The Rates plan
$29/mo7-day free trialThis page shows one representative rate per state for 20936. 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
24
Median % of Medicare
--
Rate range
$59.48 - $804.00
20936 rates in every publishing state
| State | Medicaid rate | % of Medicare | Prior auth | Vintage |
|---|---|---|---|---|
| Alaska | $243.75 | -- | -- | 2026 |
| Alabama | $122.00 | -- | -- | 2026 |
| Colorado | $109.78 | -- | -- | 2026 |
| Connecticut | $59.48 | -- | -- | 2008 |
| District of Columbia | $500.00 | -- | Not required | 1997 |
| Hawaii | $138.47 | -- | -- | 2025 |
| Iowa | $143.49 | -- | -- | 2024 |
| Idaho | $168.76 | -- | Not required | 2025 |
| Kansas | $804.00 | -- | -- | 1996 |
| Kentucky | $351.05 | -- | -- | 2026 |
| Louisiana | $167.15 | -- | -- | 2026 |
| Maine | $408.41 | -- | -- | 2026 |
| Minnesota | $91.08 | -- | -- | 2026 |
| Missouri | $267.46 | -- | Not required | 2019 |
| Mississippi | $140.36 | -- | -- | 2026 |
| New Hampshire | $109.49 | -- | Not required | 2026 |
| New Jersey | $142.00 | -- | Not required | 2026 |
| New Mexico | $169.93 | -- | -- | 2025 |
| Nevada | $121.51 | -- | -- | 2024 |
| South Carolina | $174.02 | -- | -- | 2017 |
| Utah | $137.08* | -- | Not required | 2024 |
| Virginia | $167.22 | -- | -- | 2026 |
| Wisconsin | $455.77 | -- | -- | 2009 |
| Wyoming | $246.91 | -- | -- | 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 20936?
24 state Medicaid programs publish a fee-for-service rate for 20936 (own bone from the same incision for spine surgery (add-on)), ranging from $59.48 in Connecticut to $804.00 in Kansas. The full table on this page lists every publishing state's current rate.
Which state pays the most for 20936?
Kansas publishes the highest Medicaid rate for 20936 at $804.00. Connecticut publishes the lowest at $59.48.
Does 20936 require prior authorization under Medicaid?
No publishing state flags 20936 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.