Q4125 Medicaid reimbursement rates by state
Arthroflex, per square centimeter (add-on. 6 state Medicaid programs publish a fee-for-service rate for Q4125. Rates run from $50.55 in Indiana to $127.26 in South Dakota, with a median of $82.32.
Data as of 2026-10-05. Every rate links to the official document it came from.
- States publishing
- 6
- Median rate
- $82.32units vary by state
- Highest
- $127.26South Dakota
- Medicare (non-facility)
- $116.19–$149.912026 physician fee schedule
Q4125 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 |
|---|---|---|---|---|---|---|
| South DakotaAny qualified provider (rate does not vary by provider) · South Dakota Medicaid (fee-for-service, DSS Division of Medical Services) | $127.26since 2026-01-01 | — | — | Not classified | — | South Dakota Medicaid Physician fee sche |
| District of ColumbiaAny qualified provider (rate does not vary by provider) · DC Medicaid (DHCF) fee-for-service | $119.93since 2026-01-01 | — | — | Not classified | — | REFRP00178CSV - Medical Fee Schedule Rep |
| South CarolinaAny qualified provider (rate does not vary by provider) · South Carolina Healthy Connections Medicaid (fee-for-service) | $83.49since 2026-01-01 | — | — | Not classified | — | SCDHHS Pediatric Subspecialty and Neonat |
| MichiganAny qualified provider (rate does not vary by provider) · Michigan Medicaid (fee-for-service) | $81.15since 2026-01-01 | — | — | Plans negotiate; applies out of network | — | MDHHS Oral Maxillofacial Surgeon Fee Sch |
| New HampshireAny qualified provider (rate does not vary by provider) · New Hampshire Medicaid (fee-for-service, DHHS / NH MMIS) | $79.48since 2026-04-01 | — | — | Plans negotiate; applies out of network | — | 2026 Fee Schedule - Covered Procedures R |
| IndianaAny qualified provider (rate does not vary by provider) · Indiana Medicaid (fee-for-service) | $50.55since 2026-01-01 | unit | — | Plans must pay at least this | — | IHCP Professional Fee Schedule (Last Upd |
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 Q4125?
It depends on the state. Of the 6 states with a published fee-for-service rate, the median is $82.32. South Dakota pays the most ($127.26) and Indiana the least ($50.55 per unit).
Which state pays the highest Medicaid rate for Q4125?
South Dakota, at $127.26, effective 2026-01-01.
Do managed-care plans pay the same rate for Q4125?
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.