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See a sample rate comparisonHCPCS L3251 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.
Foot, shoe molded to patient model, silicone shoe, each
| Key Fact | Detail |
|---|---|
| Service Type | Orthotic Procedures and services Other Orthopedic Footwear |
| Complexity Level | Low |
| Medicaid Fee Schedule | View Medicaid rates for L3251 |
National average reimbursement for HCPCS L3251 by major payers:
$190.51
$23.84
$34.05
$39.35
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HCPCS L3251
5 of 25 sample ratesHigher to lower in this preview
Chu Chen
Merrimack Valley Pediatric Associates, Inc.
$86.04Published rateCarson Medical Group Professional Corporation
Carson Medical Group
$36.56Published rateChristopher Raio
Good Samaritan Hosptial Medical Center
$25.92Published rateHospital Authority Of Ben Hill, Dorminy Medical Center
$20.87Published rateUpson County Hospital Inc, Upson Regional Medical Center
Upson County Hospital Inc
$17.52Published rate
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Payer Contract Negotiation
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See a sample payer proposalHCPCS L3251 vs. Other Other Orthopedic Footwear Codes
The HCPCS L3251 code is part of the Orthotic Procedures and services services used for Other Orthopedic Footwear. 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 L3251 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 |
|---|---|---|
| L3250-HCPCS | Moderate | Orthopedic footwear, custom molded shoe, removable inner mold, prosthetic shoe, each |
| L3251-HCPCS | Low | Foot, shoe molded to patient model, silicone shoe, each |
| L3252-HCPCS | Low | Foot, shoe molded to patient model, Plastazote (or similar), custom fabricated, each |
What is a fee schedule?
A fee schedule is a list of fixed prices that healthcare providers charge for specific services, including HCPCS L3251. These prices vary depending on payer type (Medicare, Medicaid, private insurance), geographic location, and provider contracts.
Understanding the L3251 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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