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Billing code L1810 · Equipment & supplies

L1810 Medicaid reimbursement rate by state (2026)

Knee orthosis, elastic with joints. Medicaid pays a median of $96.19 for L1810 across 49 states, from $65.77 in Ohio to $187.04 in Alaska.

Data as of Oct 5, 202649 statesEvery rate links to its official source

States publishing
49
National median
$96.19units vary by state
Lowest
$65.77Ohio
Highest
$187.04Alaska
Answer

What does Medicaid pay for L1810?

49 state Medicaid programs publish a fee-for-service rate for L1810. The national median is $96.19 (units differ between states). Alaska pays the most, $187.04, and Ohio the least, $65.77 per Each, a 2.8x spread.

State ranking

L1810 rate by state: highest, middle and lowest

One like-for-like fee-for-service rate per state, ranked. The workspace lists all 49 states with every variant, modifier and effective date.

#StateMedicaid rateUnitPer hourManaged-care plans% of Medicare
1Alaska Source · since 2026-01-01$187.04——Not classified—
2Hawaii Source · since 2026-06-01$163.48——Plans negotiate; applies out of network—
3Illinois Source · since 2025-01-01$138.11——Plans negotiate; applies out of network—
24North Carolina Source · since 2022-01-01$97.11——Plans must pay at least this—
25Maryland Source · since 2026-01-01$96.19——Not classified—
26Arkansas Source · since 2025-06-04$94.96——Not classified—
48Louisiana Source · since 2012-07-01$66.72——Plans must pay at least this—
49Ohio Source · since 2010-01-01$65.77Each—Plans negotiate; applies out of network—
See all 49 states for L1810 — start free

41 more states, with every modifier and provider-type variant, rate history and the plan rule in each state. 14-day free trial, no credit card.

  • Source for every rate
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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; states with several Medicare localities show a range. Confirm rates with the payer before billing.

Track L1810 in your states. Get an alert when any state changes it, with every variant and the managed-care rule.
Guide

How to read this table

  • Order. States are listed from the highest published rate to the lowest. No single unit is shared by 8 or more states for L1810, so the order is by published amount and is not a like-for-like rank.
  • Medicaid rate. The most the state's fee-for-service program pays for one unit, as published. 17 of the 49 states list more than one rate for L1810, by modifier, provider type or setting; the table shows the one that matches the provider level and setting used across states, without add-ons.
  • Unit. Of the 49 states, 3 publish L1810 per unit, and 46 schedules print no unit at all (a flat amount per service).
  • Per hour. L1810 is not billed in time units in these states, so no hourly figure is shown.
  • Managed-care plans. The rule the state sets for its plans on this rate. What each rule means is explained below.
  • % of Medicare. No Medicare physician fee schedule amount is on file for L1810, so there is no percentage.
  • Source and date. Each Source link opens the state's own document; “since” is the date the rate took effect.
Context

Why L1810 rates differ between states

Published rates for L1810 run from $65.77 in Ohio to $187.04 in Alaska. The two publish it in different units (no unit printed versus Each), so part of that gap is the unit rather than the price. Half the states pay more than the median of $96.19 and half pay less. The usual reasons for a spread like this in equipment & supplies rates:

  • Many states set equipment and supply fees as a percentage of the Medicare DMEPOS fee schedule, at different percentages and from different years.
  • A single code can carry separate purchase, rental and used-equipment amounts, and states publish different subsets of them.
  • Some items are priced individually from the manufacturer's price or the supplier's invoice, so fewer states publish a fixed fee.

Timing matters too. 29 states set the current rate for L1810 in 2026 or later, while 13 states still pay a rate that took effect in 2022 or earlier. A state that has not updated its rate in years will drift down the ranking as others raise theirs.

Managed care

What managed-care plans pay for L1810

No managed-care plan publishes what it pays for L1810. What is public is the rule each state's plan contracts set, and that rule decides how much the published rate matters when you contract with a plan.

In 12 states, the published rate binds plans: a floor, a pass-through or a state-set rate. In 21 states, plans negotiate and the published rate is a benchmark or out-of-network default. The rule for the remaining 16 states is not classified yet.

  • Plans negotiate; the published rate applies out of network (21 states). In-network rates can be above or below the published rate. The published rate is the benchmark both sides know, and the fallback if no contract is signed.
  • Plans must pay at least the published rate (11 states). The published rate is your floor. Negotiate up from it, and if a plan pays less, the contract provision is the basis for a payment dispute.
  • The state sets the plan rate (1 state). There is little to negotiate on price. Contracting is about network participation, authorization and billing terms.

Plan-negotiated rates are never estimated here. To see the rule and its citation for a particular state, open that state's managed-care page, for example Alaska managed care.

Billing

Units and billing for L1810

L1810 is a HCPCS Level II orthotic and prosthetic code in the equipment & supplies line, billed mostly by durable medical equipment suppliers, orthotists, prosthetists and pharmacies. L codes cover orthotic and prosthetic devices. Each is paid per device, and some are priced individually from the supplier's invoice.

Units follow the code: per item, per pair, per box or per month of rental, so a per-unit comparison only holds when the states use the same unit. Pricing modifiers decide which amount applies: NU for a new purchase, RR for a monthly rental and UE for used equipment.

Before billing, confirm the rate, unit and any modifier with the state's current schedule or the plan: the amounts here are as published, not a guarantee of payment.

FAQ

Frequently asked questions

What does Medicaid pay for L1810?

It depends on the state. Of the 49 states with a published fee-for-service rate, the median is $96.19. Alaska pays the most ($187.04) and Ohio the least ($65.77 per Each).

Which state pays the highest Medicaid rate for L1810?

Alaska, at $187.04, effective 2026-01-01.

Which state pays the lowest Medicaid rate for L1810?

Ohio, at $65.77 per Each, effective 2010-01-01. It publishes the code in a different unit from Alaska, so compare per unit with care.

What unit is L1810 billed in?

Of the 49 states, 3 publish L1810 per unit, and 46 schedules print no unit at all (a flat amount per service).

Do managed-care plans pay the same rate for L1810?

Not necessarily. In 12 states, the published rate binds plans: a floor, a pass-through or a state-set rate. In 21 states, plans negotiate and the published rate is a benchmark or out-of-network default. The rule for the remaining 16 states is not classified yet. Each rule is cited to the plan contract, statute or notice in the workspace.