Every state, kept current
The Rates plan
$29/mo7-day free trialThis page shows one representative rate per state for L4631. 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
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Publishing states
38
Median % of Medicare
76.5%
Rate range
$926.80 - $2,102.64
L4631 rates in every publishing state
| State | Medicaid rate | % of Medicare | Prior auth | Vintage |
|---|---|---|---|---|
| Alabama | $1,131.92 | 58.8% | -- | 2026 |
| Arkansas | $1,411.97* | 73.3% | -- | 2026 |
| Arizona | $2,102.64 | 109.1% | -- | 2026 |
| California | $1,329.32 | 69% | -- | 2026 |
| Colorado | $1,216.60 | 63.2% | Required | 2026 |
| Connecticut | $1,212.34 | 62.9% | Required | 2013 |
| District of Columbia | $1,530.11 | 79.4% | Required | 2026 |
| Iowa | $1,242.94 | 64.5% | -- | 2018 |
| Idaho | $1,585.40* | 82.3% | Not required | 2026 |
| Illinois | $1,472.16 | 76.4% | -- | 2026 |
| Indiana | $1,776.15 | 92.2% | -- | 2026 |
| Kansas | $1,408.00 | 73.1% | -- | 2026 |
| Kentucky | $1,333.46 | 69.2% | -- | 2026 |
| Massachusetts | $1,725.88 | 89.6% | -- | 2026 |
| Maryland | $1,625.74 | 84.4% | Required | 2026 |
| Maine | $1,967.57 | 102.1% | -- | 2026 |
| Michigan | $1,340.64 | 69.6% | -- | 2026 |
| Minnesota | $1,811.67 | 94% | -- | 2026 |
| Missouri | $1,287.85* | 66.8% | Required | 2019 |
| Mississippi | $1,475.15* | 76.6% | -- | 2026 |
| Montana | $1,710.05 | 88.8% | Required | 2026 |
| North Carolina | $1,330.06 | 69% | -- | 2025 |
| North Dakota | $1,316.53 | 68.3% | Required | 2026 |
| Nebraska | $1,553.93 | 80.7% | -- | 2026 |
| New Hampshire | $1,695.40 | 88% | Not required | 2026 |
| New Jersey | $1,512.34 | 78.5% | Not required | 2026 |
| New Mexico | $1,791.67 | 93% | -- | 2025 |
| Nevada | $1,751.24 | 90.9% | -- | 2017 |
| New York | $1,278.41 | 66.4% | -- | 2026 |
| Ohio | $1,066.77 | 55.4% | -- | 2011 |
| Texas | $1,377.40* | 71.5% | -- | 2012 |
| Utah | $1,223.80* | 63.5% | Not required | 2026 |
| Virginia | $1,721.38 | 89.4% | -- | 2026 |
| Vermont | $1,649.29 | 85.6% | -- | 2026 |
| Washington | $1,379.11 | 71.6% | -- | 2026 |
| Wisconsin | $926.80 | 48.1% | -- | 2011 |
| West Virginia | $1,530.11 | 79.4% | -- | 2026 |
| Wyoming | $1,473.51 | 76.5% | -- | 2024 |
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
- A2001 - Innovamatrix ac, per square centimeter (add-on, list separately in addition to primary procedure)
- A2002 - Mirragen advanced wound matrix, per square centimeter (add-on, list separately in addition to primary procedure)
- 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 L4631?
38 state Medicaid programs publish a fee-for-service rate for L4631 (ankle foot orthosis, walking boot type, varus/valgus correction, rocker bottom, anterior tibial shell, soft interface, custom arch support, plastic or other material, includes straps and closures, custom fabricated), ranging from $926.80 in Wisconsin to $2,102.64 in Arizona, with a median of 76.5% of the national Medicare amount. The full table on this page lists every publishing state's current rate.
Which state pays the most for L4631?
Arizona publishes the highest Medicaid rate for L4631 at $2,102.64 (109.1% of the national Medicare amount). Wisconsin publishes the lowest at $926.80.
Does L4631 require prior authorization under Medicaid?
7 of the 38 publishing states flag L4631 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".