31660 Medicaid reimbursement rate by state (2026)
Physician and practitioner services (fee schedule). Medicaid pays a median of $150.35 for 31660 across 32 states, from $34.37 in Rhode Island to $281.58 in Nebraska.
- States publishing
- 32
- National median
- $150.35units vary by state
- Lowest
- $34.37Rhode Island
- Highest
- $281.58Nebraska
What does Medicaid pay for 31660?
32 state Medicaid programs publish a fee-for-service rate for 31660. The national median is $150.35 (units differ between states). Nebraska pays the most, $281.58, and Rhode Island the least, $34.37, a 8.2x spread.
31660 rate by state: highest, middle and lowest
One like-for-like fee-for-service rate per state, ranked. The workspace lists all 32 states with every variant, modifier and effective date.
How to read this table
- Order. States are listed from the highest published rate to the lowest. No single unit is shared by 8 or more states for 31660, so the order is by published amount and is not a like-for-like rank.
- Medicaid rate. The most the state's fee-for-service program pays for one unit, as published. 15 of the 32 states list more than one rate for 31660, by modifier, provider type or setting; the table shows the one that matches the provider level and setting used across states, without add-ons.
- Unit. None of the 32 schedules prints a separate unit for 31660, so each amount is a flat payment for one service as the code defines it.
- Per hour. 31660 is not billed in time units in these states, so no hourly figure is shown.
- Managed-care plans. The rule the state sets for its plans on this rate. What each rule means is explained below.
- % of Medicare. No Medicare physician fee schedule amount is on file for 31660, so there is no percentage.
- Source and date. Each Source link opens the state's own document; “since” is the date the rate took effect.
Why 31660 rates differ between states
Published rates for 31660 run from $34.37 in Rhode Island to $281.58 in Nebraska, a 8.2x gap in the same unit. Half the states pay more than the median of $150.35 and half pay less. The usual reasons for a spread like this in physician & professional rates:
- Modifiers such as professional or technical component, bilateral, multiple procedure and assistant at surgery change the amount paid, and states apply them with their own percentages.
- Some states pay physician services as a percentage of the Medicare fee schedule; others keep a schedule of their own that may not have been rebased for years.
- Primary-care and pediatric add-ons, enhanced rates for certain specialties and targeted increases for access problems change individual codes without moving the rest of the schedule.
Timing matters too. 19 states set the current rate for 31660 in 2026 or later, while 8 states still pay a rate that took effect in 2022 or earlier. A state that has not updated its rate in years will drift down the ranking as others raise theirs.
What managed-care plans pay for 31660
What a plan pays for 31660 is negotiated privately, but the state decides how much room there is to negotiate. Here is how the rules break down across the 32 states.
In 7 states, the published rate binds plans: a floor, a pass-through or a state-set rate. In 14 states, plans negotiate and the published rate is a benchmark or out-of-network default. The rule for the remaining 11 states is not classified yet.
- Plans negotiate; the published rate applies out of network (14 states). In-network rates can be above or below the published rate. The published rate is the benchmark both sides know, and the fallback if no contract is signed.
- Plans must pay at least the published rate (7 states). The published rate is your floor. Negotiate up from it, and if a plan pays less, the contract provision is the basis for a payment dispute.
Plan-negotiated rates are never estimated here. To see the rule and its citation for a particular state, open that state's managed-care page, for example Nebraska managed care.
Units and billing for 31660
31660 is a CPT surgery code in the physician & professional line, billed mostly by physicians, nurse practitioners, physician assistants and other licensed practitioners. Surgical codes are paid once per procedure. The fee can include a global period of related care before and after the procedure, and modifiers for multiple, bilateral or assistant procedures raise or reduce what is actually paid.
Physician-fee-schedule codes are billed per service: one unit is one occurrence unless the code itself is defined by time or quantity. Where a state publishes separate facility and non-facility amounts, the non-facility (office) amount is usually higher because the practice carries the overhead.
Before billing, confirm the rate, unit and any modifier with the state's current schedule or the plan: the amounts here are as published, not a guarantee of payment.
Frequently asked questions
What does Medicaid pay for 31660?
It depends on the state. Of the 32 states with a published fee-for-service rate, the median is $150.35. Nebraska pays the most ($281.58) and Rhode Island the least ($34.37).
Which state pays the highest Medicaid rate for 31660?
Nebraska, at $281.58, effective 2026-07-01.
Which state pays the lowest Medicaid rate for 31660?
Rhode Island, at $34.37, effective 2013-01-01.
What unit is 31660 billed in?
None of the 32 schedules prints a separate unit for 31660, so each amount is a flat payment for one service as the code defines it.
Do managed-care plans pay the same rate for 31660?
Not necessarily. In 7 states, the published rate binds plans: a floor, a pass-through or a state-set rate. In 14 states, plans negotiate and the published rate is a benchmark or out-of-network default. The rule for the remaining 11 states is not classified yet. Each rule is cited to the plan contract, statute or notice in the workspace.