The Rates plan
$29/mo7-day free trialThis page shows one representative rate per state for 01402. Full schedules include every locality, modifier, and age-band variant.
- Every code on all 51 published schedules
- Full-schedule CSV export
- Full state Medicaid dental network lists
- Email alerts when a state changes its rates
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Publishing states
11
Median % of Medicare
--
Rate range
$7.00 - $158.90
01402 rates in every publishing state
| State | Medicaid rate | % of Medicare | Prior auth | Vintage |
|---|---|---|---|---|
| Arizona | $32.12 | -- | -- | 2026 |
| California | $88.54 | -- | -- | 2026 |
| Colorado | $21.45 | -- | -- | 2026 |
| Delaware | $20.51 | -- | -- | 2026 |
| Hawaii | $22.80 | -- | -- | 2025 |
| Missouri | $90.86* | -- | Not required | 2025 |
| Montana | $7.00 | -- | -- | 2026 |
| Oklahoma | $37.75 | -- | -- | 2026 |
| South Carolina | $18.32* | -- | -- | 2026 |
| Vermont | $127.05 | -- | -- | 2002 |
| West Virginia | $158.90 | -- | -- | 2026 |
Published Medicaid fee-for-service schedule amounts, not a coverage or eligibility guarantee. Managed-care plan rates can differ. Where no prior-authorization flag is shown, the state does not publish one. Rows marked * are representative published variants or methodology-derived rates. "--" in the prior-auth column means the state publishes no PA flag.
Related anesthesia codes
Frequently asked questions
How much does Medicaid pay for 01402?
11 state Medicaid programs publish a fee-for-service rate for 01402 (anesthesia for total knee replacement), ranging from $7.00 in Montana to $158.90 in West Virginia. The full table on this page lists every publishing state's current rate.
Which state pays the most for 01402?
West Virginia publishes the highest Medicaid rate for 01402 at $158.90. Montana publishes the lowest at $7.00.
Does 01402 require prior authorization under Medicaid?
No publishing state flags 01402 with a prior-authorization indicator on its fee schedule. Absence of a flag means the state publishes none, not that PA is never required - confirm through the state's provider manual.