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See a sample rate comparisonHCPCS L3465 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.
Heel, Thomas with wedge
| Key Fact | Detail |
|---|---|
| Service Type | Orthotic Procedures and services Shoe Heels |
| Complexity Level | Low |
| Medicaid Fee Schedule | View Medicaid rates for L3465 |
National average reimbursement for HCPCS L3465 by major payers:
$59.70
$37.59
$41.05
$82.16
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HCPCS L3465
5 of 25 sample ratesHigher to lower in this preview
Anna Jaques Hospital
$83.95Published rateProgressive Emergency Physicians PLLC
$35.39Published rateRedmond Park Hospital LLC, Redmond Hospital Based Services LLC
Redmond Park Hospital LLC
$32.09Published rateNortheast Georgia Medical Center, Inc.
Gainesville Radiology Group
$31.42Published rateMiguel A. Arenas, M.D., PC
Miguel A Arenas Md PC
$20.94Published rate
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Payer Contract Negotiation
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See a sample payer proposalHCPCS L3465 vs. Other Shoe Heels Codes
The HCPCS L3465 code is part of the Orthotic Procedures and services services used for Shoe Heels. 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 L3465 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 |
|---|---|---|
| L3460-HCPCS | Low | Heel, new rubber, standard |
| L3465-HCPCS | Low | Heel, Thomas with wedge |
| L3470-HCPCS | Low | Heel, Thomas extended to ball |
What is a fee schedule?
A fee schedule is a list of fixed prices that healthcare providers charge for specific services, including HCPCS L3465. These prices vary depending on payer type (Medicare, Medicaid, private insurance), geographic location, and provider contracts.
Understanding the L3465 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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