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Billing code 92977 · Physician & professional

92977 Medicaid reimbursement rate by state (2026)

Physician and practitioner services (fee schedule). Medicaid pays a median of $55.46 for 92977 across 9 states, from $35.78 in Michigan to $274.58 in Georgia.

Data as of Oct 5, 20269 statesEvery rate links to its official source

States publishing
9
National median
$55.46units vary by state
Lowest
$35.78Michigan
Highest
$274.58Georgia
Answer

What does Medicaid pay for 92977?

9 state Medicaid programs publish a fee-for-service rate for 92977. The national median is $55.46 (units differ between states). Georgia pays the most, $274.58, and Michigan the least, $35.78, a 7.7x spread.

State ranking

92977 rate by state: highest, middle and lowest

One like-for-like fee-for-service rate per state, ranked. The workspace lists all 9 states with every variant, modifier and effective date.

#StateMedicaid rateUnitPer hourManaged-care plans% of Medicare
1Georgia Source · since 2017-01-01$274.58——Plans negotiate; applies out of network—
2Iowa Source · since 2013-07-01$273.61——Plans must pay at least this—
3Kentucky Source · since 2020-01-01$219.11——Plans negotiate; applies out of network—
5Colorado Source · since 2024-07-01$55.46——Plans negotiate; applies out of network—
8Minnesota Source · since 2025-02-01$40.31——Plans negotiate; applies out of network—
9Michigan Source · since 2025-01-01$35.78——Plans negotiate; applies out of network—
See all 9 states for 92977 — start free

3 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.

  • Source for every rate
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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 92977 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 92977, 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. 5 of the 9 states list more than one rate for 92977, 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. None of the 9 schedules prints a separate unit for 92977, so each amount is a flat payment for one service as the code defines it.
  • Per hour. 92977 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 92977, 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 92977 rates differ between states

Published rates for 92977 run from $35.78 in Michigan to $274.58 in Georgia, a 7.7x gap in the same unit. Half the states pay more than the median of $55.46 and half pay less. The usual reasons for a spread like this in physician & professional rates:

  • 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.
  • 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.
  • Each state sets its own physician conversion factor or fee for every code, and many update them on a state budget cycle rather than on Medicare's calendar.

Timing matters too. 1 state set the current rate for 92977 in 2026 or later, while 4 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 92977

Most Medicaid members are in managed-care plans, and plans don't publish their provider fee schedules. For 92977, the public signal is the rule each state sets for its plans, recorded on each rate above.

In 2 states, the published rate binds plans: a floor, a pass-through or a state-set rate. In 7 states, plans negotiate and the published rate is a benchmark or out-of-network default.

  • Plans negotiate; the published rate applies out of network (7 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 (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.

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 Georgia managed care.

Billing

Units and billing for 92977

92977 is a CPT medicine code in the physician & professional line, billed mostly by physicians, nurse practitioners, physician assistants and other licensed practitioners. The medicine section runs from vaccines and psychiatry to dialysis, cardiology and therapy. Some of its codes are timed in 15-minute units, others are billed once per session or per test, so the unit matters more here than in most sections.

Physician-fee-schedule codes are billed per service: one unit is one occurrence unless the code itself is defined by time or quantity. Practitioners who are not physicians are often paid a reduced percentage of the published amount, so check the schedule for the reduction that applies to your provider type.

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 92977?

It depends on the state. Of the 9 states with a published fee-for-service rate, the median is $55.46. Georgia pays the most ($274.58) and Michigan the least ($35.78).

Which state pays the highest Medicaid rate for 92977?

Georgia, at $274.58, effective 2017-01-01.

Which state pays the lowest Medicaid rate for 92977?

Michigan, at $35.78, effective 2025-01-01.

What unit is 92977 billed in?

None of the 9 schedules prints a separate unit for 92977, so each amount is a flat payment for one service as the code defines it.

Do managed-care plans pay the same rate for 92977?

Not necessarily. In 2 states, the published rate binds plans: a floor, a pass-through or a state-set rate. In 7 states, plans negotiate and the published rate is a benchmark or out-of-network default. Each rule is cited to the plan contract, statute or notice in the workspace.