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L3891 Medicaid reimbursement rates by state

Addition to upper extremity joint, wrist or elbow. 8 state Medicaid programs publish a fee-for-service rate for L3891. Rates run from $0.00 in Arkansas to $344.52 in Indiana, with a median of $296.25.

Data as of 2026-10-05. Every rate links to the official document it came from.

States publishing
8
Median rate
$296.25units vary by state
Highest
$344.52Indiana
Medicare (non-facility)
—not on the physician fee schedule

L3891 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.

StateMedicaid rateUnitPer hourManaged-care plans% of MedicareSource
IndianaAny qualified provider (rate does not vary by provider) · Indiana Medicaid (fee-for-service)$344.52since 2026-01-01unit—Plans must pay at least this—IHCP Professional Fee Schedule (Last Upd
TexasAny qualified provider (rate does not vary by provider) · Texas Medicaid (fee-for-service, TMHP)$308.29since 2023-03-01——Plans negotiate; applies out of network—TMHP Texas Medicaid Fee Schedule - Ortho
WisconsinAny qualified provider (rate does not vary by provider) · Wisconsin Medicaid and BadgerCare Plus (fee-for-service, ForwardHealth maximum allowable fees)$300.04since 2010-01-01——Plans negotiate; applies out of network—ForwardHealth max fee schedule: Durable
OhioAny qualified provider (rate does not vary by provider) · Ohio Medicaid (fee-for-service)$300.00since 2026-01-01Each—Plans negotiate; applies out of network—ODM DMEPOS combined payment schedules (a
MichiganAny qualified provider (rate does not vary by provider) · Michigan Medicaid (fee-for-service)$292.50since 2023-01-01——Plans negotiate; applies out of network—MDHHS Medical Suppliers/Orthotists/Prost
AlabamaAny qualified provider (rate does not vary by provider) · Alabama Medicaid (fee-for-service, Alabama Medicaid Agency fee schedules)$153.90since 2026-05-20——Not classified—EPSDT Referral (DME) Fee Schedule (REF-0
OklahomaAny qualified provider (rate does not vary by provider) · Oklahoma SoonerCare (fee-for-service, OHCA)$129.86since 2020-08-01——Plans must pay at least this—SoonerCare Durable Medical Equipment Rat
ArkansasAny qualified provider (rate does not vary by provider) · Arkansas Medicaid (fee-for-service)$0.00since 2025-06-04——Not classified—Arkansas Medicaid Prosthetics (includes

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 L3891?

It depends on the state. Of the 8 states with a published fee-for-service rate, the median is $296.25. Indiana pays the most ($344.52 per unit) and Arkansas the least ($0.00).

Which state pays the highest Medicaid rate for L3891?

Indiana, at $344.52 per unit, effective 2026-01-01.

Do managed-care plans pay the same rate for L3891?

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.

Related Equipment & supplies codes

Track L3891 in your statesYour codes on one rate card: every payer's rule, Medicare comparison, rank and rate changes.
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