L5827 Medicaid reimbursement rates by state
Endoskeletal knee-shin system, single axis. 11 state Medicaid programs publish a fee-for-service rate for L5827. Rates run from $100.00 in Connecticut to $7,424.27 in Massachusetts, with a median of $6,869.77.
Data as of 2026-10-05. Every rate links to the official document it came from.
- States publishing
- 11
- Median rate
- $6,869.77units vary by state
- Highest
- $7,424.27Massachusetts
- Medicare (non-facility)
- —not on the physician fee schedule
L5827 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 |
|---|---|---|---|---|---|---|
| MassachusettsAny qualified provider (rate does not vary by provider) · MassHealth (fee-for-service, EOHHS 101 CMR rate regulations) | $7,424.27since 2026-07-01 | — | — | Plans negotiate; applies out of network | — | Rates for Prostheses, Prosthetic Devices |
| ArizonaAny qualified provider (rate does not vary by provider) · Arizona AHCCCS fee-for-service (AIHP, Tribal ALTCS, TRBHA and other FFS members) | $7,377.27since 2026-10-01 | — | — | Plans negotiate; applies out of network | — | AHCCCS FFS Capped Fee Schedule: Durable |
| MissouriAny qualified provider (rate does not vary by provider) · Missouri MO HealthNet (fee-for-service) | $7,208.98since 2025-04-01 | — | — | Plans negotiate; applies out of network | — | MO HealthNet fee schedule: Durable Medic |
| IndianaAny qualified provider (rate does not vary by provider) · Indiana Medicaid (fee-for-service) | $7,201.77since 2026-01-01 | unit | — | Plans must pay at least this | — | IHCP Professional Fee Schedule (Last Upd |
| MinnesotaAny qualified provider (rate does not vary by provider) · Minnesota Health Care Programs: Medical Assistance (fee-for-service) | $7,159.66since 2026-01-01 | — | — | Plans negotiate; applies out of network | — | MHCP Fee Schedule - Current Fee Schedule |
| TexasAny qualified provider (rate does not vary by provider) · Texas Medicaid (fee-for-service, TMHP) | $6,869.77since 2026-03-01 | — | — | Plans negotiate; applies out of network | — | TMHP Texas Medicaid Fee Schedule - Prost |
| OhioAny qualified provider (rate does not vary by provider) · Ohio Medicaid (fee-for-service) | $6,500.00since 2025-04-01 | Each | — | Plans negotiate; applies out of network | — | ODM DMEPOS combined payment schedules (a |
| MarylandAny qualified provider (rate does not vary by provider) · Maryland Medicaid (fee-for-service, MDH) | $5,971.55since 2026-01-01 | — | — | Not classified | — | Maryland Medicaid DME/DMS/Oxygen, Prosth |
| ColoradoAny qualified provider (rate does not vary by provider) · Child Health Plan Plus (CHP+, Colorado's CHIP) | $5,732.03since 2026-07-01 | — | — | Plans negotiate; applies out of network | — | Child Health Plan Plus FY 2026-2027 Fee |
| New JerseyAny qualified provider (rate does not vary by provider) · New Jersey Medicaid / NJ FamilyCare (fee-for-service) | $5,369.81since 2026-01-01 | — | — | Not classified | — | NJMMIS Procedure Master Listing CPTHCPCS |
| ConnecticutAny qualified provider (rate does not vary by provider) · Connecticut Medicaid / HUSKY Health (fee-for-service, CMAP) | $100.00since 2025-04-01 | — | — | Not classified | — | CMAP fee schedule: 10/01/2026 MEDS - Pro |
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 L5827?
It depends on the state. Of the 11 states with a published fee-for-service rate, the median is $6,869.77. Massachusetts pays the most ($7,424.27) and Connecticut the least ($100.00).
Which state pays the highest Medicaid rate for L5827?
Massachusetts, at $7,424.27, effective 2026-07-01.
Do managed-care plans pay the same rate for L5827?
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.