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Billing code 44720 · Physician & professional

44720 Medicaid reimbursement rate by state (2026)

Physician and practitioner services (fee schedule). Medicaid pays a median of $197.16 for 44720 across 29 states, from $30.18 in Oregon to $432.50 in Alaska.

Data as of Oct 5, 202629 statesEvery rate links to its official source

States publishing
29
National median
$197.16units vary by state
Lowest
$30.18Oregon
Highest
$432.50Alaska
Answer

What does Medicaid pay for 44720?

29 state Medicaid programs publish a fee-for-service rate for 44720. The national median is $197.16 (units differ between states). Alaska pays the most, $432.50, and Oregon the least, $30.18, a 14.3x spread.

State ranking

44720 rate by state: highest, middle and lowest

One like-for-like fee-for-service rate per state, ranked. The workspace lists all 29 states with every variant, modifier and effective date.

#StateMedicaid rateUnitPer hourManaged-care plans% of Medicare
1Alaska Source · since 2026-07-01$432.50——Not classified—
2New Mexico Source · since 2025-01-01$400.88——Plans must pay at least this—
3Montana Source · since 2026-07-01$345.88——Not classified—
14Ohio Source · since 2005-01-01$198.11——Plans negotiate; applies out of network—
15Massachusetts Source · since 2026-10-01$197.16——Plans negotiate; applies out of network—
16Vermont Source · since 2026-01-01$190.26——Not classified—
28Texas Source · since 2026-09-01$30.45——Plans negotiate; applies out of network—
29Oregon Source · since 2026-02-01$30.18——Plans negotiate; applies out of network—
See all 29 states for 44720 — start free

21 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.

  • Source for every rate
  • Full rate history
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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 44720 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 44720, 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. 16 of the 29 states list more than one rate for 44720, 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 29 states, 1 publish 44720 per unit, and 28 schedules print no unit at all (a flat amount per service).
  • Per hour. 44720 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 44720, 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 44720 rates differ between states

Published rates for 44720 run from $30.18 in Oregon to $432.50 in Alaska, a 14.3x gap in the same unit. Half the states pay more than the median of $197.16 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.
  • Many schedules pay differently by place of service (office versus facility) and by practitioner, and nurse practitioners and physician assistants are often paid a percentage of the physician amount.
  • 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. 21 states set the current rate for 44720 in 2026 or later, while 5 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.

Managed care

What managed-care plans pay for 44720

No managed-care plan publishes what it pays for 44720. What is public is the rule each state's plan contracts set, and that rule decides how much the published rate matters when you contract with a plan.

In 4 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 (4 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 Alaska managed care.

Billing

Units and billing for 44720

44720 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.

Where a state publishes separate facility and non-facility amounts, the non-facility (office) amount is usually higher because the practice carries the overhead. Physician-fee-schedule codes are billed per service: one unit is one occurrence unless the code itself is defined by time or quantity.

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 44720?

It depends on the state. Of the 29 states with a published fee-for-service rate, the median is $197.16. Alaska pays the most ($432.50) and Oregon the least ($30.18).

Which state pays the highest Medicaid rate for 44720?

Alaska, at $432.50, effective 2026-07-01.

Which state pays the lowest Medicaid rate for 44720?

Oregon, at $30.18, effective 2026-02-01.

What unit is 44720 billed in?

Of the 29 states, 1 publish 44720 per unit, and 28 schedules print no unit at all (a flat amount per service).

Do managed-care plans pay the same rate for 44720?

Not necessarily. In 4 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.