L3677 Medicaid reimbursement rates by state
Shoulder orthosis, shoulder joint design, without joints. 6 state Medicaid programs publish a fee-for-service rate for L3677. Rates run from $62.50 in Texas to $264.73 in Virginia, with a median of $161.83.
Data as of 2026-10-05. Every rate links to the official document it came from.
- States publishing
- 6
- Median rate
- $161.83units vary by state
- Highest
- $264.73Virginia
- Medicare (non-facility)
- —not on the physician fee schedule
L3677 rate in every state
One like-for-like fee-for-service rate per state, highest first. Units can differ between states; the per-hour column converts time-based units.
| State | Medicaid rate | Unit | Per hour | Managed-care plans | % of Medicare | Source |
|---|---|---|---|---|---|---|
| VirginiaAny qualified provider (rate does not vary by provider) · Virginia Medicaid (fee-for-service, DMAS) | $264.73since 2023-01-01 | Each | — | Plans must pay at least this | — | DMAS procedure fee file hcpcmedical.csv |
| North CarolinaAny qualified provider (rate does not vary by provider) · North Carolina Medicaid Direct (fee-for-service) | $189.44 | — | — | Plans negotiate; applies out of network | — | NC Medicaid fee schedule 'Orthotics and |
| MichiganAny qualified provider (rate does not vary by provider) · Michigan Medicaid (fee-for-service) | $168.60since 2023-01-01 | — | — | Plans negotiate; applies out of network | — | MDHHS Medical Suppliers/Orthotists/Prost |
| FloridaAny qualified provider (rate does not vary by provider) · Florida Medicaid (fee-for-service) | $155.05since 2026-07-01 | — | — | Plans negotiate; applies out of network | — | Durable Medical Equipment and Medical Su |
| WisconsinAny qualified provider (rate does not vary by provider) · Wisconsin Medicaid and BadgerCare Plus (fee-for-service, ForwardHealth maximum allowable fees) | $111.88since 2008-07-01 | — | — | Plans negotiate; applies out of network | — | ForwardHealth max fee schedule: Durable |
| TexasAny qualified provider (rate does not vary by provider) · Texas Medicaid (fee-for-service, TMHP) | $62.50since 2021-03-01 | — | — | Plans negotiate; applies out of network | — | TMHP Texas Medicaid Fee Schedule - Ortho |
Rates are per the unit shown for each state; units can differ between states. Medicare amounts are computed from the CMS relative value file and locality cost indices with the CMS formula; states with several Medicare localities show a range. Confirm rates with the payer before billing.
Frequently asked questions
What does Medicaid pay for L3677?
It depends on the state. Of the 6 states with a published fee-for-service rate, the median is $161.83. Virginia pays the most ($264.73 per Each) and Texas the least ($62.50).
Which state pays the highest Medicaid rate for L3677?
Virginia, at $264.73 per Each, effective 2023-01-01.
Do managed-care plans pay the same rate for L3677?
Not necessarily. Each state's plan contracts decide whether plans must pay at least the fee-for-service rate, pay a state-set rate, or negotiate their own. The table shows the rule for each state, cited to the contract or statute.