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Billing code 33279 · Physician & professional

33279 Medicaid reimbursement rate by state (2026)

Physician and practitioner services (fee schedule). Medicaid pays a median of $261.48 for 33279 across 37 states, from $52.94 in Rhode Island to $497.83 in New Mexico.

Data as of Oct 5, 202637 statesEvery rate links to its official source

States publishing
37
National median
$261.48units vary by state
Lowest
$52.94Rhode Island
Highest
$497.83New Mexico
Answer

What does Medicaid pay for 33279?

37 state Medicaid programs publish a fee-for-service rate for 33279. The national median is $261.48 (units differ between states). New Mexico pays the most, $497.83, and Rhode Island the least, $52.94, a 9.4x spread.

State ranking

33279 rate by state: highest, middle and lowest

One like-for-like fee-for-service rate per state, ranked. The workspace lists all 37 states with every variant, modifier and effective date.

#StateMedicaid rateUnitPer hourManaged-care plans% of Medicare
1New Mexico Source · since 2025-01-01$497.83——Plans must pay at least this—
2Alabama Source · since 2026-09-24$486.03——Not classified—
3Montana Source · since 2026-07-01$433.68——Not classified—
18Virginia Source · since 2026-07-01$267.36——Plans negotiate; applies out of network—
19Ohio Source · since 2024-01-01$261.48——Plans negotiate; applies out of network—
20Mississippi Source · since 2026-07-01$256.48——Plans must pay at least this—
36Kansas Source · since 2024-01-01$76.45——Not classified—
37Rhode Island Source · since 2024-01-01$52.94——Plans negotiate; applies out of network—
See all 37 states for 33279 — start free

29 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 33279 in your states. Get an alert when any state changes it, with every variant and the managed-care rule.
Guide

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 33279, 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. 21 of the 37 states list more than one rate for 33279, 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. Of the 37 states, 2 publish 33279 per unit, and 35 schedules print no unit at all (a flat amount per service).
  • Per hour. 33279 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 33279, 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.
Context

Why 33279 rates differ between states

Published rates for 33279 run from $52.94 in Rhode Island to $497.83 in New Mexico, a 9.4x gap in the same unit. Half the states pay more than the median of $261.48 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.
  • Each state sets its own physician conversion factor or fee for every code, and many update them on a state budget cycle rather than on Medicare's calendar.

Timing matters too. 23 states set the current rate for 33279 in 2026 or later. A state that has not updated its rate in years will drift down the ranking as others raise theirs.

Managed care

What managed-care plans pay for 33279

Most Medicaid members are in managed-care plans, and plans don't publish their provider fee schedules. For 33279, the public signal is the rule each state sets for its plans, recorded on each rate above.

In 8 states, the published rate binds plans: a floor, a pass-through or a state-set rate. In 19 states, plans negotiate and the published rate is a benchmark or out-of-network default. The rule for the remaining 10 states is not classified yet.

  • Plans negotiate; the published rate applies out of network (19 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 (8 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 New Mexico managed care.

Billing

Units and billing for 33279

33279 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. Practitioners who are not physicians are often paid a reduced percentage of the published amount, so check the schedule for the reduction that applies to your provider type.

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.

FAQ

Frequently asked questions

What does Medicaid pay for 33279?

It depends on the state. Of the 37 states with a published fee-for-service rate, the median is $261.48. New Mexico pays the most ($497.83) and Rhode Island the least ($52.94).

Which state pays the highest Medicaid rate for 33279?

New Mexico, at $497.83, effective 2025-01-01.

Which state pays the lowest Medicaid rate for 33279?

Rhode Island, at $52.94, effective 2024-01-01.

What unit is 33279 billed in?

Of the 37 states, 2 publish 33279 per unit, and 35 schedules print no unit at all (a flat amount per service).

Do managed-care plans pay the same rate for 33279?

Not necessarily. In 8 states, the published rate binds plans: a floor, a pass-through or a state-set rate. In 19 states, plans negotiate and the published rate is a benchmark or out-of-network default. The rule for the remaining 10 states is not classified yet. Each rule is cited to the plan contract, statute or notice in the workspace.