L6677 Medicaid Rate by State

Upper extremity addition, harness, triple control, simultaneous operation of terminal device and elbow

35 state Medicaid programs publish a fee-for-service rate for L6677 (upper extremity addition, harness, triple control, simultaneous operation of terminal device and elbow), ranging from $58.74 in Iowa to $369.29 in Montana, with a median of 78.1% of the national Medicare amount.

Every state, kept current

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This page shows one representative rate per state for L6677. Full schedules include every locality, modifier, and age-band variant.

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Publishing states

35

Median % of Medicare

78.1%

Rate range

$58.74 - $369.29

L6677 rates in every publishing state

StateMedicaid rate% of MedicarePrior authVintage
Arkansas$283.74*78.1%--2026
Arizona$332.0591.4%--2026
California$186.8351.4%--2026
Colorado$295.4781.3%--2026
Connecticut$212.1158.4%Required2013
Iowa$58.7416.2%--2024
Idaho$308.0484.8%Not required2026
Indiana$358.1098.5%--2026
Kansas$290.7480%--2026
Massachusetts$312.7386%--2026
Maryland$303.0483.4%--2026
Maine$356.5298.1%--2026
Michigan$270.2974.4%--2026
Minnesota$365.26100.5%Conditional2026
Missouri$262.74*72.3%Not required2019
Mississippi$293.84*80.8%--2026
Montana$369.29101.6%Not required2026
North Carolina$250.3668.9%--2025
Nebraska$312.0785.9%--2026
New Hampshire$307.2184.5%Not required2026
New Jersey$249.5668.7%Not required2026
New Mexico$360.0599.1%--2025
Nevada$276.5676.1%--2017
New York$252.6669.5%--2026
Ohio$279.6276.9%--2026
Oklahoma$257.0870.7%--2026
South Carolina$296.7581.6%--2024
Texas$180.03*49.5%--2026
Utah$264.28*72.7%Not required2026
Virginia$268.7173.9%--2012
Vermont$298.8582.2%--2026
Washington$267.9573.7%--2026
Wisconsin$91.7425.2%--2008
West Virginia$285.2278.5%--2026
Wyoming$227.3762.6%--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

All 126 codes from L6000 to L6975 or every dme & supplies code by number.

Frequently asked questions

How much does Medicaid pay for L6677?

35 state Medicaid programs publish a fee-for-service rate for L6677 (upper extremity addition, harness, triple control, simultaneous operation of terminal device and elbow), ranging from $58.74 in Iowa to $369.29 in Montana, with a median of 78.1% of the national Medicare amount. The full table on this page lists every publishing state's current rate.

Which state pays the most for L6677?

Montana publishes the highest Medicaid rate for L6677 at $369.29 (101.6% of the national Medicare amount). Iowa publishes the lowest at $58.74.

Does L6677 require prior authorization under Medicaid?

2 of the 35 publishing states flag L6677 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".