Every state, kept current
The Rates plan
$29/mo7-day free trialThis page shows one representative rate per state for L7403. 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
42
Median % of Medicare
77.5%
Rate range
$173.96 - $458.43
L7403 rates in every publishing state
| State | Medicaid rate | % of Medicare | Prior auth | Vintage |
|---|---|---|---|---|
| Alabama | $238.40 | 52.8% | -- | 2026 |
| Arkansas | $349.80* | 77.5% | -- | 2026 |
| Arizona | $412.21 | 91.4% | -- | 2026 |
| California | $231.94 | 51.4% | -- | 2026 |
| Colorado | $362.05 | 80.2% | -- | 2026 |
| Connecticut | $263.32 | 58.4% | Required | 2013 |
| District of Columbia | $354.06 | 78.5% | Not required | 2026 |
| Florida | $296.36 | 65.7% | -- | 2026 |
| Hawaii | $173.96 | 38.6% | -- | 2025 |
| Iowa | $310.29 | 68.8% | -- | 2024 |
| Idaho | $382.39 | 84.7% | Not required | 2026 |
| Illinois | $397.78 | 88.2% | -- | 2026 |
| Indiana | $444.59 | 98.5% | -- | 2026 |
| Kansas | $360.99 | 80% | -- | 2026 |
| Kentucky | $268.11 | 59.4% | -- | 2026 |
| Louisiana | $247.48 | 54.8% | -- | 2026 |
| Massachusetts | $388.21 | 86% | -- | 2026 |
| Maryland | $376.19 | 83.4% | -- | 2026 |
| Maine | $442.58 | 98.1% | -- | 2026 |
| Michigan | $335.58 | 74.4% | -- | 2026 |
| Minnesota | $453.48 | 100.5% | Conditional | 2026 |
| Missouri | $326.19* | 72.3% | Not required | 2019 |
| Mississippi | $364.75* | 80.8% | -- | 2026 |
| Montana | $458.43 | 101.6% | Not required | 2026 |
| North Carolina | $295.98 | 65.6% | -- | 2025 |
| North Dakota | $402.16 | 89.1% | Not required | 2026 |
| Nebraska | $387.43 | 85.9% | -- | 2026 |
| New Hampshire | $381.36 | 84.5% | Not required | 2026 |
| New Jersey | $309.81 | 68.7% | Not required | 2026 |
| New Mexico | $446.94 | 99.1% | -- | 2025 |
| Nevada | $289.93 | 64.3% | -- | 2015 |
| New York | $306.99 | 68% | -- | 2026 |
| Ohio | $347.12 | 76.9% | -- | 2026 |
| Oklahoma | $319.12 | 70.7% | -- | 2026 |
| South Carolina | $368.36 | 81.6% | -- | 2024 |
| Texas | $335.88* | 74.4% | -- | 2010 |
| Utah | $328.08* | 72.7% | Not required | 2026 |
| Virginia | $333.58 | 73.9% | -- | 2012 |
| Vermont | $370.98 | 82.2% | -- | 2026 |
| Washington | $332.64 | 73.7% | -- | 2026 |
| West Virginia | $354.06 | 78.5% | -- | 2026 |
| Wyoming | $282.27 | 62.6% | -- | 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
- 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 29 codes from L7007 to L7700 or every dme & supplies code by number.
Frequently asked questions
How much does Medicaid pay for L7403?
42 state Medicaid programs publish a fee-for-service rate for L7403 (addition to upper extremity prosthesis, below elbow/wrist disarticulation, acrylic material), ranging from $173.96 in Hawaii to $458.43 in Montana, with a median of 77.5% of the national Medicare amount. The full table on this page lists every publishing state's current rate.
Which state pays the most for L7403?
Montana publishes the highest Medicaid rate for L7403 at $458.43 (101.6% of the national Medicare amount). Hawaii publishes the lowest at $173.96.
Does L7403 require prior authorization under Medicaid?
2 of the 42 publishing states flag L7403 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".