Custom Orthotics Cost

Compare Medicare foot orthotic fee schedule amounts by state and code. These are Medicare fee schedule amounts, not retail prices. This is not medical advice.

Data as of October 7, 2026. Fee file: October 2026.

Medicare foot orthotic fee schedule by state

Amounts are in US dollars, per HCPCS unit. Each code description below ends in "each". The quarter is October 2026. This table uses the CMS NR columns and the rows with blank modifiers.

CMS explains the column choice: Note: Fee schedule amounts for those codes not adjusted using competitive bidding information will only have fee schedule amounts in the non-rural (NR) columns. CMS download, DMEREAD 2026.pdf The tool also uses these columns. A missing or unverified amount is shown as "Not verified".

Inclusion or exclusion of a fee schedule for an item or service does not imply any health insurance coverage. CMS fee file disclaimer Download the official CMS fee ZIP.

Verified CMS HCPCS descriptions

The tool includes these codes found in both the CMS fee file and the October HCPCS file. Descriptions below quote the CMS long-description cells. Use the code supplied by your clinician or supplier.

L3000

Foot, insert, removable, molded to patient model, 'ucb' type, berkeley shell, each CMS HCPCS file

L3010

Foot, insert, removable, molded to patient model, longitudinal arch support, each CMS HCPCS file

L3020

Foot, insert, removable, molded to patient model, longitudinal/ metatarsal support, each CMS HCPCS file

L3030

Foot, insert, removable, formed to patient foot, each CMS HCPCS file

L3031

Foot, insert/plate, removable, addition to lower extremity orthosis, high strength, lightweight material, all hybrid lamination/prepreg composite, each CMS HCPCS file

L3040

Foot, arch support, removable, premolded, longitudinal, each CMS HCPCS file

L3050

Foot, arch support, removable, premolded, metatarsal, each CMS HCPCS file

L3060

Foot, arch support, removable, premolded, longitudinal/ metatarsal, each CMS HCPCS file

Medicare orthotics coverage conditions

For the L codes in the lookup, the CMS coverage wording is: are covered if they are on a shoe that is an integral part of a covered brace and if they are medically necessary for the proper functioning of the brace. CMS Orthopedic Footwear policy The full policy lists each selected code before this condition.

Shoes and related modifications, inserts, heel/sole replacements or shoe transfers billed without a KX modifier will be denied as noncovered because coverage is statutorily excluded. CMS billing condition

A Standard Written Order (SWO) must be communicated to the supplier before a claim is submitted. CMS Orthopedic Footwear LCD Medicare will only cover your orthopedic shoes if your doctors and suppliers are enrolled in Medicare. Medicare.gov provider requirements

After you meet the Part B deductible , you pay 20% of the Medicare-approved amount (if your supplier accepts assignment ). Medicare.gov costs The tool multiplies the selected fee by this percentage and rounds to the nearest cent. This is conditional arithmetic, not a quote for an approved claim. It assumes the item is covered, the deductible is met, your supplier accepts assignment, and the fee is the approved amount. Ask your supplier to confirm the approved amount and your bill.

Diabetic therapeutic inserts use separate codes

Depth-inlay or custom molded shoes for diabetics and related inserts and modifications are billed using A codes whether or not the shoe is an integral part of a brace. CMS coding guidelines

You have diabetes and severe diabetes-related foot disease. Medicare.gov eligibility The doctor who treats your diabetes must certify your need for therapeutic shoes or inserts. Medicare.gov certification The L-code fee lookup does not determine eligibility for the separate diabetic footwear benefit.

Frequently asked questions

How much do custom orthotics cost?

This tool shows Medicare fee schedule amounts, not retail prices. A retail price range is Not verified. CMS states: Inclusion or exclusion of a fee schedule for an item or service does not imply any health insurance coverage. CMS fee file and readme

Does Medicare cover custom orthotics?

The CMS condition for the L codes in this tool is: are covered if they are on a shoe that is an integral part of a covered brace and if they are medically necessary for the proper functioning of the brace. CMS A52481

Does Medicare cover prescribed orthotics?

A prescription alone does not establish coverage. CMS states: A Standard Written Order (SWO) must be communicated to the supplier before a claim is submitted. CMS L33641 Check the coverage condition above with your supplier.

Does Medicare cover orthotics inserts for diabetes?

The separate therapeutic footwear benefit has its own coding and eligibility. CMS states: Depth-inlay or custom molded shoes for diabetics and related inserts and modifications are billed using A codes whether or not the shoe is an integral part of a brace. CMS A52481 Medicare.gov states: You have diabetes and severe diabetes-related foot disease. Medicare.gov The doctor who treats your diabetes must certify your need for therapeutic shoes or inserts. Medicare.gov provider requirements

Does Medicare cover the cost of orthotics?

For covered orthopedic shoes, Medicare.gov states: After you meet the Part B deductible , you pay 20% of the Medicare-approved amount (if your supplier accepts assignment ). Medicare.gov costs The tool applies this percentage to the selected schedule amount for arithmetic only. It does not confirm coverage or your actual bill.

What is the cost of custom orthotics near me?

Select your state to view its official Medicare fee schedule amount. For a retail quote, Ask your doctor or healthcare provider how much your test, item, or service will cost. Medicare.gov Retail prices for local suppliers are Not verified.

Official sources

• CMS October 2026 DMEPOS fee schedule and official ZIP: DMEPOS_OCT.csv, DMEPOS_OCT.txt, and DMEREAD 2026.pdf.
• CMS October 2026 Alpha-Numeric HCPCS ZIP: long descriptions in HCPC2026_OCT_ANWEB_09232026.xlsx.
• CMS A52481: Orthopedic Footwear Policy Article: insert coverage and coding.
• CMS L33641: Orthopedic Footwear LCD: written order requirement.
• Medicare.gov: Orthopedic shoes: coinsurance and supplier enrollment.
• Medicare.gov: Therapeutic shoes and inserts: diabetes eligibility and certification.

Data as of October 7, 2026. Retail prices, local supplier quotes, and individual claim eligibility: Not verified.