Every state, kept current
The Rates plan
$29/mo7-day free trialThis page shows one representative rate per state for L4210. Full schedules include every locality, modifier, and age-band variant.
- Every code on all 51 published schedules
- Full-schedule CSV export and state network lists
- Email alerts when a state changes its rates
$29/mo after the trial. Cancel anytime.
Publishing states
23
Median % of Medicare
--
Rate range
$8.00 - $300.00
L4210 rates in every publishing state
| State | Medicaid rate | % of Medicare | Prior auth | Vintage |
|---|---|---|---|---|
| Alabama | $27.00 | -- | -- | 2026 |
| Arkansas | $28.27* | -- | -- | 2026 |
| Colorado | $26.17 | -- | -- | 2026 |
| District of Columbia | $300.00 | -- | Required | 2015 |
| Hawaii | $21.02 | -- | -- | 2025 |
| Kansas | $300.00 | -- | -- | 2006 |
| Kentucky | $32.03 | -- | -- | 2026 |
| Louisiana | $105.00 | -- | -- | 2026 |
| Maryland | $26.35 | -- | -- | 2026 |
| Maine | $91.03 | -- | -- | 2026 |
| Michigan | $44.16 | -- | -- | 2026 |
| North Dakota | $22.16 | -- | Required | 2026 |
| New Jersey | $69.00 | -- | Not required | 2026 |
| New Mexico | $200.00 | -- | -- | 2026 |
| Nevada | $8.00 | -- | -- | -- |
| New York | $35.35 | -- | -- | 2026 |
| Ohio | $18.50 | -- | -- | 2024 |
| Oklahoma | $82.72 | -- | -- | 2020 |
| South Carolina | $10.87 | -- | -- | 2024 |
| Texas | $51.33* | -- | -- | 2016 |
| Utah | $13.18* | -- | Not required | 2010 |
| Virginia | $90.00 | -- | -- | 2010 |
| Wyoming | $20.96 | -- | -- | 2021 |
Published Medicaid fee-for-service schedule amounts, not a coverage or eligibility guarantee. Managed-care plan rates can differ. Where no prior-authorization flag is shown, the state does not publish one. Rows marked * are representative published variants or methodology-derived rates. "--" in the prior-auth column means the state publishes no PA flag.
Related dme & supplies codes
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- A2005 - Microlyte matrix, per square centimeter (add-on, list separately in addition to primary procedure)
- A2006 - Novosorb synpath dermal matrix, per square centimeter (add-on, list separately in addition to primary procedure)
- A2007 - Restrata, per square centimeter (add-on, list separately in addition to primary procedure)
- A2008 - Theragenesis, per square centimeter (add-on, list separately in addition to primary procedure)
- A2009 - Symphony, per square centimeter (add-on, list separately in addition to primary procedure)
- A2010 - Apis, per square centimeter (add-on, list separately in addition to primary procedure)
All 30 codes from L4000 to L4631 or every dme & supplies code by number.
Frequently asked questions
How much does Medicaid pay for L4210?
23 state Medicaid programs publish a fee-for-service rate for L4210 (repair of orthotic device, repair or replace minor parts), ranging from $8.00 in Nevada to $300.00 in District of Columbia. The full table on this page lists every publishing state's current rate.
Which state pays the most for L4210?
District of Columbia publishes the highest Medicaid rate for L4210 at $300.00. Nevada publishes the lowest at $8.00.
Does L4210 require prior authorization under Medicaid?
2 of the 23 publishing states flag L4210 as requiring prior authorization (always or conditionally) on their fee schedules. States without a flag publish no PA indicator for this code - that means "not published", not "no PA required".