0332T Medicaid reimbursement rate by state (2026)
Surgery center facility fee (per procedure). Medicaid pays a median of $374.67 for 0332T across 7 states, from $14.47 in Iowa to $718.90 in Delaware.
- States publishing
- 7
- National median
- $374.67units vary by state
- Lowest
- $14.47Iowa
- Highest
- $718.90Delaware
What does Medicaid pay for 0332T?
7 state Medicaid programs publish a fee-for-service rate for 0332T. The national median is $374.67 (units differ between states). Delaware pays the most, $718.90, and Iowa the least, $14.47, a 49.7x spread.
0332T rate by state: highest, middle and lowest
One like-for-like fee-for-service rate per state, ranked. The workspace lists all 7 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 0332T, 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. 2 of the 7 states list more than one rate for 0332T, 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 7 schedules prints a separate unit for 0332T, so each amount is a flat payment for one service as the code defines it.
- Per hour. 0332T 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 0332T, 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 0332T rates differ between states
Published rates for 0332T run from $14.47 in Iowa to $718.90 in Delaware, a 49.7x gap in the same unit. Half the states pay more than the median of $374.67 and half pay less. The usual reasons for a spread like this in hospital outpatient rates:
- Many outpatient amounts are hospital-specific or adjusted by hospital type.
- States pay outpatient hospital care under different systems: grouped payments, a fee schedule or a percentage of charges.
Timing matters too. 6 states set the current rate for 0332T in 2026 or later, while 1 state 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 0332T
What a plan pays for 0332T is negotiated privately, but the state decides how much room there is to negotiate. Here is how the rules break down across the 7 states.
In 2 states, the published rate binds plans: a floor, a pass-through or a state-set rate. In 3 states, plans negotiate and the published rate is a benchmark or out-of-network default. The rule for the remaining 2 states is not classified yet.
- Plans negotiate; the published rate applies out of network (3 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 Delaware managed care.
Units and billing for 0332T
0332T is a CPT Category III code in the hospital outpatient line, billed mostly by hospital outpatient departments. Category III codes are temporary codes for emerging technology. Payers often price them case by case, so fewer states publish a fixed fee.
Outpatient services are billed per procedure, and some systems package lower-cost items into the payment for the main service.
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 0332T?
It depends on the state. Of the 7 states with a published fee-for-service rate, the median is $374.67. Delaware pays the most ($718.90) and Iowa the least ($14.47).
Which state pays the highest Medicaid rate for 0332T?
Delaware, at $718.90, effective 2026-01-01.
Which state pays the lowest Medicaid rate for 0332T?
Iowa, at $14.47, effective 2026-01-01.
What unit is 0332T billed in?
None of the 7 schedules prints a separate unit for 0332T, so each amount is a flat payment for one service as the code defines it.
Do managed-care plans pay the same rate for 0332T?
Not necessarily. In 2 states, the published rate binds plans: a floor, a pass-through or a state-set rate. In 3 states, plans negotiate and the published rate is a benchmark or out-of-network default. The rule for the remaining 2 states is not classified yet. Each rule is cited to the plan contract, statute or notice in the workspace.