L5230 Medicaid reimbursement rate by state (2026)
Above knee, for proximal femoral focal deficiency. Medicaid pays a median of $3,962.37 for L5230 across 48 states, from $1,975.00 in Pennsylvania to $7,946.47 in Alaska.
- States publishing
- 48
- National median
- $3,962.37units vary by state
- Lowest
- $1,975.00Pennsylvania
- Highest
- $7,946.47Alaska
What does Medicaid pay for L5230?
48 state Medicaid programs publish a fee-for-service rate for L5230. The national median is $3,962.37 (units differ between states). Alaska pays the most, $7,946.47, and Pennsylvania the least, $1,975.00, a 4.0x spread.
L5230 rate by state: highest, middle and lowest
One like-for-like fee-for-service rate per state, ranked. The workspace lists all 48 states with every variant, modifier and effective date.
Frequently asked questions
What does Medicaid pay for L5230?
It depends on the state. Of the 48 states with a published fee-for-service rate, the median is $3,962.37. Alaska pays the most ($7,946.47) and Pennsylvania the least ($1,975.00).
Which state pays the highest Medicaid rate for L5230?
Alaska, at $7,946.47, effective 2026-01-01.
Do managed-care plans pay the same rate for L5230?
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 workspace shows the rule for each state, cited to the contract or statute.