L5570 Medicaid Rate by State

Preparatory, above knee - knee disarticulation, ischial level socket, non-alignable system, pylon, no cover, sach foot, thermoplastic or equal, direct formed

42 state Medicaid programs publish a fee-for-service rate for L5570 (preparatory, above knee - knee disarticulation, ischial level socket, non-alignable system, pylon, no cover, sach foot, thermoplastic or equal, direct formed), ranging from $669.65 in Missouri to $3,544.64 in North Dakota, with a median of 74.8% of the national Medicare amount.

Every state, kept current

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This page shows one representative rate per state for L5570. Full schedules include every locality, modifier, and age-band variant.

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Publishing states

42

Median % of Medicare

74.8%

Rate range

$669.65 - $3,544.64

L5570 rates in every publishing state

StateMedicaid rate% of MedicarePrior authVintage
Alabama$1,460.0051.9%--2026
Arkansas$2,027.15*72.1%--2026
Arizona$2,938.76104.5%--2026
California$1,167.5241.5%--2026
Colorado$2,304.8481.9%Required2026
Connecticut$1,605.6657.1%Required2013
Delaware$2,473.7688%--2026
Hawaii$1,347.6147.9%--2025
Iowa$1,767.0762.8%--2024
Idaho$2,404.8485.5%Not required2026
Illinois$2,267.0780.6%--2026
Indiana$2,735.2297.3%--2026
Kansas$2,352.4683.6%--2026
Kentucky$1,545.6755%--2026
Louisiana$1,679.9259.7%--2026
Massachusetts$2,546.4190.5%--2026
Maryland$2,102.7074.8%Required2026
Maine$2,903.01103.2%--2026
Michigan$2,064.5473.4%--2026
Minnesota$2,789.9299.2%--2026
Missouri$669.65*23.8%Not required2019
Mississippi$1,979.01*70.4%--2026
Montana$3,146.23111.9%Not required2026
North Carolina$1,605.8657.1%--2025
North Dakota$3,544.64126%Required2026
Nebraska$2,524.8789.8%--2026
New Hampshire$2,501.4488.9%Not required2026
New Jersey$1,960.3469.7%Not required2026
New Mexico$3,033.88107.9%--2025
Nevada$2,447.6587%--2017
New York$1,717.0061%--2026
Ohio$2,183.0477.6%--2026
Oklahoma$2,166.1977%--2026
Pennsylvania$900.0032%--1985
Texas$1,675.91*59.6%--1992
Utah$2,251.60*80.1%Not required2026
Virginia$1,864.4766.3%--2012
Vermont$2,433.4186.5%--2026
Washington$2,091.9174.4%--2026
Wisconsin$1,636.6958.2%--2008
West Virginia$1,979.0170.4%--2026
Wyoming$2,009.5071.4%Required2021

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

All 189 codes from L5000 to L5992 or every dme & supplies code by number.

Frequently asked questions

How much does Medicaid pay for L5570?

42 state Medicaid programs publish a fee-for-service rate for L5570 (preparatory, above knee - knee disarticulation, ischial level socket, non-alignable system, pylon, no cover, sach foot, thermoplastic or equal, direct formed), ranging from $669.65 in Missouri to $3,544.64 in North Dakota, with a median of 74.8% of the national Medicare amount. The full table on this page lists every publishing state's current rate.

Which state pays the most for L5570?

North Dakota publishes the highest Medicaid rate for L5570 at $3,544.64 (126% of the national Medicare amount). Missouri publishes the lowest at $669.65.

Does L5570 require prior authorization under Medicaid?

5 of the 42 publishing states flag L5570 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".