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L3470 — Heel, thomas extended to ball

HCPCS Level II L-code · short descriptor: “Shoe heel thomas extend to b”

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
Status
Active (April 2026 HCPCS)

Prior authorization

Not on the Medicare required-PA list as of the January 13, 2026 update (74 items). Medicare Advantage and commercial plans set their own prior-authorization rules for this code — verify per plan before delivery.

L3470 Medicare fee schedule (April 2026)

Base (no modifier) Prosthetics & orthotics

Medicare allowable ranges from $74.74 to $82.20 depending on state and rural status.

Former-CBA payment limits: ceiling $91.22 · floor $68.41

StateNon-ruralRural
AK$74.74
AL$76.99
AR$76.99
AZ$74.74
CA$74.74
CO$77.47
CT$74.74
DC$74.74
DE$74.74
FL$76.99
GA$76.99
HI$74.74
IA$76.19
ID$74.74
IL$76.57
IN$76.57
KS$76.19
KY$76.99
LA$76.99
MA$74.74
MD$74.74
ME$74.74
MI$76.57
MN$76.57
MO$76.19
MS$76.99
MT$77.47
NC$76.99
ND$77.47
NE$76.19
NH$74.74
NJ$74.74
NM$76.99
NV$74.74
NY$74.74
OH$76.57
OK$76.99
OR$74.74
PA$74.74
PR$82.20
RI$74.74
SC$76.99
SD$77.47
TN$76.99
TX$76.99
UT$77.47
VA$74.74
VI$82.20
VT$74.74
WA$74.74
WI$76.57
WV$74.74
WY$77.47
Amounts are the Medicare DMEPOS fee-schedule allowables effective April 2026. 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.

Common denial codes to watch

Related L-codes

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