L3201 – Orthopedic shoe, oxford with supinator or pronator, infant
HCPCS Level II code · L codes: Orthotic and Prosthetic Procedures and Devices
HCPCS codeL3201
- Long description
- Orthopedic shoe, oxford with supinator or pronator, infant
- Short description
- Oxford w supinat/pronat inf
- Pricing indicator
00Not separately priced by Part B (bundled, not covered or Part A only)- Medicare coverage
DSpecial coverage instructions apply- BETOS category
D1FProsthetic/Orthotic devices- Added
- January 1, 1984
- Last change
- January 1, 1997 – No change
Frequently asked questions
What is HCPCS code L3201?
L3201 is a HCPCS Level II code for orthopedic shoe, oxford with supinator or pronator, infant.
Does Medicare cover L3201?
The HCPCS file lists coverage code D: Special coverage instructions apply. Coverage and payment also depend on local coverage determinations and the patient’s plan.
Nearby L codes
- L3080 – Foot, arch support, non-removable attached to shoe, metatarsal, each
- L3090 – Foot, arch support, non-removable attached to shoe, longitudinal/metatarsal, each
- L3100 – Hallus-valgus night dynamic splint, prefabricated, off-the-shelf
- L3140 – Foot, abduction rotation bar, including shoes
- L3150 – Foot, abduction rotation bar, without shoes
- L3160 – Foot, adjustable shoe-styled positioning device
- L3161 – Foot, adductus positioning device, adjustable
- L3170 – Foot, plastic, silicone or equal, heel stabilizer, prefabricated, off-the-shelf, each
- L3202 – Orthopedic shoe, oxford with supinator or pronator, child
- L3203 – Orthopedic shoe, oxford with supinator or pronator, junior
- L3204 – Orthopedic shoe, hightop with supinator or pronator, infant
- L3206 – Orthopedic shoe, hightop with supinator or pronator, child
- L3207 – Orthopedic shoe, hightop with supinator or pronator, junior
- L3208 – Surgical boot, each, infant
- L3209 – Surgical boot, each, child
- L3211 – Surgical boot, each, junior
Source: CMS HCPCS Level II quarterly file, October 2026. Reference only – check payer policy before billing.