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Billing code 77523 · Radiology

77523 Medicaid reimbursement rate by state (2026)

Imaging and radiology. Medicaid pays a median of $767.60 for 77523 across 34 states, from $0.90 in Virginia to $2,632.50 in Alabama.

Data as of Oct 5, 202634 statesEvery rate links to its official source

States publishing
34
National median
$767.60units vary by state
Lowest
$0.90Virginia
Highest
$2,632.50Alabama
Answer

What does Medicaid pay for 77523?

34 state Medicaid programs publish a fee-for-service rate for 77523. The national median is $767.60 (units differ between states). Alabama pays the most, $2,632.50, and Virginia the least, $0.90, a 2925.0x spread.

State ranking

77523 rate by state: highest, middle and lowest

One like-for-like fee-for-service rate per state, ranked. The workspace lists all 34 states with every variant, modifier and effective date.

#StateMedicaid rateUnitPer hourManaged-care plans% of Medicare
1Alabama Source · since 2026-04-10$2,632.50——Not classified—
2Illinois Source · since 2013-06-01$1,351.50——Plans negotiate; applies out of network—
3New Mexico Source · since 2025-01-01$1,144.64——Plans must pay at least this—
17West Virginia Source · since 2026-04-01$772.64——Plans negotiate; applies out of network—
18Indiana Source · since 2026-01-01$762.56unit—Plans must pay at least this—
19Hawaii Source · since 2026-06-01$746.92——Plans negotiate; applies out of network—
33Louisiana Source · since 2012-07-01$16.45——Plans must pay at least this—
34Virginia Source · since 2011-07-01$0.90——Plans negotiate; applies out of network—
See all 34 states for 77523 — start free

26 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 77523 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 77523, 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. 19 of the 34 states list more than one rate for 77523, 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 34 states, 1 publish 77523 per unit, and 33 schedules print no unit at all (a flat amount per service).
  • Per hour. 77523 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 77523, 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.
Context

Why 77523 rates differ between states

Published rates for 77523 run from $0.90 in Virginia to $2,632.50 in Alabama, a 2925.0x gap in the same unit. Half the states pay more than the median of $767.60 and half pay less. The usual reasons for a spread like this in radiology rates:

  • 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.
  • Imaging fees are split into a professional component (the reading) and a technical component (the equipment and staff), and states publish one, the other or a global amount.

Timing matters too. 12 states set the current rate for 77523 in 2026 or later, while 12 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 77523

What a plan pays for 77523 is negotiated privately, but the state decides how much room there is to negotiate. Here is how the rules break down across the 34 states.

In 8 states, the published rate binds plans: a floor, a pass-through or a state-set rate. In 16 states, plans negotiate and the published rate is a benchmark or out-of-network default. The rule for the remaining 10 states is not classified yet.

  • Plans negotiate; the published rate applies out of network (16 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 Alabama managed care.

Billing

Units and billing for 77523

77523 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.

Contrast agents and radiopharmaceuticals are usually billed separately under their own codes. 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.

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 77523?

It depends on the state. Of the 34 states with a published fee-for-service rate, the median is $767.60. Alabama pays the most ($2,632.50) and Virginia the least ($0.90).

Which state pays the highest Medicaid rate for 77523?

Alabama, at $2,632.50, effective 2026-04-10.

Which state pays the lowest Medicaid rate for 77523?

Virginia, at $0.90, effective 2011-07-01.

What unit is 77523 billed in?

Of the 34 states, 1 publish 77523 per unit, and 33 schedules print no unit at all (a flat amount per service).

Do managed-care plans pay the same rate for 77523?

Not necessarily. In 8 states, the published rate binds plans: a floor, a pass-through or a state-set rate. In 16 states, plans negotiate and the published rate is a benchmark or out-of-network default. The rule for the remaining 10 states is not classified yet. Each rule is cited to the plan contract, statute or notice in the workspace.