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Billing code 77061 · Radiology

77061 Medicaid reimbursement rate by state (2026)

Imaging and radiology. Medicaid pays a median of $30.91 for 77061 across 14 states, from $16.40 in Connecticut to $87.72 in Wisconsin.

Data as of Oct 5, 202614 statesEvery rate links to its official source

States publishing
14
National median
$30.91units vary by state
Lowest
$16.40Connecticut
Highest
$87.72Wisconsin
Answer

What does Medicaid pay for 77061?

14 state Medicaid programs publish a fee-for-service rate for 77061. The national median is $30.91 (units differ between states). Wisconsin pays the most, $87.72, and Connecticut the least, $16.40, a 5.3x spread.

State ranking

77061 rate by state: highest, middle and lowest

One like-for-like fee-for-service rate per state, ranked. The workspace lists all 14 states with every variant, modifier and effective date.

#StateMedicaid rateUnitPer hourManaged-care plans% of Medicare
1Wisconsin Source · since 2022-01-01$87.72——Plans negotiate; applies out of network—
2Arizona Source · since 2026-10-01$80.83——Plans negotiate; applies out of network—
3South Carolina Source · since 2015-01-01$74.09——Not classified—
7Maine Source · since 2019-01-01$33.82——Not classified—
8Oregon Source · since 2024-01-01$27.99——Plans negotiate; applies out of network—
9Maryland Source · since 2026-01-01$25.68——Not classified—
13Kansas Source · since 2019-12-01$19.20——Plans must pay at least this—
14Connecticut Source · since 2016-01-01$16.40——Not classified—
See all 14 states for 77061 — start free

6 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 77061 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 77061, 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. 12 of the 14 states list more than one rate for 77061, 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 14 states, 1 publish 77061 per percent of billed charges, and 13 schedules print no unit at all (a flat amount per service).
  • Per hour. 77061 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 77061, 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 77061 rates differ between states

Published rates for 77061 run from $16.40 in Connecticut to $87.72 in Wisconsin, a 5.3x gap in the same unit. Half the states pay more than the median of $30.91 and half pay less. The usual reasons for a spread like this in radiology rates:

  • Advanced imaging such as CT, MRI and PET is often under separate pricing and prior-authorization policies that vary from state to state.
  • Some states pay hospitals for the technical component through an outpatient system and pay only the professional component from the physician schedule.
  • States that benchmark imaging to Medicare use different percentages and different Medicare years.

Timing matters too. 3 states set the current rate for 77061 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.

Managed care

What managed-care plans pay for 77061

No managed-care plan publishes what it pays for 77061. 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 3 states, the published rate binds plans: a floor, a pass-through or a state-set rate. In 6 states, plans negotiate and the published rate is a benchmark or out-of-network default. The rule for the remaining 5 states is not classified yet.

  • Plans negotiate; the published rate applies out of network (6 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 (3 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 Wisconsin managed care.

Billing

Units and billing for 77061

77061 is a CPT radiology code in the radiology line, billed mostly by radiology groups, imaging centers and hospitals. Imaging codes are paid per study and split into a professional component (the reading, modifier 26) and a technical component (the equipment and staff, modifier TC). A global amount covers both.

Imaging is billed per study, with modifier 26 for the professional component and TC for the technical component; a claim without either is paid at the global amount where the state publishes one. Contrast agents and radiopharmaceuticals are usually billed separately under their own codes.

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 77061?

It depends on the state. Of the 14 states with a published fee-for-service rate, the median is $30.91. Wisconsin pays the most ($87.72) and Connecticut the least ($16.40).

Which state pays the highest Medicaid rate for 77061?

Wisconsin, at $87.72, effective 2022-01-01.

Which state pays the lowest Medicaid rate for 77061?

Connecticut, at $16.40, effective 2016-01-01.

What unit is 77061 billed in?

Of the 14 states, 1 publish 77061 per percent of billed charges, and 13 schedules print no unit at all (a flat amount per service).

Do managed-care plans pay the same rate for 77061?

Not necessarily. In 3 states, the published rate binds plans: a floor, a pass-through or a state-set rate. In 6 states, plans negotiate and the published rate is a benchmark or out-of-network default. The rule for the remaining 5 states is not classified yet. Each rule is cited to the plan contract, statute or notice in the workspace.