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Billing code 73719 · Radiology

73719 Medicaid reimbursement rate by state (2026)

Imaging and radiology. Medicaid pays a median of $199.34 for 73719 across 49 states, from $63.71 in Texas to $515.31 in Georgia.

Data as of Oct 5, 202649 statesEvery rate links to its official source

States publishing
49
National median
$199.34units vary by state
Lowest
$63.71Texas
Highest
$515.31Georgia
Answer

What does Medicaid pay for 73719?

49 state Medicaid programs publish a fee-for-service rate for 73719. The national median is $199.34 (units differ between states). Georgia pays the most, $515.31, and Texas the least, $63.71, a 8.1x spread.

Medicare (non-facility, 2026 physician fee schedule): $230.54–$355.79 depending on the state's Medicare locality.

State ranking

73719 rate by state: highest, middle and lowest

One like-for-like fee-for-service rate per state, ranked. The workspace lists all 49 states with every variant, modifier and effective date.

#StateMedicaid rateUnitPer hourManaged-care plans% of Medicare
1Georgia Source · since 2017-01-01$515.31——Plans negotiate; applies out of network—
2Arkansas Source · since 2025-06-13$514.92——Not classified—
3Nebraska Source · since 2026-07-01$469.27——Plans negotiate; applies out of network—
24Minnesota Source · since 2026-02-01$203.78——Plans negotiate; applies out of network—
25Maryland Source · since 2026-01-01$199.34——Not classified—
26Utah Source · since 2026-07-01$192.74——Plans negotiate; applies out of network—
48District of Columbia Source · since 2026-01-01$64.50——Not classified—
49Texas Source · since 2025-03-01$63.71——Plans negotiate; applies out of network—
See all 49 states for 73719 — start free

41 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.

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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 73719 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 73719, 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. 45 of the 49 states list more than one rate for 73719, 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. Of the 49 states, 2 publish 73719 per unit, and 47 schedules print no unit at all (a flat amount per service).
  • Per hour. 73719 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. Medicare amounts exist for 73719, but no state's Medicaid unit matches Medicare's billing unit closely enough to compute a percentage.
  • Source and date. Each Source link opens the state's own document; “since” is the date the rate took effect.
Context

Why 73719 rates differ between states

Published rates for 73719 run from $63.71 in Texas to $515.31 in Georgia, a 8.1x gap in the same unit. Half the states pay more than the median of $199.34 and half pay less. The usual reasons for a spread like this in radiology rates:

  • Some states pay hospitals for the technical component through an outpatient system and pay only the professional component from the physician schedule.
  • States that benchmark imaging to Medicare use different percentages and different Medicare years.
  • Advanced imaging such as CT, MRI and PET is often under separate pricing and prior-authorization policies that vary from state to state.

Timing matters too. 31 states set the current rate for 73719 in 2026 or later, while 8 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 73719

What a plan pays for 73719 is negotiated privately, but the state decides how much room there is to negotiate. Here is how the rules break down across the 49 states.

In 9 states, the published rate binds plans: a floor, a pass-through or a state-set rate. In 25 states, plans negotiate and the published rate is a benchmark or out-of-network default. The rule for the remaining 15 states is not classified yet.

  • Plans negotiate; the published rate applies out of network (25 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 (9 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 73719

73719 is a CPT radiology code in the radiology line, billed mostly by radiology groups, imaging centers and hospitals. Imaging codes are paid per study and split into a professional component (the reading, modifier 26) and a technical component (the equipment and staff, modifier TC). A global amount covers both.

Imaging is billed per study, with modifier 26 for the professional component and TC for the technical component; a claim without either is paid at the global amount where the state publishes one. Contrast agents and radiopharmaceuticals are usually billed separately under their own codes.

Medicare's 2026 physician fee schedule pays $230.54–$355.79 for 73719 (non-facility), depending on the Medicare locality. That is a useful reference point, but Medicare and Medicaid can define the unit differently, so compare only where the units match.

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 73719?

It depends on the state. Of the 49 states with a published fee-for-service rate, the median is $199.34. Georgia pays the most ($515.31) and Texas the least ($63.71).

Which state pays the highest Medicaid rate for 73719?

Georgia, at $515.31, effective 2017-01-01.

Which state pays the lowest Medicaid rate for 73719?

Texas, at $63.71, effective 2025-03-01.

What unit is 73719 billed in?

Of the 49 states, 2 publish 73719 per unit, and 47 schedules print no unit at all (a flat amount per service).

Do managed-care plans pay the same rate for 73719?

Not necessarily. In 9 states, the published rate binds plans: a floor, a pass-through or a state-set rate. In 25 states, plans negotiate and the published rate is a benchmark or out-of-network default. The rule for the remaining 15 states is not classified yet. Each rule is cited to the plan contract, statute or notice in the workspace.