C5275 Medicaid reimbursement rates by state
Application of low cost skin substitute graft to face. 5 state Medicaid programs publish a fee-for-service rate for C5275. Rates run from $176.34 in Utah to $546.91 in Rhode Island, with a median of $317.31.
Data as of 2026-10-05. Every rate links to the official document it came from.
- States publishing
- 5
- Median rate
- $317.31units vary by state
- Highest
- $546.91Rhode Island
- Medicare (non-facility)
- —not on the physician fee schedule
C5275 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 |
|---|---|---|---|---|---|---|
| Rhode IslandAny qualified provider (rate does not vary by provider) · Rhode Island Medicaid (fee-for-service) | $546.91since 2026-07-01 | — | — | Plans negotiate; applies out of network | — | RI APC (Outpatient) Fee Schedule, as of |
| New MexicoAny qualified provider (rate does not vary by provider) · New Mexico Medicaid (fee-for-service, HCA Medical Assistance Division) | $379.75since 2014-01-01 | — | — | Plans must pay at least this | — | OPPS Codes (NM Medicaid Hospital Outpati |
| KentuckyAny qualified provider (rate does not vary by provider) · Kentucky Medicaid (fee-for-service, DMS fee schedules) | $317.31since 2025-01-01 | — | — | Plans negotiate; applies out of network | — | KY Medicaid ASC fee schedule (2025ASCFee |
| MassachusettsAny qualified provider (rate does not vary by provider) · MassHealth (fee-for-service, EOHHS 101 CMR rate regulations) | $213.47since 2026-05-01 | — | — | Plans negotiate; applies out of network | — | Rates for Freestanding Ambulatory Surger |
| UtahAny qualified provider (rate does not vary by provider) · Utah Medicaid (fee-for-service, Traditional plan) | $176.34since 2025-07-01 | — | — | Plans negotiate; applies out of network | — | Utah Medicaid Coverage and Reimbursement |
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 C5275?
It depends on the state. Of the 5 states with a published fee-for-service rate, the median is $317.31. Rhode Island pays the most ($546.91) and Utah the least ($176.34).
Which state pays the highest Medicaid rate for C5275?
Rhode Island, at $546.91, effective 2026-07-01.
Do managed-care plans pay the same rate for C5275?
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.