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Billing code 275 · Hospital inpatient

275 Medicaid reimbursement rate by state (2026)

Inpatient DRG pricing input (outlier, cost ratio, stay). Medicaid pays a median of $7.57 for 275 across 10 states, from $0.0521 in Virginia to $3,608.98 in New Hampshire.

Data as of Oct 5, 202610 statesEvery rate links to its official source

States publishing
10
National median
$7.57units vary by state
Lowest
$0.0521Virginia
Highest
$3,608.98New Hampshire
Answer

What does Medicaid pay for 275?

10 state Medicaid programs publish a fee-for-service rate for 275. The national median is $7.57 (units differ between states). New Hampshire pays the most, $3,608.98, and Virginia the least, $0.0521 per EAPG Weight Effective 7/1/2016, a 69270.2x spread.

State ranking

275 rate by state: highest, middle and lowest

One like-for-like fee-for-service rate per state, ranked. The workspace lists all 10 states with every variant, modifier and effective date.

#StateMedicaid rateUnitPer hourManaged-care plans% of Medicare
1New Hampshire Source · since 2025-10-01$3,608.98——Plans must pay at least this—
2Kansas Source · since 2024-01-01$78.00——Plans must pay at least this—
3New Mexico Source · since 2026-09-24$11.90——Plans must pay at least this—
5West Virginia Source · since 2025-10-01$8.01——Plans negotiate; applies out of network—
6Oregon Source · since 2025-10-01$7.13Weights - 10% Cap Applied—Not classified—
9Illinois Source$0.0968——Plans negotiate; applies out of network—
10Virginia Source · since 2016-07-01$0.0521EAPG Weight Effective 7/1/2016—Plans negotiate; applies out of network—
See all 10 states for 275 — start free

3 more states, with every modifier and provider-type variant, rate history and the plan rule in each state. 14-day free trial, no credit card.

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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; states with several Medicare localities show a range. Confirm rates with the payer before billing.

Track 275 in your states. Get an alert when any state changes it, with every variant and the managed-care rule.
FAQ

Frequently asked questions

What does Medicaid pay for 275?

It depends on the state. Of the 10 states with a published fee-for-service rate, the median is $7.57. New Hampshire pays the most ($3,608.98) and Virginia the least ($0.0521 per EAPG Weight Effective 7/1/2016).

Which state pays the highest Medicaid rate for 275?

New Hampshire, at $3,608.98, effective 2025-10-01.

Do managed-care plans pay the same rate for 275?

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 workspace shows the rule for each state, cited to the contract or statute.