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Billing code L8606 · Equipment & supplies

L8606 Medicaid reimbursement rate by state (2026)

Injectable bulking agent, synthetic implant, urinary tract. Medicaid pays a median of $220.85 for L8606 across 21 states, from $146.09 in California to $266.86 in Delaware.

Data as of Oct 5, 202621 statesEvery rate links to its official source

States publishing
21
National median
$220.85units vary by state
Lowest
$146.09California
Highest
$266.86Delaware
Answer

What does Medicaid pay for L8606?

21 state Medicaid programs publish a fee-for-service rate for L8606. The national median is $220.85 (units differ between states). Delaware pays the most, $266.86, and California the least, $146.09, a 1.8x spread.

State ranking

L8606 rate by state: highest, middle and lowest

One like-for-like fee-for-service rate per state, ranked. The workspace lists all 21 states with every variant, modifier and effective date.

#StateMedicaid rateUnitPer hourManaged-care plans% of Medicare
1Delaware Source · since 2026-01-01$266.86——Plans negotiate; applies out of network—
2New Mexico Source · since 2025-01-01$264.11——Plans must pay at least this—
3Washington Source · since 2026-07-01$263.88——Plans negotiate; applies out of network—
10Florida Source · since 2026-01-01$224.58——Plans negotiate; applies out of network—
11Vermont Source · since 2026-01-01$220.85——Not classified—
12Ohio Source · since 2026-01-01$214.47——Plans negotiate; applies out of network—
20Indiana Source · since 2014-01-01$158.02unit—Plans must pay at least this—
21California Source · since 2026-10-01$146.09——Plans negotiate; applies out of network—
See all 21 states for L8606 — start free

13 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
  • Full rate history
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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 L8606 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 L8606, 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. 7 of the 21 states list more than one rate for L8606, 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 21 states, 1 publish L8606 per unit, and 20 schedules print no unit at all (a flat amount per service).
  • Per hour. L8606 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 L8606, 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 L8606 rates differ between states

Published rates for L8606 run from $146.09 in California to $266.86 in Delaware, a 1.8x gap in the same unit. Half the states pay more than the median of $220.85 and half pay less. The usual reasons for a spread like this in equipment & supplies rates:

  • 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.
  • Many states set equipment and supply fees as a percentage of the Medicare DMEPOS fee schedule, at different percentages and from different years.

Timing matters too. 13 states set the current rate for L8606 in 2026 or later, while 4 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 L8606

What a plan pays for L8606 is negotiated privately, but the state decides how much room there is to negotiate. Here is how the rules break down across the 21 states.

In 3 states, the published rate binds plans: a floor, a pass-through or a state-set rate. In 13 states, plans negotiate and the published rate is a benchmark or out-of-network default. The rule for the remaining 5 states is not classified yet.

  • Plans negotiate; the published rate applies out of network (13 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 (3 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.

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 Delaware managed care.

Billing

Units and billing for L8606

L8606 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.

Pricing modifiers decide which amount applies: NU for a new purchase, RR for a monthly rental and UE for used equipment. 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.

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 L8606?

It depends on the state. Of the 21 states with a published fee-for-service rate, the median is $220.85. Delaware pays the most ($266.86) and California the least ($146.09).

Which state pays the highest Medicaid rate for L8606?

Delaware, at $266.86, effective 2026-01-01.

Which state pays the lowest Medicaid rate for L8606?

California, at $146.09, effective 2026-10-01.

What unit is L8606 billed in?

Of the 21 states, 1 publish L8606 per unit, and 20 schedules print no unit at all (a flat amount per service).

Do managed-care plans pay the same rate for L8606?

Not necessarily. In 3 states, the published rate binds plans: a floor, a pass-through or a state-set rate. In 13 states, plans negotiate and the published rate is a benchmark or out-of-network default. The rule for the remaining 5 states is not classified yet. Each rule is cited to the plan contract, statute or notice in the workspace.