The Rates plan
$29/mo7-day free trialThis page shows one representative rate per state for 19499. 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
12
Median % of Medicare
--
Rate range
$14.50 - $3,529.56
19499 rates in every publishing state
| State | Medicaid rate | % of Medicare | Prior auth | Vintage |
|---|---|---|---|---|
| Arizona | $2,289.36 | -- | -- | 2021 |
| District of Columbia | $384.00 | -- | Required | 1999 |
| Hawaii | $127.70 | -- | -- | 2025 |
| Kentucky | $325.00 | -- | Required | 2026 |
| Maine | $14.50 | -- | -- | 2026 |
| Michigan | $2,092.13 | -- | -- | 2026 |
| Missouri | $3,529.56 | -- | Not required | 2026 |
| Mississippi | $2,973.43 | -- | -- | 2026 |
| Montana | $413.46 | -- | Required | 2026 |
| New Mexico | $1,668.41 | -- | -- | 2026 |
| Rhode Island | $2,085.75 | -- | -- | 2026 |
| South Carolina | $293.65 | -- | -- | 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 19499?
12 state Medicaid programs publish a fee-for-service rate for 19499 (unlisted breast procedure), ranging from $14.50 in Maine to $3,529.56 in Missouri. The full table on this page lists every publishing state's current rate.
Which state pays the most for 19499?
Missouri publishes the highest Medicaid rate for 19499 at $3,529.56. Maine publishes the lowest at $14.50.
Does 19499 require prior authorization under Medicaid?
3 of the 12 publishing states flag 19499 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".