MyMedi-AI

L3000 — Foot, insert, removable, molded to patient model, 'ucb' type, berkeley shell, each

HCPCS Level II L-code · short descriptor: “Ft insert ucb berkeley shell”

Code system
HCPCS Level II
Family
L — Orthotics & prosthetics
Medicare coverage status
Special coverage instructions apply
DMEPOS payment category
Prosthetics & orthotics
Prior authorization
Not on Medicare required-PA list
Face-to-face & WOPD
Not on the required list
MUE unit limit
2
Status
Active (HCPCS Level II October 2026)

Prior authorization

Not on the Medicare required-PA list (CMS Required Prior Authorization List — 74 items in force on 2026-10-25; 8 more from 2026-10-28; sources: CMS list updated 2026-01-13, CMS-6109-N (91 FR 47972)). Medicare Advantage and commercial plans set their own prior-authorization rules for this code — verify per plan before delivery.

Order readiness — what the written order must contain

Every Medicare DMEPOS claim needs a Standard Written Order with all six elements (42 CFR 410.38(d)):

  • Beneficiary name or Medicare Beneficiary Identifier (MBI) (42 CFR 410.38(d)(1)(i)(A))
  • General description of the item (42 CFR 410.38(d)(1)(i)(B))
  • Quantity to be dispensed, if applicable (42 CFR 410.38(d)(1)(i)(C))
  • Order date (42 CFR 410.38(d)(1)(i)(D))
  • Treating practitioner name or NPI (42 CFR 410.38(d)(1)(i)(E))
  • Treating practitioner signature (42 CFR 410.38(d)(1)(i)(F))

Not on the F2F/WOPD list (CMS Required F2F & WOPD List — 83 items in force on 2026-10-25; 22 more from 2026-10-28; sources: CMS list effective 2026-04-13 (91 FR 1250), CMS-6109-N (91 FR 47972)). The standard written order must reach the supplier before claim submission.

Blank requirements checklist only — MyMedi-AI never collects or stores completed orders.

L3000 Medicare fee schedule (October 2026)

Base (no modifier) Prosthetics & orthotics

Medicare allowable ranges from $376.80 to $414.48 depending on state and rural status.

Former-CBA payment limits: ceiling $459.83 · floor $344.87

StateNon-ruralRural
AK$376.80—
AL$388.16—
AR$388.12—
AZ$376.80—
CA$376.80—
CO$390.25—
CT$376.80—
DC$376.80—
DE$376.80—
FL$388.16—
GA$388.16—
HI$376.80—
IA$384.17—
ID$376.80—
IL$386.06—
IN$386.06—
KS$384.17—
KY$388.16—
LA$388.12—
MA$376.80—
MD$376.80—
ME$376.80—
MI$386.06—
MN$386.06—
MO$384.17—
MS$388.16—
MT$390.25—
NC$388.16—
ND$390.25—
NE$384.17—
NH$376.80—
NJ$376.80—
NM$388.12—
NV$376.80—
NY$376.80—
OH$386.06—
OK$388.12—
OR$376.80—
PA$376.80—
PR$414.48—
RI$376.80—
SC$388.16—
SD$390.25—
TN$388.16—
TX$388.12—
UT$390.25—
VA$376.80—
VI$414.48—
VT$376.80—
WA$376.80—
WI$386.06—
WV$376.80—
WY$390.25—
Amounts are the Medicare DMEPOS fee-schedule allowables effective October 2026 (CMS DMEPOS Fee Schedule October 2026 (DME26-D)). Medicare typically pays 80% of the allowable after the Part B deductible; the patient owes 20%. A 2% sequestration reduction applies to the Medicare share. Former competitive-bidding-area adjustments and non-continental rates can differ — verify with your DME MAC.

Unit limit (MUE)

Medicare's Medically Unlikely Edit caps L3000 at 2 units per date of service (clinical). Units above the MUE deny — typically as CO-151. Rationale: Anatomic Consideration.

Common denial codes to watch

Related L-codes

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