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Billing code 480 · Hospital inpatient

480 Medicaid reimbursement rate by state (2026)

Inpatient DRG pricing input (outlier, cost ratio, stay). Medicaid pays a median of $2.91 for 480 across 13 states, from $0.1586 in Illinois to $2,005.65 in New Hampshire.

Data as of Oct 5, 202613 statesEvery rate links to its official source

States publishing
13
National median
$2.91units vary by state
Lowest
$0.1586Illinois
Highest
$2,005.65New Hampshire
Answer

What does Medicaid pay for 480?

13 state Medicaid programs publish a fee-for-service rate for 480. The national median is $2.91 (units differ between states). New Hampshire pays the most, $2,005.65, and Illinois the least, $0.1586, a 12646.0x spread.

State ranking

480 rate by state: highest, middle and lowest

One like-for-like fee-for-service rate per state, ranked. The workspace lists all 13 states with every variant, modifier and effective date.

#StateMedicaid rateUnitPer hourManaged-care plans% of Medicare
1New Hampshire Source · since 2025-10-01$2,005.65——Plans must pay at least this—
2Kansas Source · since 2023-01-01$78.00——Plans must pay at least this—
3North Carolina Source · since 2026-10-01$5.20——Plans must pay at least this—
6West Virginia Source · since 2025-10-01$3.46——Plans negotiate; applies out of network—
7Oregon Source · since 2025-10-01$2.91Weights - 10% Cap Applied—Not classified—
8Vermont Source · since 2025-10-01$2.82——Not classified—
12Virginia Source · since 2016-07-01$0.1703EAPG Weight Effective 7/1/2016—Plans negotiate; applies out of network—
13Illinois Source · since 2019-10-01$0.1586——Plans negotiate; applies out of network—
See all 13 states for 480 — start free

5 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 480 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 480?

It depends on the state. Of the 13 states with a published fee-for-service rate, the median is $2.91. New Hampshire pays the most ($2,005.65) and Illinois the least ($0.1586).

Which state pays the highest Medicaid rate for 480?

New Hampshire, at $2,005.65, effective 2025-10-01.

Do managed-care plans pay the same rate for 480?

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.