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L5628 Medicaid reimbursement rate by state (2026)

Addition to lower extremity, test socket, hemipelvectomy. Medicaid pays a median of $495.81 for L5628 across 49 states, from $150.00 in Iowa to $788.11 in Minnesota.

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

States publishing
49
National median
$495.81units vary by state
Lowest
$150.00Iowa
Highest
$788.11Minnesota

What does Medicaid pay for L5628?

49 state Medicaid programs publish a fee-for-service rate for L5628 at the nurse midwife level. The national median is $495.81 (units differ between states). Minnesota pays the most, $788.11, and Iowa the least, $150.00, a 5.3x spread.

L5628 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
1Minnesota Source · since 2026-01-01$788.11——Plans negotiate; applies out of network—
2Indiana Source · since 2026-01-01$772.66unit—Plans must pay at least this—
3New Mexico Source · since 2025-01-01$689.53——Plans must pay at least this—
24Virginia Source · since 2012-01-01$497.64——Plans negotiate; applies out of network—
25Arizona Source · since 2026-10-01$495.81——Plans negotiate; applies out of network—
26Kansas Source · since 2026-07-01$495.63——Plans must pay at least this—
48California Source · since 2026-10-01$174.10——Plans negotiate; applies out of network—
49Iowa Source · since 2024-07-01$150.00——State sets the plan rate—
See all 49 states for L5628 — 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.

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 L5628 in your states. Get an alert when any state changes it, with every variant and the managed-care rule.

Frequently asked questions

What does Medicaid pay for L5628?

It depends on the state. Of the 49 states with a published fee-for-service rate, the median is $495.81. Minnesota pays the most ($788.11) and Iowa the least ($150.00).

Which state pays the highest Medicaid rate for L5628?

Minnesota, at $788.11, effective 2026-01-01.

Do managed-care plans pay the same rate for L5628?

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.