77799 Medicaid reimbursement rate by state (2026)
Imaging and radiology. Medicaid pays a median of $70.77 for 77799 across 8 states, from $7.00 in Minnesota to $200.00 in District of Columbia.
- States publishing
- 8
- National median
- $70.77units vary by state
- Lowest
- $7.00Minnesota
- Highest
- $200.00District of Columbia
What does Medicaid pay for 77799?
8 state Medicaid programs publish a fee-for-service rate for 77799. The national median is $70.77 (units differ between states). District of Columbia pays the most, $200.00, and Minnesota the least, $7.00 per base unit, a 28.6x spread.
77799 rate by state: highest, middle and lowest
One like-for-like fee-for-service rate per state, ranked. The workspace lists all 8 states with every variant, modifier and effective date.
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 77799, 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. 4 of the 8 states list more than one rate for 77799, 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 8 states, 2 publish 77799 per base unit and 1 per percent of billed charges, and 5 schedules print no unit at all (a flat amount per service).
- Per hour. 77799 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 77799, 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.
Why 77799 rates differ between states
Published rates for 77799 run from $7.00 in Minnesota to $200.00 in District of Columbia. The two publish it in different units (no unit printed versus base unit), so part of that gap is the unit rather than the price. Half the states pay more than the median of $70.77 and half pay less. The usual reasons for a spread like this in radiology rates:
- Some states pay hospitals for the technical component through an outpatient system and pay only the professional component from the physician schedule.
- Advanced imaging such as CT, MRI and PET is often under separate pricing and prior-authorization policies that vary from state to state.
- States that benchmark imaging to Medicare use different percentages and different Medicare years.
Timing matters too. 1 state set the current rate for 77799 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.
What managed-care plans pay for 77799
What a plan pays for 77799 is negotiated privately, but the state decides how much room there is to negotiate. Here is how the rules break down across the 8 states.
In 2 states, the published rate binds plans: a floor, a pass-through or a state-set rate. In 1 state, 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 must pay at least the published rate (2 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.
- Plans negotiate; the published rate applies out of network (1 state). 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.
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 District of Columbia managed care.
Units and billing for 77799
77799 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.
Frequently asked questions
What does Medicaid pay for 77799?
It depends on the state. Of the 8 states with a published fee-for-service rate, the median is $70.77. District of Columbia pays the most ($200.00) and Minnesota the least ($7.00 per base unit).
Which state pays the highest Medicaid rate for 77799?
District of Columbia, at $200.00, effective 1983-10-01.
Which state pays the lowest Medicaid rate for 77799?
Minnesota, at $7.00 per base unit, effective 2025-01-01. It publishes the code in a different unit from District of Columbia, so compare per unit with care.
What unit is 77799 billed in?
Of the 8 states, 2 publish 77799 per base unit and 1 per percent of billed charges, and 5 schedules print no unit at all (a flat amount per service).
Do managed-care plans pay the same rate for 77799?
Not necessarily. In 2 states, the published rate binds plans: a floor, a pass-through or a state-set rate. In 1 state, 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.