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Billing code 77047 · Radiology

77047 Medicaid reimbursement rate by state (2026)

Imaging and radiology. Medicaid pays a median of $137.00 for 77047 across 48 states, from $62.87 in Texas to $742.71 in Iowa.

Data as of Oct 5, 202648 statesEvery rate links to its official source

States publishing
48
National median
$137.00units vary by state
Lowest
$62.87Texas
Highest
$742.71Iowa
Answer

What does Medicaid pay for 77047?

48 state Medicaid programs publish a fee-for-service rate for 77047. The national median is $137.00 (units differ between states). Iowa pays the most, $742.71, and Texas the least, $62.87, a 11.8x spread.

Medicare (non-facility, 2026 physician fee schedule): $192.12–$291.78 depending on the state's Medicare locality.

State ranking

77047 rate by state: highest, middle and lowest

One like-for-like fee-for-service rate per state, ranked. The workspace lists all 48 states with every variant, modifier and effective date.

#StateMedicaid rateUnitPer hourManaged-care plans% of Medicare
1Iowa Source · since 2024-07-01$742.71——Plans must pay at least this—
2Nebraska Source · since 2026-07-01$390.72——Plans negotiate; applies out of network—
3Massachusetts Source · since 2026-10-01$236.98——Plans negotiate; applies out of network—
24Delaware Source · since 2026-01-01$139.00——Plans negotiate; applies out of network—
25District of Columbia Source · since 2026-01-01$135.00——Not classified—
26Nevada Source · since 2019-01-01$134.67——Plans must pay at least this—
47Wisconsin Source · since 2019-01-01$63.31——Plans negotiate; applies out of network—
48Texas Source · since 2025-03-01$62.87——Plans negotiate; applies out of network—
See all 48 states for 77047 — start free

40 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 77047 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 77047, 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. 43 of the 48 states list more than one rate for 77047, 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 48 states, 2 publish 77047 per unit, and 46 schedules print no unit at all (a flat amount per service).
  • Per hour. 77047 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 77047, 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 77047 rates differ between states

Published rates for 77047 run from $62.87 in Texas to $742.71 in Iowa, a 11.8x gap in the same unit. Half the states pay more than the median of $137.00 and half pay less. The usual reasons for a spread like this in radiology rates:

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

Timing matters too. 29 states set the current rate for 77047 in 2026 or later, while 11 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 77047

No managed-care plan publishes what it pays for 77047. What is public is the rule each state's plan contracts set, and that rule decides how much the published rate matters when you contract with a plan.

In 8 states, the published rate binds plans: a floor, a pass-through or a state-set rate. In 26 states, plans negotiate and the published rate is a benchmark or out-of-network default. The rule for the remaining 14 states is not classified yet.

  • Plans negotiate; the published rate applies out of network (26 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 (8 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 Iowa managed care.

Billing

Units and billing for 77047

77047 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 $192.12–$291.78 for 77047 (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 77047?

It depends on the state. Of the 48 states with a published fee-for-service rate, the median is $137.00. Iowa pays the most ($742.71) and Texas the least ($62.87).

Which state pays the highest Medicaid rate for 77047?

Iowa, at $742.71, effective 2024-07-01.

Which state pays the lowest Medicaid rate for 77047?

Texas, at $62.87, effective 2025-03-01.

What unit is 77047 billed in?

Of the 48 states, 2 publish 77047 per unit, and 46 schedules print no unit at all (a flat amount per service).

Do managed-care plans pay the same rate for 77047?

Not necessarily. In 8 states, the published rate binds plans: a floor, a pass-through or a state-set rate. In 26 states, plans negotiate and the published rate is a benchmark or out-of-network default. The rule for the remaining 14 states is not classified yet. Each rule is cited to the plan contract, statute or notice in the workspace.