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L5850 Medicaid reimbursement rate by state (2026)

Addition, endoskeletal system. Medicaid pays a median of $126.53 for L5850 across 49 states, from $46.84 in Florida to $238.89 in North Dakota.

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

States publishing
49
National median
$126.53units vary by state
Lowest
$46.84Florida
Highest
$238.89North Dakota

What does Medicaid pay for L5850?

49 state Medicaid programs publish a fee-for-service rate for L5850 at the nurse midwife level. The national median is $126.53 (units differ between states). North Dakota pays the most, $238.89, and Florida the least, $46.84, a 5.1x spread.

L5850 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
1North Dakota Source · since 2026-07-01$238.89——Not classified—
2Montana Source · since 2026-01-01$208.81——Not classified—
3New Mexico Source · since 2025-01-01$204.71——Plans must pay at least this—
24District of Columbia Source · since 2026-04-01$130.08——Not classified—
25South Carolina Source · since 2024-07-01$126.53——Not classified—
26Kansas Source · since 2026-07-01$125.29——Plans must pay at least this—
48Virginia Source · since 1989-07-01$55.00——Plans negotiate; applies out of network—
49Florida Source · since 2026-07-01$46.84——Plans negotiate; applies out of network—
See all 49 states for L5850 — 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 L5850 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 L5850?

It depends on the state. Of the 49 states with a published fee-for-service rate, the median is $126.53. North Dakota pays the most ($238.89) and Florida the least ($46.84).

Which state pays the highest Medicaid rate for L5850?

North Dakota, at $238.89, effective 2026-07-01.

Do managed-care plans pay the same rate for L5850?

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.