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Billing code 47384 · Physician & professional

47384 Medicaid reimbursement rate by state (2026)

Physician and practitioner services (fee schedule). Medicaid pays a median of $334.55 for 47384 across 23 states, from $65.53 in Rhode Island to $647.85 in Alabama.

Data as of Oct 5, 202623 statesEvery rate links to its official source

States publishing
23
National median
$334.55units vary by state
Lowest
$65.53Rhode Island
Highest
$647.85Alabama
Answer

What does Medicaid pay for 47384?

23 state Medicaid programs publish a fee-for-service rate for 47384. The national median is $334.55 (units differ between states). Alabama pays the most, $647.85, and Rhode Island the least, $65.53, a 9.9x spread.

State ranking

47384 rate by state: highest, middle and lowest

One like-for-like fee-for-service rate per state, ranked. The workspace lists all 23 states with every variant, modifier and effective date.

#StateMedicaid rateUnitPer hourManaged-care plans% of Medicare
1Alabama Source · since 2026-09-24$647.85——Not classified—
2Montana Source · since 2026-07-01$596.17——Not classified—
3North Dakota Source · since 2026-07-01$451.72——Not classified—
11Idaho Source · since 2026-07-01$344.46——Not classified—
12Ohio Source · since 2026-01-01$334.55——Plans negotiate; applies out of network—
13Utah Source · since 2026-07-01$326.58——Plans negotiate; applies out of network—
22New Hampshire Source · since 2026-01-01$132.47——Plans negotiate; applies out of network—
23Rhode Island Source · since 2026-01-01$65.53——Plans negotiate; applies out of network—
See all 23 states for 47384 — start free

15 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 47384 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 47384, 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. 10 of the 23 states list more than one rate for 47384, 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 23 states, 1 publish 47384 per unit, and 22 schedules print no unit at all (a flat amount per service).
  • Per hour. 47384 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 47384, 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 47384 rates differ between states

Published rates for 47384 run from $65.53 in Rhode Island to $647.85 in Alabama, a 9.9x gap in the same unit. Half the states pay more than the median of $334.55 and half pay less. The usual reasons for a spread like this in physician & professional rates:

  • 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.
  • 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.

Timing matters too. 23 states set the current rate for 47384 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 47384

Most Medicaid members are in managed-care plans, and plans don't publish their provider fee schedules. For 47384, the public signal is the rule each state sets for its plans, recorded on each rate above.

In 4 states, the published rate binds plans: a floor, a pass-through or a state-set rate. In 11 states, plans negotiate and the published rate is a benchmark or out-of-network default. The rule for the remaining 8 states is not classified yet.

  • Plans negotiate; the published rate applies out of network (11 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 Alabama managed care.

Billing

Units and billing for 47384

47384 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 47384?

It depends on the state. Of the 23 states with a published fee-for-service rate, the median is $334.55. Alabama pays the most ($647.85) and Rhode Island the least ($65.53).

Which state pays the highest Medicaid rate for 47384?

Alabama, at $647.85, effective 2026-09-24.

Which state pays the lowest Medicaid rate for 47384?

Rhode Island, at $65.53, effective 2026-01-01.

What unit is 47384 billed in?

Of the 23 states, 1 publish 47384 per unit, and 22 schedules print no unit at all (a flat amount per service).

Do managed-care plans pay the same rate for 47384?

Not necessarily. In 4 states, the published rate binds plans: a floor, a pass-through or a state-set rate. In 11 states, plans negotiate and the published rate is a benchmark or out-of-network default. The rule for the remaining 8 states is not classified yet. Each rule is cited to the plan contract, statute or notice in the workspace.