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L6925 Medicaid reimbursement rates by state

Wrist disarticulation, external power. 18 state Medicaid programs publish a fee-for-service rate for L6925 at the nurse midwife level. Rates run from $3,434.67 in Florida to $11,019.87 in Minnesota, with a median of $7,388.40.

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

States publishing
18
Median rate
$7,388.40units vary by state
Highest
$11,019.87Minnesota
Medicare (non-facility)
—not on the physician fee schedule

L6925 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
MinnesotaAny qualified provider (rate does not vary by provider) · Minnesota Health Care Programs: Medical Assistance (fee-for-service)$11,019.87since 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)$10,803.79since 2026-01-01unit—Plans must pay at least this—IHCP Professional Fee Schedule (Last Upd
MassachusettsAny qualified provider (rate does not vary by provider) · MassHealth (fee-for-service, EOHHS 101 CMR rate regulations)$9,522.22since 2026-07-01——Plans negotiate; applies out of network—Rates for Prostheses, Prosthetic Devices
MarylandAny qualified provider (rate does not vary by provider) · Maryland Medicaid (fee-for-service, MDH)$8,793.63since 2026-01-01——Not classified—Maryland Medicaid DME/DMS/Oxygen, Prosth
ArizonaCertified nurse-midwife · Arizona AHCCCS fee-for-service (AIHP, Tribal ALTCS, TRBHA and other FFS members)$8,727.57since 2026-10-01——Plans negotiate; applies out of network—AHCCCS FFS Capped Fee Schedule: Durable
OhioAny qualified provider (rate does not vary by provider) · Ohio Medicaid (fee-for-service)$8,171.26since 2026-01-01——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)$8,154.70since 2026-01-01——Plans negotiate; applies out of network—MDHHS Medical Suppliers/Orthotists/Prost
WashingtonAny qualified provider (rate does not vary by provider) · Washington Apple Health (Medicaid) fee-for-service$7,830.19since 2021-07-01——Plans negotiate; applies out of network—HCA Prosthetics and orthotics fee schedu
VirginiaAny qualified provider (rate does not vary by provider) · Virginia Medicaid (fee-for-service, DMAS)$7,797.35since 2012-01-01——Plans negotiate; applies out of network—DMAS procedure fee file hcpcmedical.csv
TexasAny qualified provider (rate does not vary by provider) · Texas Medicaid (fee-for-service, TMHP)$6,979.44since 2010-07-01——Plans negotiate; applies out of network—TMHP Texas Medicaid Fee Schedule - Prost
KentuckyAny qualified provider (rate does not vary by provider) · Kentucky Medicaid (fee-for-service, DMS fee schedules)$6,872.21since 2020-01-01——State sets the plan rate—KY Medicaid DME fee schedule (2020Medica
WisconsinAny qualified provider (rate does not vary by provider) · Wisconsin Medicaid and BadgerCare Plus (fee-for-service, ForwardHealth maximum allowable fees)$6,792.66since 2008-07-01——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)$6,602.74since 2026-07-01——Not classified—NJMMIS Procedure Master Listing CPTHCPCS
GeorgiaAny qualified provider (rate does not vary by provider) · Georgia Medicaid (fee-for-service)$6,011.74since 2016-07-01——Plans negotiate; applies out of network—Orthotic and Prosthetic Fee Schedule - E
LouisianaAny qualified provider (rate does not vary by provider) · Louisiana Medicaid (fee-for-service)$5,142.57since 2012-07-01——Plans must pay at least this—Louisiana Medicaid Durable Medical Equip
ColoradoAny qualified provider (rate does not vary by provider) · Child Health Plan Plus (CHP+, Colorado's CHIP)$5,115.74since 2026-07-01——Plans negotiate; applies out of network—Child Health Plan Plus FY 2026-2027 Fee
CaliforniaAny qualified provider (rate does not vary by provider) · California Medi-Cal (fee-for-service)$3,830.58since 2026-10-01——Plans negotiate; applies out of network—Medi-Cal Rates (Rates files zip: rates_d
FloridaAny qualified provider (rate does not vary by provider) · Florida Medicaid (fee-for-service)$3,434.67since 2026-07-01——Plans negotiate; applies out of network—Durable Medical Equipment and Medical Su

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 L6925?

It depends on the state. Of the 18 states with a published fee-for-service rate, the median is $7,388.40. Minnesota pays the most ($11,019.87) and Florida the least ($3,434.67).

Which state pays the highest Medicaid rate for L6925?

Minnesota, at $11,019.87, effective 2026-01-01.

Do managed-care plans pay the same rate for L6925?

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.

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