Hospital outpatient Medicaid rates by code
138 hospital outpatient codes with published Medicaid rates in five or more states. Each page compares every state's rate, unit and managed-care rule.
| Code | Service | States | Median rate |
|---|---|---|---|
| 0101T | Outpatient hospital services (fee schedule) | 5 | $128.76 |
| 0102T | Outpatient hospital services (fee schedule) | 5 | $1,562.63 |
| 0263T | Surgery center facility fee (per procedure) | 5 | $2,120.09 |
| 0264T | Surgery center facility fee (per procedure) | 5 | $2,120.09 |
| 0265T | Surgery center facility fee (per procedure) | 5 | $2,120.09 |
| 0274T | Surgery center facility fee (per procedure) | 5 | $3,460.46 |
| 0308T | Surgery center facility fee (per procedure) | 5 | $1,584.76 |
| 0331T | Surgery center facility fee (per procedure) | 5 | $292.06 |
| 0332T | Surgery center facility fee (per procedure) | 5 | $292.06 |
| 0335T | Surgery center facility fee (per procedure) | 5 | $1,866.38 |
| 0342T | Outpatient hospital services (fee schedule) | 5 | $2,270.45 |
| 0408T | Surgery center facility fee (per procedure) | 5 | $21,930.03 |
| 0409T | Outpatient hospital services (fee schedule) | 5 | $18,671.23 |
| 0410T | Surgery center facility fee (per procedure) | 5 | $6,696.85 |
| 0411T | Surgery center facility fee (per procedure) | 5 | $6,696.85 |
| 0412T | Outpatient hospital services (fee schedule) | 6 | $1,792.24 |
| 0414T | Outpatient hospital services (fee schedule) | 5 | $18,006.69 |
| 0415T | Outpatient hospital services (fee schedule) | 5 | $327.35 |
| 0416T | Outpatient hospital services (fee schedule) | 5 | $1,072.14 |
| 0419T | Outpatient hospital services (fee schedule) | 5 | $384.68 |
| 0420T | Outpatient hospital services (fee schedule) | 5 | $384.68 |
| 0422T | Outpatient hospital services (fee schedule) | 5 | $46.53 |
| 0440T | Outpatient hospital services (fee schedule) | 6 | $1,123.38 |
| 0442T | Surgery center facility fee (per procedure) | 6 | $4,349.39 |
| 0524T | Outpatient hospital services (fee schedule) | 6 | $1,185.15 |
| 0525T | Surgery center facility fee (per procedure) | 6 | $5,689.02 |
| 0526T | Outpatient hospital services (fee schedule) | 6 | $3,957.70 |
| 0527T | Surgery center facility fee (per procedure) | 6 | $4,138.36 |
| 0530T | Outpatient hospital services (fee schedule) | 6 | $1,183.80 |
| 0531T | Outpatient hospital services (fee schedule) | 6 | $1,183.80 |
| 0532T | Outpatient hospital services (fee schedule) | 6 | $1,183.80 |
| 0596T | Surgery center facility fee (per procedure) | 5 | $70.30 |
| 0597T | Surgery center facility fee (per procedure) | 5 | $70.30 |
| 0600T | Surgery center facility fee (per procedure) | 5 | $715.00 |
| 0601T | Surgery center facility fee (per procedure) | 5 | $715.00 |
| 0627T | Surgery center facility fee (per procedure) | 5 | $1,369.07 |
| 0629T | Surgery center facility fee (per procedure) | 5 | $1,369.65 |
| 0647T | Surgery center facility fee (per procedure) | 5 | $209.87 |
| 0651T | Surgery center facility fee (per procedure) | 5 | $124.46 |
| 0679T | Surgery center facility fee (per procedure) | 5 | $3,457.91 |
| 0680T | Surgery center facility fee (per procedure) | 5 | $15,111.06 |
| 0681T | Surgery center facility fee (per procedure) | 5 | $1,327.81 |
| 0682T | Surgery center facility fee (per procedure) | 5 | $1,327.81 |
| 0686T | Outpatient hospital services (fee schedule) | 5 | $8,932.05 |
| 0689T | Surgery center facility fee (per procedure) | 6 | $18.33 |
| 0697T | Outpatient hospital services (fee schedule) | 5 | $485.12 |
| 0707T | Surgery center facility fee (per procedure) | 7 | $1,465.66 |
| 0793T | Surgery center facility fee (per procedure) | 5 | $9,781.18 |
| 0817T | Surgery center facility fee (per procedure) | 5 | $3,530.78 |
| 0818T | Surgery center facility fee (per procedure) | 5 | $474.54 |
| 0819T | Surgery center facility fee (per procedure) | 5 | $474.54 |
| 0864T | Surgery center facility fee (per procedure) | 5 | $32.05 |
| 0915T | Outpatient hospital services (fee schedule) | 6 | $19,998.76 |
| 0916T | Outpatient hospital services (fee schedule) | 6 | $15,117.85 |
| 0917T | Outpatient hospital services (fee schedule) | 6 | $5,668.23 |
| 0918T | Outpatient hospital services (fee schedule) | 6 | $5,668.23 |
| 0919T | Outpatient hospital services (fee schedule) | 6 | $1,628.79 |
| 0920T | Outpatient hospital services (fee schedule) | 6 | $1,628.79 |
| 0921T | Outpatient hospital services (fee schedule) | 6 | $1,628.79 |
| 0922T | Outpatient hospital services (fee schedule) | 6 | $1,628.79 |
| 0923T | Outpatient hospital services (fee schedule) | 6 | $15,117.85 |
| 0924T | Outpatient hospital services (fee schedule) | 6 | $271.68 |
| 0925T | Outpatient hospital services (fee schedule) | 6 | $854.93 |
| 0946T | Outpatient hospital services (fee schedule) | 6 | $45.53 |
| 171 | EAPG relative weight (outpatient hospital or surgery center) | 5 | $4.03 |
| 2020 | APG relative weight | 5 | $0.2076 |
| 2030 | APG relative weight | 5 | $0.3167 |
| 2061 | APG relative weight | 6 | $0.3385 |
| 2062 | APG relative weight | 6 | $0.8075 |
| 223 | EAPG relative weight (outpatient hospital or surgery center) | 6 | $7.26 |
| 224 | EAPG relative weight (outpatient hospital or surgery center) | 6 | $18.39 |
| 225 | EAPG relative weight (outpatient hospital or surgery center) | 5 | $5.27 |
| 227 | EAPG relative weight (outpatient hospital or surgery center) | 6 | $4.18 |
| 246 | EAPG relative weight (outpatient hospital or surgery center) | 6 | $27.05 |
| 248 | EAPG relative weight (outpatient hospital or surgery center) | 6 | $4.75 |
| 295 | APG relative weight | 6 | $1.10 |
| 3033 | EAPG relative weight (outpatient hospital or surgery center) | 6 | $5.81 |
| 3035 | EAPG relative weight (outpatient hospital or surgery center) | 5 | $7.36 |
| 337 | APG relative weight | 10 | $9.50 |
| 351 | IHS / tribal outpatient visit (all-inclusive rate) | 11 | $1.59 |
| 359 | IHS / tribal outpatient visit (all-inclusive rate) | 10 | $4.16 |
| 360 | Surgery center facility fee (per procedure) | 10 | $2.98 |
| 361 | Surgery center facility fee (per procedure) | 7 | $6.00 |
| 362 | EAPG relative weight (outpatient hospital or surgery center) | 6 | $3.58 |
| 363 | EAPG relative weight (outpatient hospital or surgery center) | 5 | $3.18 |
| 369 | Surgery center facility fee (per procedure) | 11 | $2.08 |
| 4001 | Outpatient hospital APC relative weight | 5 | $1.40 |
| 401 | Outpatient hospital services (fee schedule) | 6 | $2.04 |
| 403 | Outpatient hospital services (fee schedule) | 7 | $2.00 |
| 423 | IHS / tribal outpatient visit (all-inclusive rate) | 13 | $5.00 |
| 459 | Outpatient hospital services (fee schedule) | 6 | $0.1161 |
| 460 | APG relative weight | 5 | $3.85 |
| 466 | EAPG relative weight (outpatient hospital or surgery center) | 11 | $8.50 |
| 512 | IHS / tribal outpatient visit (all-inclusive rate) | 10 | $2.65 |
| 513 | IHS / tribal outpatient visit (all-inclusive rate) | 9 | $2.00 |
| 519 | IHS / tribal outpatient visit (all-inclusive rate) | 12 | $2.00 |
| 720 | Outpatient hospital services (fee schedule) | 6 | $1.82 |
| 769 | Outpatient hospital services (fee schedule) | 7 | $1.74 |
| 771 | Outpatient facility rate (other rate code) | 6 | $0.5728 |
| 901 | Outpatient hospital services (fee schedule) | 7 | $7.69 |
| 969 | IHS / tribal outpatient visit (all-inclusive rate) | 7 | $12.70 |
| 982 | IHS / tribal outpatient visit (all-inclusive rate) | 7 | $2.76 |
| 987 | IHS / tribal outpatient visit (all-inclusive rate) | 7 | $3.43 |
| C2645 | Brachytherapy planar source, palladium-103 | 11 | $3.49 |
| C7507 | Percutaneous vertebral augmentations | 10 | $5,915.08 |
| C7508 | Percutaneous vertebral augmentations | 10 | $5,915.08 |
| C7517 | Catheter placement in coronary artery(s) for coronary... | 9 | $2,421.93 |
| C7520 | Catheter placement in coronary artery(ies) for coronary... | 5 | $2,412.78 |
| C7562 | Catheter placement in coronary artery(s) for coronary... | 8 | $2,506.44 |
| C7567 | Bronchoscopy, rigid or flexible | 6 | $2,130.67 |
| C7568 | Catheter placement in coronary artery(ies) for coronary... | 6 | $2,370.84 |
| C7569 | Percutaneous transluminal coronary angioplasty | 5 | $5,809.14 |
| C7570 | Catheter placement in coronary artery(s) for coronary... | 5 | $2,421.93 |
| C7571 | Percutaneous transluminal coronary angioplasty | 5 | $5,809.14 |
| C8001 | 3d anatomical segmentation imaging for preoperative... | 8 | $78.40 |
| C8004 | Simulation angiogram with use of a pressure-generating... | 10 | $6,255.34 |
| C8005 | Bronchoscopy, rigid or flexible | 7 | $15,750.45 |
| C8007 | Open implantation of hypoglossal nerve neurostimulator array... | 7 | $21,568.01 |
| C8008 | Revision or replacement of hypoglossal nerve neurostimulator... | 7 | $5,462.04 |
| C8009 | Removal of hypoglossal nerve neurostimulator array and pulse... | 7 | $1,296.54 |
| C8010 | Percutaneous placement of permanent common carotid embolic... | 6 | $7,396.97 |
| C8011 | Open implantation of hypoglossal nerve(s) neurostimulator... | 7 | $21,568.01 |
| C8012 | Revision or replacement of hypoglossal nerve(s)... | 7 | $5,462.04 |
| C8013 | Removal of hypoglossal nerve(s) neurostimulator electrode... | 7 | $1,296.54 |
| C8014 | Cystourethroscopy, with ureteroscopy and/or pyeloscopy | 7 | $2,372.96 |
| C9176 | Tc-99m from domestically produced non-heu mo-99 | 5 | $9.00 |
| C9758 | Blinded procedure for nyha class iii/iv heart failure | 8 | $12,449.99 |
| C9760 | Non-randomized, non-blinded procedure for nyha class ii | 8 | $13,297.21 |
| C9777 | Esophageal mucosal integrity testing by electrical... | 10 | $2,146.72 |
| C9785 | Endoscopic outlet reduction, gastric pouch application | 10 | $4,449.80 |
| G0235 | Pet imaging, any site, not otherwise specified | 7 | $187.41 |
| G0302 | Pre-operative pulmonary surgery services for preparation for... | 7 | $260.82 |
| G0303 | Pre-operative pulmonary surgery services for preparation for... | 7 | $150.92 |
| G0304 | Pre-operative pulmonary surgery services for preparation for... | 7 | $199.39 |
| G0305 | Post-discharge pulmonary surgery services after lvrs | 7 | $199.39 |
| G0390 | Trauma response team associated with hospital critical care... | 6 | $821.93 |
| S0209 | Emergency department APG base rate | 8 | $1.25 |
| T2005 | Emergency department APG base rate | 10 | $35.07 |
Hospital outpatient rates in your statesRates, managed-care rules, Medicare comparison and changes, for the codes you bill.