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    v1.0.28
    OpenPayerBilling CodesOrthotic Procedures and servicesHCPCS hcpcs-l3221-orthopedic-mens-shoe-depth-inlay
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    HCPCS L3221: Orthopedic Footwear, Men’s Shoe, Depth Inlay

    HCPCS Level II code L3221 describes orthopedic footwear, men’s shoe, depth inlay, each, representing a custom or prefabricated depth-inlay shoe provided as orthopedic footwear; service type is orthopedic shoe provision and the typical site of service is outpatient durable medical equipment supply or specialty orthotics/prosthetics clinic where fitting and dispensing occur.

    For related coverage guidance, see recent payer policy updates: Interferential Stimulation Devices (for home use), Durable Medical Equipment (DME): Tumor Treating Fields (Alternating Electric Field Therapy) Medical Guideline, Durable Medical Equipment (DME): Bone Growth Stimulators Medical Guideline.

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    Clinical & Coding Specifications

    Clinical Context

    A 68-year-old male patient with diabetic peripheral neuropathy and a history of chronic plantar forefoot ulceration presents to a podiatry clinic for evaluation. The patient reports recurrent pressure-related callus formation and difficulty wearing standard shoes due to increased depth requirements from toe deformities and soft-tissue loss. The podiatrist measures the foot, documents need for accommodative depth and inlay to offload high-pressure areas, and orders custom orthopedic footwear — specifically a men’s depth-inlay shoe billed with L3221. The typical clinical workflow includes: initial evaluation and lower-extremity exam, wound assessment if present, measurement and casting or scanning for depth shoe, fabrication by a certified orthotist or shoe manufacturer, confirmation of fit at delivery, and documentation of medical necessity including diagnosis codes, prior authorization if required by the payor, and delivery notes with patient acceptance. Typical site of service is an outpatient clinic, podiatry practice, orthotics/prosthetics supplier, or durable medical equipment vendor. The service type is durable medical equipment/prosthetic/orthotic footwear (orthopedic footwear, mens shoe, depth inlay, each).

    Related CPT Codes

    CPT CodeDescriptionRelationship to This Procedure
    11720Debridement of nail(s) by partial or complete removalPerformed before fitting if onychopathy contributes to pressure points addressed by depth inlay footwear.
    11730Avulsion of nail plate, partial or complete, simple; singlePerformed when toenail pathology requires treatment prior to footwear use.
    11056Debridement of skin and/or subcutaneous tissueUsed for callus or hyperkeratotic lesion removal prior to fitting orthopedic footwear.
    99456Work-related or medical disability examination (mes)May be used for functional assessments or documentation supporting need for DME in disability contexts.
    99070Supplies and materials (e.g., extra-corporeal supplies)Billed when additional non-covered supplies or custom materials are provided with the shoe.

    If additional procedure codes are required for surgical correction or advanced wound care before shoe fitting, those services are billed separately per standard CPT coding and payer rules.

    Related Modifiers

    7 rows

    ModifierDescriptionWhen to Use
    59Modifier 59 indicates a distinct procedural service when two procedures that are not normally billed together are clinically and procedurally separate. The CPT definition (as reiterated by CMS)…- Use modifier -59 to report a distinct procedural service when documentation supports that the procedure reported is not normally billed together with another service on the same day because of a…
    22Modifier –22 (Increased Procedural Services) is used when a reported procedure is substantially more extensive than normally required. The CPT Manual and CMS state it may be appended only when the…- When to use: Append modifier -22 to a procedural CPT code when the service performed is substantially more extensive than the usual service described by that code — i.e., the procedure required…
    52Modifier ‑52 (Reduced Services) indicates that a service or procedure was partially reduced or omitted at the provider’s discretion, allowing reporting of the basic procedure number with a qualifier…- Use modifier -52 when a physician or qualified health professional electively reduces or omits part of a procedure or service (for example, performing fewer required views or omitting a portion of…
    53Modifier 53 (Discontinued Procedure) signals that a surgical or diagnostic service was begun by the physician but terminated because of extenuating circumstances that threatened the patient’s…- Use modifier -53 when a physician/qualified healthcare professional has started a surgical or diagnostic procedure (e.g., anesthesia administered, incision or scope insertion) and then discontinues…
    62Modifier 62 indicates that two surgeons function as co‑surgeons, each performing distinct parts of the same primary surgical procedure. It is appended to the primary procedure code (and any…- Use modifier -62 when two surgeons act as co‑surgeons (both primary surgeons) on a single definitive primary procedure, each performing distinct parts of the same surgical procedure (append -62 to…
    78CPT modifier -78 indicates an unplanned, related return to the operating or procedure room by the same provider during the global postoperative period. It is appended when treatment for a…- Use modifier -78 when an unplanned, related complication during the original procedure’s global postoperative period requires the patient to return to a formal operating or procedure room and the…
    80CPT® Modifier 80 (Assistant Surgeon) is appended to a surgical CPT code when a physician (MD or DO) provides full, continuous assistance throughout the operative procedure. It is intended only for…- Use CPT Modifier -80 when a physician (MD or DO) serves as an assistant surgeon and provides full, continuous assistance throughout the entire operative procedure; append -80 to the surgical CPT…

    Related Provider Taxonomies

    8 rows

    Taxonomy CodeSpecialtyNotes
    207K00000XAllergy & Immunology PhysicianAn allergist-immunologist is trained in evaluation, physical and laboratory diagnosis, and management of disorders involving the immune system. Select…
    213E00000XPodiatristA podiatrist is a person qualified by a Doctor of Podiatric Medicine (D.P.M.) degree, licensed by the state, and practicing within the scope of that l…
    207R00000XInternal Medicine PhysicianA physician who provides long-term, comprehensive care in the office and the hospital, managing both common and complex illness of adolescents, adults…
    207L00000XAnesthesiology PhysicianAn anesthesiologist is trained to provide pain relief and maintenance, or restoration, of a stable condition during and immediately following an opera…
    2080T0002XPediatric Medical Toxicology PhysicianMedical toxicologists are physicians that specialize in the prevention, evaluation, treatment and monitoring of injury and illness from exposures to d…
    243U00000XRadiology Practitioner AssistantA Radiology Practitioner Assistant (RPA) is a health professional certified as a registered radiographer with the American Registry of Radiologic Tech…
    246QH0000XHematology Specialist/TechnologistTechnologists, Technicians & Other Technical Service Providers · Specialist/Technologist, Pathology
    208VP0014XInterventional Pain Medicine PhysicianInterventional Pain Medicine is the discipline of medicine devoted to the diagnosis and treatment of pain and related disorders principally with the a…

    Related ICD-10-CM Codes

    23 rows

    ICD-10-CM CodeDescription
    E10.621Type 1 diabetes mellitus with foot ulcer
    E10.65Type 1 diabetes mellitus with hyperglycemia
    E11.621Type 2 diabetes mellitus with foot ulcer
    E11.65Type 2 diabetes mellitus with hyperglycemia
    I73.9Peripheral vascular disease, unspecified
    L80Vitiligo
    L97.909Non-pressure chronic ulcer of unspecified part of unspecified lower leg with unspecified severity
    L97.919Non-pressure chronic ulcer of unspecified part of right lower leg with unspecified severity
    M16.11Unilateral primary osteoarthritis, right hip
    M17.11Unilateral primary osteoarthritis, right knee

    Showing 1–10 of 23

    Related Payer Policy Updates

    Specialty: Durable Medical Equipment (DME)1 / 3

    5 rows

    PolicyPayerEffective Date
    Interferential Stimulation Devices (for home use)Moda Health2026-10-01
    Durable Medical Equipment (DME): Tumor Treating Fields (Alternating Electric Field Therapy) Medical GuidelineWPS Health Insurance2026-10-01
    Durable Medical Equipment (DME): Bone Growth Stimulators Medical GuidelineWPS Health Insurance2026-10-01
    General Durable Medical Equipment (DME) Medical GuidelineWPS Health Insurance2026-10-01
    Prior Authorization for Durable Medical Equipment (DME)Blue Cross Blue Shield - Rhode Island2026-10-01

    Related Codes

    HCPCS-L0112-CRANIAL-CERVICAL-ORTHOSIS-CONGENITAL-TORTICOLLIS-CUSTOM

    HCPCS L0112: Cranial Cervical Orthosis, Congenital Torticollis Type

    HCPCS-L0113-CRANIAL-CERVICAL-ORTHOSIS-TORTICOLLIS

    HCPCS Level II L0113: Prefabricated Cranial Cervical Orthosis for Torticollis

    HCPCS-L0130-CERVICAL-FLEXIBLE-THERMOPLASTIC-COLLAR-MOLDED-TO-PATIENT

    HCPCS Level II L0130: Cervical Flexible Thermoplastic Collar, Molded to Patient

    HCPCS-L0140-CERVICAL-SEMI-RIGID-ADJUSTABLE-PLASTIC-COLLAR

    HCPCS Level II L0140: Cervical Semi-Rigid Adjustable Plastic Collar

    HCPCS-L0150-CERVICAL-SEMI-RIGID-ADJUSTABLE-CHIN-CUP

    HCPCS Level II L0150: Cervical Semi-Rigid Adjustable Chin Cup

    HCPCS-L0160-CERVICAL-SEMI-RIGID-OCCIPITAL-MANDIBULAR-SUPPORT

    HCPCS Level II L0160: Cervical Semi-Rigid Occipital/Mandibular Support

    HCPCS-L0170-CERVICAL-COLLAR-MOLDED-TO-PATIENT-MODEL

    HCPCS Level II L0170: Cervical Collar, Custom-Molded

    HCPCS-L0172-CERVICAL-COLLAR-SEMI-RIGID-THERMOPLASTIC-FOAM

    HCPCS L0172: Cervical Collar, Semi-Rigid Prefabricated

    HCPCS-L0174-CERVICAL-COLLAR-SEMI-RIGID-THORACIC-EXTENSION

    HCPCS L0174: Cervical Collar, Semi-Rigid Thermoplastic with Thoracic Extension

    HCPCS-L0180-CERVICAL-MULTIPLE-POST-COLLAR-OCCIPITAL-MANDIBULAR-ADJUSTABLE

    HCPCS Level II L0180: Cervical Orthosis with Occipital/Mandibular Supports

    Showing 1–10 of 466

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    Frequently Asked Questions

    References

    1. 1.CPT® Codes and Descriptions. AAPC. Retrieved Aug 11, 2026.Maintains the CPT code set's official descriptions and guidelines, licensed from the American Medical Association, used as the definitional source for CPT codes on this page.
    2. 2.HCPCS Quarterly Update. Centers for Medicare & Medicaid Services (CMS). Retrieved Aug 11, 2026.CMS's quarterly release of HCPCS Level II codes and short/long descriptors, the source for HCPCS code definitions and update history.
    3. 3.ICD-10-CM Full Code List. Centers for Medicare & Medicaid Services (CMS). Retrieved Aug 11, 2026.CMS's complete ICD-10-CM diagnosis code list, used to cross-reference diagnosis codes associated with this procedure or service.
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