0657T Medicaid reimbursement rates by state
Surgery center facility fee (per procedure). 6 state Medicaid programs publish a fee-for-service rate for 0657T. Rates run from $195.96 in South Dakota to $13,236.53 in Arkansas, with a median of $3,726.89.
Data as of 2026-10-05. Every rate links to the official document it came from.
- States publishing
- 6
- Median rate
- $3,726.89units vary by state
- Highest
- $13,236.53Arkansas
- Medicare (non-facility)
- —not on the physician fee schedule
0657T 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 |
|---|---|---|---|---|---|---|
| ArkansasAny qualified provider (rate does not vary by provider) · Arkansas Medicaid (fee-for-service) | $13,236.53since 2026-01-01 | — | — | Not classified | — | Arkansas Medicaid CY2026 Ambulatory Surg |
| DelawareAny qualified provider (rate does not vary by provider) · Delaware Medicaid (fee-for-service, DMMA / DMAP) | $8,872.01since 2026-01-01 | — | — | Plans negotiate; applies out of network | — | DMAP 2026 ASC Fee Schedule |
| UtahAny qualified provider (rate does not vary by provider) · Utah Medicaid (fee-for-service, Traditional plan) | $7,257.82since 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) | $195.96since 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) | $195.96since 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) | $195.96since 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 0657T?
It depends on the state. Of the 6 states with a published fee-for-service rate, the median is $3,726.89. Arkansas pays the most ($13,236.53) and South Dakota the least ($195.96).
Which state pays the highest Medicaid rate for 0657T?
Arkansas, at $13,236.53, effective 2026-01-01.
Do managed-care plans pay the same rate for 0657T?
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.