L5841 Medicaid reimbursement rates by state
Addition, endoskeletal knee-shin system, polycentric. 24 state Medicaid programs publish a fee-for-service rate for L5841. Rates run from $1,465.00 in Ohio to $5,130.39 in Hawaii, with a median of $2,919.51.
Data as of 2026-10-05. Every rate links to the official document it came from.
- States publishing
- 24
- Median rate
- $2,919.51units vary by state
- Highest
- $5,130.39Hawaii
- Medicare (non-facility)
- —not on the physician fee schedule
L5841 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 |
|---|---|---|---|---|---|---|
| HawaiiAny qualified provider (rate does not vary by provider) · Hawaii Medicaid (Med-QUEST) fee-for-service | $5,130.39since 2026-06-01 | — | — | Plans negotiate; applies out of network | — | Medicaid Fee-For-Service (FFS) Fee Sched |
| NevadaAny qualified provider (rate does not vary by provider) · Nevada Medicaid (fee-for-service provider-type reimbursement schedules) | $3,744.04since 2024-04-01 | — | — | Plans negotiate; applies out of network | — | Provider Type 33, Durable Medical Equipm |
| ArizonaAny qualified provider (rate does not vary by provider) · Arizona AHCCCS fee-for-service (AIHP, Tribal ALTCS, TRBHA and other FFS members) | $3,555.03since 2026-10-01 | — | — | Plans negotiate; applies out of network | — | AHCCCS FFS Capped Fee Schedule: Durable |
| Rhode IslandAny qualified provider (rate does not vary by provider) · Rhode Island Medicaid (fee-for-service) | $3,380.86since 2024-04-01 | — | — | Plans negotiate; applies out of network | — | RI Medicaid Interactive Fee For Service |
| MontanaAny qualified provider (rate does not vary by provider) · Montana Medicaid and HMK Plus (fee-for-service) | $3,239.03since 2026-01-01 | — | — | Not classified | — | Montana Healthcare Programs fee schedule |
| MassachusettsAny qualified provider (rate does not vary by provider) · MassHealth (fee-for-service, EOHHS 101 CMR rate regulations) | $3,178.01since 2026-07-01 | — | — | Plans negotiate; applies out of network | — | Rates for Prostheses, Prosthetic Devices |
| New MexicoAny qualified provider (rate does not vary by provider) · New Mexico Medicaid (fee-for-service, HCA Medical Assistance Division) | $3,061.31since 2025-01-01 | — | — | Plans must pay at least this | — | New Mexico Medicaid Fee for Service HCPC |
| DelawareAny qualified provider (rate does not vary by provider) · Delaware Medicaid (fee-for-service, DMMA / DMAP) | $3,053.14since 2026-01-01 | — | — | Plans negotiate; applies out of network | — | DMAP 2026 Physician Fee Schedule |
| New HampshireAny qualified provider (rate does not vary by provider) · New Hampshire Medicaid (fee-for-service, DHHS / NH MMIS) | $3,042.77since 2024-07-01 | — | — | Not classified | — | 2026 Fee Schedule - Covered Procedures R |
| TexasAny qualified provider (rate does not vary by provider) · Texas Medicaid (fee-for-service, TMHP) | $3,023.20since 2025-03-01 | — | — | Plans negotiate; applies out of network | — | TMHP Texas Medicaid Fee Schedule - Prost |
| IdahoAny qualified provider (rate does not vary by provider) · Idaho Medicaid (fee-for-service, Division of Medicaid / Gainwell) | $2,995.51since 2026-07-01 | — | — | Not classified | — | Idaho Medicaid Numerical Fee Schedule Ju |
| VermontAny qualified provider (rate does not vary by provider) · Vermont Medicaid (fee-for-service, DVHA) | $2,960.00since 2026-01-01 | — | — | Not classified | — | Vermont Medicaid Fee Schedule - DME Code |
| IowaAny qualified provider (rate does not vary by provider) · Iowa Medicaid (fee-for-service schedules; the floor IA Health Link plans must pay) | $2,879.02since 2025-12-01 | — | — | State sets the plan rate | — | Iowa Medicaid fee schedule #08 PHARMACY |
| MinnesotaAny qualified provider (rate does not vary by provider) · Minnesota Health Care Programs: Medical Assistance (fee-for-service) | $2,814.38since 2026-01-01 | — | — | Plans negotiate; applies out of network | — | MHCP Fee Schedule - Current Fee Schedule |
| IndianaAny qualified provider (rate does not vary by provider) · Indiana Medicaid (fee-for-service) | $2,759.19since 2026-01-01 | unit | — | Plans must pay at least this | — | IHCP Professional Fee Schedule (Last Upd |
| KansasAny qualified provider (rate does not vary by provider) · MediKan (Kansas state-funded medical program, KMAP fee schedule) | $2,507.21since 2026-07-01 | — | — | Paid by the state, outside plans | — | KMAP Fee Schedule MKN Medicaid (FeeSched |
| ColoradoAny qualified provider (rate does not vary by provider) · Health First Colorado (Colorado Medicaid, fee-for-service) | $2,431.27since 2026-07-01 | — | — | Not classified | — | Health First Colorado Physician Fee Sche |
| ConnecticutAny qualified provider (rate does not vary by provider) · Connecticut Medicaid / HUSKY Health (fee-for-service, CMAP) | $2,336.00since 2024-04-01 | — | — | Not classified | — | CMAP fee schedule: 10/01/2026 MEDS - Pro |
| UtahAny qualified provider (rate does not vary by provider) · Utah Medicaid (fee-for-service, Traditional plan) | $2,318.01since 2026-07-01 | — | — | Plans negotiate; applies out of network | — | Utah Medicaid Coverage and Reimbursement |
| MississippiAny qualified provider (rate does not vary by provider) · Mississippi Medicaid (fee-for-service) | $2,296.38since 2026-07-01 | — | — | Plans must pay at least this | — | DOM Comprehensive Fee Schedule, Septembe |
| OklahomaAny qualified provider (rate does not vary by provider) · Oklahoma SoonerCare (fee-for-service, OHCA) | $2,210.37since 2026-01-01 | — | — | Plans must pay at least this | — | SoonerCare Durable Medical Equipment Rat |
| WisconsinAny qualified provider (rate does not vary by provider) · Wisconsin Medicaid and BadgerCare Plus (fee-for-service, ForwardHealth maximum allowable fees) | $2,155.62since 2024-04-01 | — | — | Plans negotiate; applies out of network | — | ForwardHealth max fee schedule: Durable |
| New JerseyAny qualified provider (rate does not vary by provider) · New Jersey Medicaid / NJ FamilyCare (fee-for-service) | $2,096.12since 2026-07-01 | — | — | Not classified | — | NJMMIS Procedure Master Listing CPTHCPCS |
| OhioAny qualified provider (rate does not vary by provider) · Ohio Medicaid (fee-for-service) | $1,465.00since 2024-04-01 | Each | — | Plans negotiate; applies out of network | — | ODM DMEPOS combined payment schedules (a |
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 L5841?
It depends on the state. Of the 24 states with a published fee-for-service rate, the median is $2,919.51. Hawaii pays the most ($5,130.39) and Ohio the least ($1,465.00 per Each).
Which state pays the highest Medicaid rate for L5841?
Hawaii, at $5,130.39, effective 2026-06-01.
Do managed-care plans pay the same rate for L5841?
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
L0120Cervical, flexible, non-adjustable, prefabricated · 45 statesL0130Cervical, flexible, thermoplastic collar, molded to patient · 45 statesL0140Cervical, semi-rigid, adjustable (plastic collar) · 45 statesL0150Cervical, semi-rigid, adjustable molded chin cup · 45 statesL0172Cervical, collar, semi-rigid thermoplastic foam, two-piece · 45 statesL0174Cervical, collar, semi-rigid, thermoplastic foam · 45 statesL0200Cervical, multiple post collar · 45 statesL0220Thoracic, rib belt, custom fabricated · 45 statesL0450Tlso, flexible, provides trunk support · 45 statesL0472Tlso, triplanar control, hyperextension · 45 statesL0482Tlso, triplanar control · 45 statesL0484Tlso, triplanar control · 45 states
Track L5841 in your statesYour codes on one rate card: every payer's rule, Medicare comparison, rank and rate changes.