The Rates plan
$29/mo7-day free trialThis page shows one representative rate per state for 21743. Full schedules include every locality, modifier, and age-band variant.
- Every code on all 51 published schedules
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Publishing states
34
Median % of Medicare
45.7%
Rate range
$400.00 - $4,402.86
21743 rates in every publishing state
| State | Medicaid rate | % of Medicare | Prior auth | Vintage |
|---|---|---|---|---|
| Alabama | $400.00 | 19.2% | -- | 2026 |
| Arkansas | $1,979.86* | 95% | -- | 2026 |
| Arizona | $613.31* | 29.4% | -- | 2003 |
| Colorado | $1,008.86 | 48.4% | Required | 2026 |
| Connecticut | $842.56 | 40.4% | -- | 2026 |
| Florida | $1,385.05 | 66.5% | -- | 2025 |
| Georgia | $981.44 | 47.1% | -- | 2026 |
| Idaho | $1,342.67 | 64.4% | Not required | 2025 |
| Illinois | $874.68 | 42% | -- | 2026 |
| Indiana | $944.40 | 45.3% | -- | 2024 |
| Kansas | $603.00 | 28.9% | -- | 2003 |
| Kentucky | $859.84 | 41.3% | -- | 2026 |
| Louisiana | $696.28 | 33.4% | -- | 2026 |
| Maine | $952.39 | 45.7% | -- | 2026 |
| Michigan | $421.31 | 20.2% | -- | 2026 |
| Minnesota | $1,106.39 | 53.1% | -- | 2026 |
| Missouri | $954.68 | 45.8% | Not required | 2022 |
| Mississippi | $2,484.80 | -- | -- | 2026 |
| Montana | $2,269.49 | 108.9% | -- | 2026 |
| North Carolina | $936.34 | 44.9% | -- | 2025 |
| Nebraska | $2,074.80 | 99.6% | -- | 2026 |
| New Mexico | $508.28 | 24.4% | -- | 2025 |
| Nevada | $1,415.81 | 67.9% | -- | 2024 |
| Ohio | $629.92 | 30.2% | -- | 2003 |
| Oklahoma | $1,123.36 | 53.9% | -- | 2026 |
| Oregon | $1,667.25* | 80% | -- | 2026 |
| Pennsylvania | $1,000.00 | 48% | -- | 2016 |
| Rhode Island | $4,402.86 | -- | -- | 2026 |
| South Carolina | $675.22 | 32.4% | -- | 2024 |
| Texas | $821.43* | 39.4% | -- | 2026 |
| Utah | $888.12* | 42.6% | Not required | 2026 |
| Virginia | $533.47* | 25.6% | -- | 2009 |
| Wisconsin | $2,331.37 | 111.9% | -- | 2017 |
| Wyoming | $986.19 | 47.3% | Required | 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 21743?
34 state Medicaid programs publish a fee-for-service rate for 21743 (sunken chest (pectus) repair, Nuss, with chest scope), ranging from $400.00 in Alabama to $4,402.86 in Rhode Island, with a median of 45.7% of the national Medicare amount. The full table on this page lists every publishing state's current rate.
Which state pays the most for 21743?
Rhode Island publishes the highest Medicaid rate for 21743 at $4,402.86. Alabama publishes the lowest at $400.00.
Does 21743 require prior authorization under Medicaid?
2 of the 34 publishing states flag 21743 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".