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0335T Medicaid reimbursement rates by state

Surgery center facility fee (per procedure). 7 state Medicaid programs publish a fee-for-service rate for 0335T. Rates run from $81.10 in Iowa to $5,693.84 in Kentucky, with a median of $3,038.40.

Data as of 2026-10-05. Every rate links to the official document it came from.

States publishing
7
Median rate
$3,038.40units vary by state
Highest
$5,693.84Kentucky
Medicare (non-facility)
—not on the physician fee schedule

0335T rate in every state

One like-for-like fee-for-service rate per state, highest first. Units can differ between states; the per-hour column converts time-based units.

StateMedicaid rateUnitPer hourManaged-care plans% of MedicareSource
KentuckyAny qualified provider (rate does not vary by provider) · Kentucky Medicaid (fee-for-service, DMS fee schedules)$5,693.84since 2026-01-01——Plans negotiate; applies out of network—KY Medicaid ASC fee schedule (2026ASCFee
ArkansasAny qualified provider (rate does not vary by provider) · Arkansas Medicaid (fee-for-service)$5,541.31since 2026-01-01——Not classified—Arkansas Medicaid CY2026 Ambulatory Surg
DelawareAny qualified provider (rate does not vary by provider) · Delaware Medicaid (fee-for-service, DMMA / DMAP)$3,520.41since 2026-01-01——Plans negotiate; applies out of network—DMAP 2026 ASC Fee Schedule
UtahAny qualified provider (rate does not vary by provider) · Utah Medicaid (fee-for-service, Traditional plan)$3,038.40since 2026-07-01——Plans negotiate; applies out of network—Utah Medicaid Coverage and Reimbursement
New MexicoAny qualified provider (rate does not vary by provider) · New Mexico Medicaid (fee-for-service, HCA Medical Assistance Division)$1,866.38since 2015-01-01——Plans must pay at least this—OPPS Codes (NM Medicaid Hospital Outpati
ConnecticutAny qualified provider (rate does not vary by provider) · Connecticut Medicaid / HUSKY Health (fee-for-service, CMAP)$81.10since 2026-01-01——Not classified—CMAP Addendum B - OPPS Payment Type by P
IowaAny qualified provider (rate does not vary by provider) · Iowa Medicaid (fee-for-service schedules; the floor IA Health Link plans must pay)$81.10since 2026-01-01——Plans must pay at least this—Iowa Medicaid Addendum B (CY 26-Janaury)

Rates are per the unit shown for each state; units can differ between states. Medicare amounts are computed from the CMS relative value file and locality cost indices with the CMS formula; states with several Medicare localities show a range. Confirm rates with the payer before billing.

Frequently asked questions

What does Medicaid pay for 0335T?

It depends on the state. Of the 7 states with a published fee-for-service rate, the median is $3,038.40. Kentucky pays the most ($5,693.84) and Iowa the least ($81.10).

Which state pays the highest Medicaid rate for 0335T?

Kentucky, at $5,693.84, effective 2026-01-01.

Do managed-care plans pay the same rate for 0335T?

Not necessarily. Each state's plan contracts decide whether plans must pay at least the fee-for-service rate, pay a state-set rate, or negotiate their own. The table shows the rule for each state, cited to the contract or statute.

Related Hospital outpatient codes

Track 0335T in your statesYour codes on one rate card: every payer's rule, Medicare comparison, rank and rate changes.
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