The Rates plan
$29/mo7-day free trialThis page shows one representative rate per state for 11954. Full schedules include every locality, modifier, and age-band variant.
- Every code on all 51 published schedules
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Publishing states
26
Median % of Medicare
74.2%
Rate range
$34.71 - $187.00
11954 rates in every publishing state
| State | Medicaid rate | % of Medicare | Prior auth | Vintage |
|---|---|---|---|---|
| Arkansas | $96.95* | 95% | -- | 2026 |
| Colorado | $136.93 | 79% | Required | 2026 |
| Connecticut | $101.41 | 58.5% | Required | 2026 |
| Delaware | $167.83 | 96.8% | -- | 2026 |
| Hawaii | $111.53 | 64.3% | -- | 2025 |
| Iowa | $107.81 | 62.2% | -- | 2024 |
| Illinois | $74.91 | 43.2% | -- | 2024 |
| Kentucky | $88.88 | 51.3% | Required | 2026 |
| Massachusetts | $121.20 | 69.9% | -- | 2025 |
| Maine | $116.43 | 67.2% | -- | 2026 |
| Michigan | $110.55 | 63.8% | -- | 2026 |
| Minnesota | $129.42 | 74.7% | Required | 2026 |
| North Carolina | $116.14 | 67% | -- | 2025 |
| North Dakota | $187.00 | 107.9% | Not required | 2026 |
| Nebraska | $148.20 | 85.5% | -- | 2026 |
| Nevada | $140.53 | 81.1% | -- | 2024 |
| New York | $144.26 | 83.2% | -- | 2026 |
| Ohio | $121.22 | 69.9% | -- | 2024 |
| Oklahoma | $149.90 | 86.5% | -- | 2026 |
| Oregon | $138.45* | 79.9% | -- | 2026 |
| Rhode Island | $127.41 | -- | -- | 2026 |
| Texas | $128.57* | 74.2% | -- | 2025 |
| Virginia | $150.17* | 86.6% | -- | 2026 |
| Vermont | $142.00 | 81.9% | Required | 2026 |
| Wisconsin | $34.71 | 20% | -- | 2008 |
| West Virginia | $119.56 | 69% | -- | 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 physician codes
- 10004 - Needle biopsy without imaging, each added lesion
- 10005 - Needle biopsy with ultrasound guidance, first lesion
- 10006 - Needle biopsy with ultrasound guidance, each added lesion
- 10007 - Needle biopsy with fluoroscopic guidance, first lesion
- 10009 - Needle biopsy with CT guidance, first lesion
- 10011 - Needle biopsy with MRI guidance, first lesion
- 10012 - Needle biopsy with MRI guidance, each added lesion
- 10021 - Fine needle aspiration biopsy, first lesion, no imaging
Frequently asked questions
How much does Medicaid pay for 11954?
26 state Medicaid programs publish a fee-for-service rate for 11954 (filler injection, over 10 cc), ranging from $34.71 in Wisconsin to $187.00 in North Dakota, with a median of 74.2% of the national Medicare amount. The full table on this page lists every publishing state's current rate.
Which state pays the most for 11954?
North Dakota publishes the highest Medicaid rate for 11954 at $187.00 (107.9% of the national Medicare amount). Wisconsin publishes the lowest at $34.71.
Does 11954 require prior authorization under Medicaid?
5 of the 26 publishing states flag 11954 as requiring prior authorization (always or conditionally) on their fee schedules. States without a flag publish no PA indicator for this code - that means "not published", not "no PA required".