Chad - I have the exact same problem. In fact I read to see which of your feet is larger so we could maybe work a deal but sadly my L foot is my biggie too.
To date, the shoe that works best for me are Brooks Cascadias. Not perfect but better than most. Enough room for pinkie toes.
I have also tried having a pair of custom shoes made by Hersey. This has been a miserable experience to date. Two tries that were way off and another that's been "on the way" for months.
My rationale up front was that $500 for shoes with a 5 year life expectancy, including a mold, is a lot cheaper than cycling thru $100 trail shoes that don't really fit. I still like the rationale - just wouldn't recommend Hersey at this point :(
I'd be REALLY careful about heel wedges...they can really mess up your biomechanics and led to all kinds of unintended consequences.