L5642 Medicaid reimbursement rate by state (2026)
Addition to lower extremity, above knee, leather socket. Medicaid pays a median of $618.88 for L5642 across 49 states, from $111.10 in Iowa to $1,011.34 in Montana.
Data as of 2026-10-05. Every rate links to the official document it came from.
- States publishing
- 49
- National median
- $618.88units vary by state
- Lowest
- $111.10Iowa
- Highest
- $1,011.34Montana
What does Medicaid pay for L5642?
49 state Medicaid programs publish a fee-for-service rate for L5642 at the nurse midwife level. The national median is $618.88 (units differ between states). Montana pays the most, $1,011.34, and Iowa the least, $111.10, a 9.1x spread.
L5642 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.
Frequently asked questions
What does Medicaid pay for L5642?
It depends on the state. Of the 49 states with a published fee-for-service rate, the median is $618.88. Montana pays the most ($1,011.34) and Iowa the least ($111.10).
Which state pays the highest Medicaid rate for L5642?
Montana, at $1,011.34, effective 2026-01-01.
Do managed-care plans pay the same rate for L5642?
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.