Search all medical codes

Foot, insert, removable, formed to patient foot, each

HCPCS code

Name of the Procedure:

Foot Insert, Removable, Custom Molded (commonly referred to as Orthotic Insert, Custom Foot Orthosis)


This procedure involves creating a custom-molded foot insert, designed specifically for an individual's foot. These inserts are removable and provide support, cushioning, and realignment of the feet to improve overall foot function and alleviate discomfort.


The custom-molded foot insert is designed to address various foot conditions, including flat feet, plantar fasciitis, and other biomechanical anomalies. The goal is to alleviate discomfort, improve foot alignment, and enhance overall mobility.


  • Persistent foot pain
  • Plantar fasciitis
  • Flat feet or high arches
  • Overpronation or supination
  • Diabetic foot ulcers
  • Arthritis-related foot issues


  • No specific fasting or medication adjustments required.
  • A comprehensive foot examination and possibly imaging studies (e.g., X-rays) to assess the foot structure.

Procedure Description

  1. Foot Assessment: The healthcare provider conducts a detailed examination of the patient's foot, including gait analysis.
  2. Foot Impression/Mold: A mold of the foot is taken using plaster, foam, or digital scanning technology.
  3. Orthotic Fabrication: The mold is sent to a lab where the custom foot insert is created using materials such as EVA (ethylene vinyl acetate), rubber, or plastic.
  4. Fitting: The patient returns to the clinic to try on the custom insert, and adjustments are made for optimal fit and comfort.

Tools and Equipment:

  • Impression materials (plaster, foam boxes, or digital scanners)
  • Lab machinery for material shaping and forming


The entire process, from the initial assessment to final fitting, may take several weeks. Individual sessions typically last between 30 minutes to 1 hour.


The procedure is carried out in an outpatient clinic or podiatrist’s office.


  • Podiatrist or Orthotic Specialist
  • Lab Technicians (for fabrication)

Risks and Complications

  • Minor discomfort during the initial wearing period as the patient adjusts
  • Rare possibility of improper fit resulting in pain or irritation, requiring further adjustments


  • Improved foot alignment and biomechanics
  • Reduction in foot pain and discomfort
  • Enhanced mobility and quality of life
  • May prevent further foot complications

Benefits can often be realized within a few weeks of starting to use the inserts.


  • Gradual adjustment period, wearing the insert for short durations initially and increasing over time
  • Regular follow-up appointments for fit adjustments
  • No specific physical restrictions post-fitting


  • Over-the-counter shoe inserts: Less expensive but not custom-fitted.
  • Physical therapy: Can help with foot strengthening and pain relief.
  • Surgical interventions: For severe structural issues, though this carries higher risks.

Patient Experience

Patients might initially experience discomfort as they adjust to the new inserts. Regular use will lead to improved comfort and foot function. Any discomfort can be managed with pain relievers and adjustments by the specialist.

Medical Policies and Guidelines for Foot, insert, removable, formed to patient foot, each

Related policies from health plans

Similar Codes

Contact us to learn more

Choose your own adventure


Send us a message or questions and we can share more details.


Setup a calendar meeting with us; find a time now.