesch Boots |
| Complexity Level | Low |
| Medicaid Fee Schedule | View Medicaid rates for L3213 |
National average reimbursement for HCPCS L3213 by major payers:
$47.26
$37.40
$32.64
$61.04
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HCPCS L3213
5 of 25 sample ratesHigher to lower in this preview
Chu Chen
Merrimack Valley Pediatric Associates, Inc.
$135.23Published rateUnion County Hospital Authority, Union General Hospital
Union County Hospital Authority
$45.88Published ratePaulding Medical Center, Inc., Wellstar Paulding Hospital
Paulding Medical Center Inc
$40.77Published rateJacob Holloway
$30.89Published rateWildwood Sanitarium, Incorporated, Wildwood Lifestyle Center And Hospital
Wildwood Sanitarium Incorporated
$18.35Published rate
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Payer Contract Negotiation
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See a sample payer proposalHCPCS L3213 vs. Other Benesch Boots Codes
The HCPCS L3213 code is part of the Orthotic Procedures and services services used for Benesch Boots. It represents a moderate-complexity encounter and is one of several codes that vary based on time spent, level of medical decision-making, and documentation requirements.
The HCPCS L3213 code involves more provider time and moderate medical decision-making, unlike lower-level codes that require less time and simpler assessments. It typically includes multiple diagnoses, medication management, or test interpretation, leading to higher reimbursement and more detailed documentation requirements.
| Code | Complexity | Description |
|---|---|---|
| L3212-HCPCS | Low | Benesch boot, pair, infant |
| L3213-HCPCS | Low | Benesch boot, pair, child |
| L3214-HCPCS | Low | Benesch boot, pair, junior |
What is a fee schedule?
A fee schedule is a list of fixed prices that healthcare providers charge for specific services, including HCPCS L3213. These prices vary depending on payer type (Medicare, Medicaid, private insurance), geographic location, and provider contracts.
Understanding the L3213 fee schedule helps patients estimate costs and providers optimize billing for accurate reimbursements.
Factors that affect fee schedules
Medicare & Medicaid Rates
Government-set reimbursement amounts
Private Insurance Rates
Negotiated rates between providers and insurance companies
Geographic Location
Costs may be higher in urban areas.
Provider Type
Hospital providers may have different rates than private practice.
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