Surgery center payment group rate: Medicaid rates by state
7 states publish a Medicaid rate for surgery center payment group rate. The median is —; rates range from $300.00 in District of Columbia to $1,735.05 in Alaska.
- States
- 7
- Median
- —
- Highest
- $1,735.05Alaska
- Lowest
- $300.00District of Columbia
- Rates on file
- 930
Surgery center payment group rate: highest and lowest states
Headline rate per state for the same provider level, as published.
How surgery center payment group rate is compared
A billing code alone doesn't make a fair comparison: states bill surgery center payment group rate under different codes, units and provider types. This benchmark lines up one comparable rate per state.
- Provider level. States are compared at the same provider level wherever the schedule distinguishes one. Rates for other levels on file (any qualified provider) are kept separate, never mixed into this ranking.
- Unit. Of the 7 states, 1 publish their headline rate per per group basis and 1 per procedure, and 5 schedules print no unit at all (a flat amount per service). The ranking uses the rate as published, so read the unit before comparing two states.
- Variants. 7 of the 7 states publish more than one rate for this service (by modifier, program, setting or provider type); the headline rate is the one that matches the comparison, and the workspace lists every variant.
- Depth. 930 rates for this service are on file across all states, versions and provider levels; this page shows one headline rate per state.
Why surgery center payment group rate rates differ between states
The highest-paying state, Alaska, pays $1,735.05; the lowest, District of Columbia, pays $300.00, a 5.8x gap. 7 of the 7 states pay above the median of —. Common reasons rates for hospital outpatient services spread this way:
- Many outpatient amounts are hospital-specific or adjusted by hospital type.
- States pay outpatient hospital care under different systems: grouped payments, a fee schedule or a percentage of charges.
Billing notes
Outpatient services are billed per procedure, and some systems package lower-cost items into the payment for the main service.
Frequently asked questions
Which state pays the most for surgery center payment group rate?
Alaska: $1,735.05 per per group basis.
Which state pays the least for surgery center payment group rate?
District of Columbia: $300.00.
What is the average Medicaid rate for surgery center payment group rate?
Across 7 states the median is —, comparing the same provider level in each state. 7 states pay above it.
How are the states compared?
One headline rate per state, matched on the service and provider level, as published. Rates for other provider levels and add-ons are not mixed in.
What unit is surgery center payment group rate billed in?
Of the 7 states, 1 publish it per per group basis and 1 per procedure, and 5 schedules print no unit at all (a flat amount per service).
Do managed-care plans pay these rates?
It depends on the state. Each state's managed-care page shows whether plans must pay at least the published rate, follow a state-set rate, or negotiate their own for this service line.