Hospital outpatient Medicaid rates by code
171 hospital outpatient codes with published Medicaid rates in five or more states. Each page compares every state's rate, unit and managed-care rule.
| Code | Service | States | Median rate |
|---|---|---|---|
| 0261 | Outpatient hospital services (fee schedule) | 5 | $1.84 |
| 0271 | Outpatient hospital services (fee schedule) | 5 | $2.66 |
| 0272 | Outpatient hospital services (fee schedule) | 5 | $2.66 |
| 0274T | Surgery center facility fee (per procedure) | 8 | $2,692.74 |
| 0291 | Outpatient hospital services (fee schedule) | 5 | $1.00 |
| 0292 | Outpatient hospital (percent of charges or cost) | 5 | $0.7116 |
| 0293 | Outpatient hospital (percent of charges or cost) | 5 | $0.6574 |
| 0331T | Surgery center facility fee (per procedure) | 7 | $374.67 |
| 0332T | Surgery center facility fee (per procedure) | 7 | $374.67 |
| 0335T | Surgery center facility fee (per procedure) | 7 | $3,038.40 |
| 0342T | Outpatient hospital services (fee schedule) | 7 | $2,270.45 |
| 0409T | Outpatient hospital services (fee schedule) | 7 | $11,427.08 |
| 0410T | Surgery center facility fee (per procedure) | 7 | $4,265.23 |
| 0414T | Outpatient hospital services (fee schedule) | 7 | $11,483.76 |
| 0419T | Outpatient hospital services (fee schedule) | 7 | $384.68 |
| 0422T | Outpatient hospital services (fee schedule) | 7 | $46.53 |
| 0450 | Outpatient hospital services (fee schedule) | 5 | $4.98 |
| 0451 | Outpatient hospital services (fee schedule) | 5 | $1.80 |
| 0471 | Outpatient hospital services (fee schedule) | 5 | $3.56 |
| 0472 | Outpatient hospital services (fee schedule) | 5 | $1.37 |
| 0481 | Outpatient hospital (percent of charges or cost) | 5 | $1.44 |
| 0482 | Outpatient hospital services (fee schedule) | 5 | $1.74 |
| 0510 | Outpatient hospital services (fee schedule) | 5 | $2.88 |
| 0519T | Surgery center facility fee (per procedure) | 7 | $3,130.53 |
| 0558T | Outpatient hospital services (fee schedule) | 5 | $7.56 |
| 0621T | Surgery center facility fee (per procedure) | 7 | $1,900.58 |
| 0632T | Surgery center facility fee (per procedure) | 7 | $6,689.42 |
| 0645T | Surgery center facility fee (per procedure) | 6 | $2,340.08 |
| 0651T | Surgery center facility fee (per procedure) | 7 | $359.64 |
| 0656T | Surgery center facility fee (per procedure) | 6 | $3,726.89 |
| 0657T | Surgery center facility fee (per procedure) | 6 | $3,726.89 |
| 0679T | Surgery center facility fee (per procedure) | 7 | $3,457.91 |
| 0680T | Surgery center facility fee (per procedure) | 7 | $8,932.63 |
| 0681T | Surgery center facility fee (per procedure) | 7 | $1,327.81 |
| 0682T | Surgery center facility fee (per procedure) | 7 | $1,327.81 |
| 0697T | Outpatient hospital services (fee schedule) | 8 | $384.27 |
| 0698T | Outpatient hospital services (fee schedule) | 6 | $491.80 |
| 0790T | Surgery center facility fee (per procedure) | 6 | $3,726.89 |
| 0793T | Surgery center facility fee (per procedure) | 8 | $7,465.97 |
| 0870T | Outpatient hospital services (fee schedule) | 5 | $23,256.72 |
| 0871T | Outpatient hospital services (fee schedule) | 5 | $18,273.21 |
| 0872T | Surgery center facility fee (per procedure) | 6 | $1,069.74 |
| 0915T | Outpatient hospital services (fee schedule) | 9 | $14,732.73 |
| 0916T | Outpatient hospital services (fee schedule) | 9 | $11,483.76 |
| 0917T | Outpatient hospital services (fee schedule) | 9 | $4,265.23 |
| 0918T | Outpatient hospital services (fee schedule) | 9 | $4,265.23 |
| 0919T | Outpatient hospital services (fee schedule) | 9 | $1,269.99 |
| 0920T | Outpatient hospital services (fee schedule) | 9 | $1,269.99 |
| 0921T | Outpatient hospital services (fee schedule) | 9 | $1,269.99 |
| 0922T | Outpatient hospital services (fee schedule) | 9 | $1,269.99 |
| 0923T | Outpatient hospital services (fee schedule) | 9 | $11,483.76 |
| 0924T | Outpatient hospital services (fee schedule) | 9 | $216.00 |
| 0925T | Outpatient hospital services (fee schedule) | 9 | $637.71 |
| 0946T | Outpatient hospital services (fee schedule) | 9 | $36.86 |
| 106 | EAPG relative weight (outpatient hospital or surgery center) | 5 | $14.07 |
| 107 | APG relative weight | 5 | $5.98 |
| 127 | APG relative weight | 5 | $3.38 |
| 128 | EAPG relative weight (outpatient hospital or surgery center) | 5 | $6.67 |
| 129 | EAPG relative weight (outpatient hospital or surgery center) | 5 | $8.60 |
| 171 | EAPG relative weight (outpatient hospital or surgery center) | 7 | $4.03 |
| 2016 | APG relative weight | 5 | $0.0646 |
| 2020 | APG relative weight | 6 | $0.2208 |
| 2030 | APG relative weight | 6 | $0.3021 |
| 2044 | EAPG relative weight (outpatient hospital or surgery center) | 6 | $0.8865 |
| 2061 | APG relative weight | 7 | $0.2447 |
| 2062 | Outpatient hospital services (fee schedule) | 9 | $0.6151 |
| 2070 | Outpatient hospital services (fee schedule) | 7 | $0.0957 |
| 2071 | Outpatient hospital services (fee schedule) | 8 | $0.1985 |
| 2072 | Outpatient hospital services (fee schedule) | 8 | $0.1028 |
| 223 | EAPG relative weight (outpatient hospital or surgery center) | 8 | $7.26 |
| 224 | EAPG relative weight (outpatient hospital or surgery center) | 8 | $18.39 |
| 225 | EAPG relative weight (outpatient hospital or surgery center) | 6 | $5.66 |
| 227 | EAPG relative weight (outpatient hospital or surgery center) | 8 | $4.18 |
| 237 | EAPG relative weight (outpatient hospital or surgery center) | 5 | $1.81 |
| 238 | APG relative weight | 5 | $5.32 |
| 246 | EAPG relative weight (outpatient hospital or surgery center) | 8 | $27.05 |
| 248 | EAPG relative weight (outpatient hospital or surgery center) | 8 | $4.75 |
| 295 | APG relative weight | 7 | $0.7898 |
| 3011 | EAPG relative weight (outpatient hospital or surgery center) | 5 | $14.46 |
| 3030 | APG relative weight | 5 | $20.21 |
| 3033 | EAPG relative weight (outpatient hospital or surgery center) | 7 | $5.86 |
| 3035 | EAPG relative weight (outpatient hospital or surgery center) | 6 | $7.33 |
| 3050 | EAPG relative weight (outpatient hospital or surgery center) | 6 | $8.26 |
| 3051 | EAPG relative weight (outpatient hospital or surgery center) | 6 | $19.38 |
| 3052 | EAPG relative weight (outpatient hospital or surgery center) | 6 | $12.32 |
| 361 | Surgery center facility fee (per procedure) | 10 | $4.40 |
| 362 | EAPG relative weight (outpatient hospital or surgery center) | 9 | $3.22 |
| 363 | EAPG relative weight (outpatient hospital or surgery center) | 7 | $3.18 |
| 365 | APG relative weight | 5 | $0.4259 |
| 366 | APG relative weight | 5 | $0.5074 |
| 367 | EAPG relative weight (outpatient hospital or surgery center) | 5 | $2.07 |
| 396 | APG relative weight | 5 | $0.0134 |
| 4001 | Outpatient hospital APC relative weight | 5 | $1.40 |
| 401 | Outpatient hospital services (fee schedule) | 8 | $0.5389 |
| 403 | Outpatient hospital services (fee schedule) | 10 | $1.50 |
| 459 | Outpatient hospital services (fee schedule) | 7 | $0.0827 |
| 460 | APG relative weight | 6 | $3.00 |
| 526 | EAPG relative weight (outpatient hospital or surgery center) | 5 | $0.4308 |
| 527 | APG relative weight | 5 | $0.22 |
| 586 | APG relative weight | 5 | $0.3322 |
| 587 | EAPG relative weight (outpatient hospital or surgery center) | 5 | $0.7727 |
| 610 | APG relative weight | 5 | $0.4219 |
| 647 | EAPG relative weight (outpatient hospital or surgery center) | 5 | $0.4645 |
| 648 | EAPG relative weight (outpatient hospital or surgery center) | 5 | $0.5366 |
| 649 | EAPG relative weight (outpatient hospital or surgery center) | 5 | $0.4645 |
| 676 | APG relative weight | 5 | $0.2503 |
| 720 | Outpatient hospital services (fee schedule) | 9 | $1.00 |
| 721 | Outpatient hospital services (fee schedule) | 8 | $0.7308 |
| 762 | EAPG relative weight (outpatient hospital or surgery center) | 5 | $0.6467 |
| 763 | EAPG relative weight (outpatient hospital or surgery center) | 6 | $0.6661 |
| 764 | APG relative weight | 6 | $0.3587 |
| 765 | Outpatient hospital services (fee schedule) | 6 | $0.6057 |
| 766 | APG relative weight | 5 | $0.2779 |
| 767 | Outpatient hospital services (fee schedule) | 6 | $0.7199 |
| 771 | Outpatient hospital services (fee schedule) | 8 | $0.5846 |
| 772 | Outpatient hospital services (fee schedule) | 6 | $1.51 |
| 777 | Outpatient hospital services (fee schedule) | 6 | $0.5336 |
| 781 | Outpatient hospital services (fee schedule) | 6 | $0.3735 |
| 852 | Outpatient hospital services (fee schedule) | 6 | $0.4686 |
| 861 | Outpatient hospital services (fee schedule) | 8 | $0.8286 |
| 874 | Outpatient hospital services (fee schedule) | 6 | $0.3168 |
| 877 | Outpatient hospital services (fee schedule) | 6 | $0.3443 |
| 878 | Outpatient hospital services (fee schedule) | 6 | $0.2753 |
| 879 | Outpatient hospital services (fee schedule) | 6 | $0.3749 |
| 900 | Outpatient hospital services (fee schedule) | 6 | $0.2539 |
| C2645 | Brachytherapy planar source, palladium-103 | 16 | $3.53 |
| C5271 | Application of low cost skin substitute graft to trunk | 5 | $317.31 |
| C5273 | Application of low cost skin substitute graft to trunk | 5 | $948.27 |
| C5275 | Application of low cost skin substitute graft to face | 5 | $317.31 |
| C5277 | Application of low cost skin substitute graft to face | 5 | $317.31 |
| C7507 | Percutaneous vertebral augmentations | 13 | $5,787.61 |
| C7508 | Percutaneous vertebral augmentations | 12 | $5,915.08 |
| C7517 | Catheter placement in coronary artery(s) for coronary... | 12 | $2,199.85 |
| C7520 | Catheter placement in coronary artery(ies) for coronary... | 6 | $2,216.82 |
| C7562 | Catheter placement in coronary artery(s) for coronary... | 11 | $2,421.93 |
| C7567 | Bronchoscopy, rigid or flexible | 10 | $1,747.59 |
| C7568 | Catheter placement in coronary artery(ies) for coronary... | 10 | $1,944.57 |
| C7569 | Percutaneous transluminal coronary angioplasty | 9 | $3,764.30 |
| C7570 | Catheter placement in coronary artery(s) for coronary... | 9 | $1,569.40 |
| C7571 | Percutaneous transluminal coronary angioplasty | 9 | $3,764.30 |
| C8001 | 3d anatomical segmentation imaging for preoperative... | 11 | $88.05 |
| C8004 | Simulation angiogram with use of a pressure-generating... | 15 | $5,253.02 |
| C8005 | Bronchoscopy, rigid or flexible | 9 | $15,407.10 |
| C8007 | Open implantation of hypoglossal nerve neurostimulator array... | 12 | $22,212.20 |
| C8008 | Revision or replacement of hypoglossal nerve neurostimulator... | 12 | $5,910.94 |
| C8009 | Removal of hypoglossal nerve neurostimulator array and pulse... | 12 | $1,574.32 |
| C8010 | Percutaneous placement of permanent common carotid embolic... | 10 | $7,396.97 |
| C8011 | Open implantation of hypoglossal nerve(s) neurostimulator... | 12 | $22,212.20 |
| C8012 | Revision or replacement of hypoglossal nerve(s)... | 12 | $5,910.94 |
| C8013 | Removal of hypoglossal nerve(s) neurostimulator electrode... | 12 | $1,574.32 |
| C8014 | Cystourethroscopy, with ureteroscopy and/or pyeloscopy | 10 | $2,620.38 |
| C9176 | Tc-99m from domestically produced non-heu mo-99 | 9 | $8.80 |
| C9758 | Blinded procedure for nyha class iii/iv heart failure | 13 | $12,399.48 |
| C9760 | Non-randomized, non-blinded procedure for nyha class ii | 13 | $12,558.47 |
| C9777 | Esophageal mucosal integrity testing by electrical... | 16 | $1,927.22 |
| C9785 | Endoscopic outlet reduction, gastric pouch application | 15 | $4,352.43 |
| D0371 | Outpatient hospital services (fee schedule) | 5 | $0.9726 |
| D2410 | Outpatient hospital services (fee schedule) | 5 | $7.23 |
| D2420 | Outpatient hospital services (fee schedule) | 5 | $7.23 |
| D2430 | Outpatient hospital services (fee schedule) | 5 | $7.23 |
| D3431 | Outpatient hospital services (fee schedule) | 5 | $7.23 |
| G0235 | Pet imaging, any site, not otherwise specified | 11 | $209.32 |
| G0302 | Pre-operative pulmonary surgery services for preparation for... | 11 | $289.74 |
| G0303 | Pre-operative pulmonary surgery services for preparation for... | 11 | $167.66 |
| G0304 | Pre-operative pulmonary surgery services for preparation for... | 11 | $224.92 |
| G0305 | Post-discharge pulmonary surgery services after lvrs | 11 | $224.92 |
| G0390 | Trauma response team associated with hospital critical care... | 8 | $971.94 |
| G0555 | Provision of replacement patient electronics system (e.g. | 7 | $600.22 |
| G0680 | Detection and quantification of coronary artery calcium... | 5 | $15.50 |
| S0209 | Emergency department APG base rate | 12 | $1.28 |
| T2005 | Emergency department APG base rate | 15 | $40.53 |
Hospital outpatient rates in your statesRates, managed-care rules, Medicare comparison and changes, for the codes you bill.