C9785 Medicaid reimbursement rates by state
Endoscopic outlet reduction, gastric pouch application. 14 state Medicaid programs publish a fee-for-service rate for C9785. Rates run from $118.80 in South Dakota to $10,860.07 in Minnesota, with a median of $4,449.80.
Data as of 2026-10-05. Every rate links to the official document it came from.
- States publishing
- 14
- Median rate
- $4,449.80units vary by state
- Highest
- $10,860.07Minnesota
- Medicare (non-facility)
- —not on the physician fee schedule
C9785 rate in every state
One like-for-like fee-for-service rate per state, highest first. Units can differ between states; the per-hour column converts time-based units.
| State | Medicaid rate | Unit | Per hour | Managed-care plans | % of Medicare | Source |
|---|---|---|---|---|---|---|
| MinnesotaAny qualified provider (rate does not vary by provider) · Minnesota Health Care Programs: Medical Assistance (fee-for-service) | $10,860.07since 2023-07-01 | — | — | Plans negotiate; applies out of network | — | MHCP Fee Schedule - Current Fee Schedule |
| WyomingAny qualified provider (rate does not vary by provider) · Wyoming Medicaid (fee-for-service, Department of Health) | $9,561.00since 2026-01-01 | — | — | Not classified | — | Wyoming Medicaid APC-Based Fee Schedule |
| New MexicoAny qualified provider (rate does not vary by provider) · New Mexico Medicaid (fee-for-service, HCA Medical Assistance Division) | $9,087.30since 2023-07-01 | — | — | Plans must pay at least this | — | OPPS Codes (NM Medicaid Hospital Outpati |
| MontanaAny qualified provider (rate does not vary by provider) · Montana Medicaid and HMK Plus (fee-for-service) | $5,120.50since 2026-01-01 | — | — | Not classified | — | Montana Healthcare Programs ASC Covered |
| DelawareAny qualified provider (rate does not vary by provider) · Delaware Medicaid (fee-for-service, DMMA / DMAP) | $5,117.82since 2026-01-01 | — | — | Plans negotiate; applies out of network | — | DMAP 2026 ASC Fee Schedule |
| ArkansasAny qualified provider (rate does not vary by provider) · Arkansas Medicaid (fee-for-service) | $4,864.48since 2026-01-01 | — | — | Not classified | — | Arkansas Medicaid CY2026 Ambulatory Surg |
| MissouriAny qualified provider (rate does not vary by provider) · Missouri MO HealthNet (fee-for-service) | $4,547.17since 2026-07-01 | — | — | Plans negotiate; applies out of network | — | MO HealthNet fee schedule: Ambulatory Su |
| MassachusettsAny qualified provider (rate does not vary by provider) · MassHealth (fee-for-service, EOHHS 101 CMR rate regulations) | $4,352.43since 2026-01-01 | — | — | Plans negotiate; applies out of network | — | Administrative Bulletin 26-16: 101 CMR 3 |
| ArizonaAny qualified provider (rate does not vary by provider) · Arizona AHCCCS fee-for-service (AIHP, Tribal ALTCS, TRBHA and other FFS members) | $3,457.91since 2026-10-01 | — | — | Plans negotiate; applies out of network | — | AHCCCS Final Ambulatory Surgery Center R |
| MichiganAny qualified provider (rate does not vary by provider) · Michigan Medicaid (fee-for-service) | $2,678.02since 2026-07-01 | — | — | Plans negotiate; applies out of network | — | MDHHS ASC payment rates, July 2026 |
| UtahAny qualified provider (rate does not vary by provider) · Utah Medicaid (fee-for-service, Traditional plan) | $2,667.28since 2026-07-01 | — | — | Plans negotiate; applies out of network | — | Utah Medicaid Coverage and Reimbursement |
| ConnecticutAny qualified provider (rate does not vary by provider) · Connecticut Medicaid / HUSKY Health (fee-for-service, CMAP) | $118.80since 2026-01-01 | — | — | Not classified | — | CMAP Addendum B - OPPS Payment Type by P |
| IowaAny qualified provider (rate does not vary by provider) · Iowa Medicaid (fee-for-service schedules; the floor IA Health Link plans must pay) | $118.80since 2026-01-01 | — | — | Plans must pay at least this | — | Iowa Medicaid Addendum B (CY 26-Janaury) |
| South DakotaAny qualified provider (rate does not vary by provider) · South Dakota Medicaid (fee-for-service, DSS Division of Medical Services) | $118.80since 2026-02-27 | — | — | Not classified | — | Outpatient Hospital Prospective Payment |
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 with the CMS formula; states with several Medicare localities show a range. Confirm rates with the payer before billing.
Frequently asked questions
What does Medicaid pay for C9785?
It depends on the state. Of the 14 states with a published fee-for-service rate, the median is $4,449.80. Minnesota pays the most ($10,860.07) and South Dakota the least ($118.80).
Which state pays the highest Medicaid rate for C9785?
Minnesota, at $10,860.07, effective 2023-07-01.
Do managed-care plans pay the same rate for C9785?
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 table shows the rule for each state, cited to the contract or statute.