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Billing code 77285 · Radiology

77285 Medicaid reimbursement rate by state (2026)

Imaging and radiology. Medicaid pays a median of $293.76 for 77285 across 47 states, from $47.71 in Texas to $588.51 in Alaska.

Data as of Oct 5, 202647 statesEvery rate links to its official source

States publishing
47
National median
$293.76units vary by state
Lowest
$47.71Texas
Highest
$588.51Alaska
Answer

What does Medicaid pay for 77285?

47 state Medicaid programs publish a fee-for-service rate for 77285. The national median is $293.76 (units differ between states). Alaska pays the most, $588.51, and Texas the least, $47.71, a 12.3x spread.

Medicare (non-facility, 2026 physician fee schedule): $393.17–$639.98 depending on the state's Medicare locality.

State ranking

77285 rate by state: highest, middle and lowest

One like-for-like fee-for-service rate per state, ranked. The workspace lists all 47 states with every variant, modifier and effective date.

#StateMedicaid rateUnitPer hourManaged-care plans% of Medicare
1Alaska Source · since 2026-07-01$588.51——Not classified—
2Montana Source · since 2026-07-01$558.24——Not classified—
3Arizona Source · since 2026-10-01$465.98——Plans negotiate; applies out of network—
23Kansas Source · since 2024-01-01$300.73——Plans must pay at least this—
24Hawaii Source · since 2026-06-01$293.76——Plans negotiate; applies out of network—
25Missouri Source · since 2022-07-01$291.27——Plans negotiate; applies out of network—
46New York Source · since 2023-10-01$49.11unit—Plans negotiate; applies out of network—
47Texas Source · since 2026-03-01$47.71——Plans negotiate; applies out of network—
See all 47 states for 77285 — start free

39 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 77285 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 77285, 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. 42 of the 47 states list more than one rate for 77285, 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 47 states, 2 publish 77285 per unit, and 45 schedules print no unit at all (a flat amount per service).
  • Per hour. 77285 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. Medicare amounts exist for 77285, but no state's Medicaid unit matches Medicare's billing unit closely enough to compute a percentage.
  • Source and date. Each Source link opens the state's own document; “since” is the date the rate took effect.
Context

Why 77285 rates differ between states

Published rates for 77285 run from $47.71 in Texas to $588.51 in Alaska, a 12.3x gap in the same unit. Half the states pay more than the median of $293.76 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. 31 states set the current rate for 77285 in 2026 or later, while 7 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 77285

Most Medicaid members are in managed-care plans, and plans don't publish their provider fee schedules. For 77285, the public signal is the rule each state sets for its plans, recorded on each rate above.

In 9 states, the published rate binds plans: a floor, a pass-through or a state-set rate. In 24 states, plans negotiate and the published rate is a benchmark or out-of-network default. The rule for the remaining 14 states is not classified yet.

  • Plans negotiate; the published rate applies out of network (24 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 (9 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 77285

77285 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.

Contrast agents and radiopharmaceuticals are usually billed separately under their own codes. 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.

Medicare's 2026 physician fee schedule pays $393.17–$639.98 for 77285 (non-facility), depending on the Medicare locality. That is a useful reference point, but Medicare and Medicaid can define the unit differently, so compare only where the units match.

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 77285?

It depends on the state. Of the 47 states with a published fee-for-service rate, the median is $293.76. Alaska pays the most ($588.51) and Texas the least ($47.71).

Which state pays the highest Medicaid rate for 77285?

Alaska, at $588.51, effective 2026-07-01.

Which state pays the lowest Medicaid rate for 77285?

Texas, at $47.71, effective 2026-03-01.

What unit is 77285 billed in?

Of the 47 states, 2 publish 77285 per unit, and 45 schedules print no unit at all (a flat amount per service).

Do managed-care plans pay the same rate for 77285?

Not necessarily. In 9 states, the published rate binds plans: a floor, a pass-through or a state-set rate. In 24 states, plans negotiate and the published rate is a benchmark or out-of-network default. The rule for the remaining 14 states is not classified yet. Each rule is cited to the plan contract, statute or notice in the workspace.