Every state, kept current
The Rates plan
$29/mo7-day free trialThis page shows one representative rate per state for 43999. Full schedules include every locality, modifier, and age-band variant.
- Every code on all 51 published schedules
- Full-schedule CSV export and state network lists
- Email alerts when a state changes its rates
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Publishing states
11
Median % of Medicare
--
Rate range
$100.00 - $1,027.21
43999 rates in every publishing state
| State | Medicaid rate | % of Medicare | Prior auth | Vintage |
|---|---|---|---|---|
| Arizona | $586.96 | -- | -- | 2021 |
| Florida | $935.58 | -- | Required | 2026 |
| Idaho | $885.17 | -- | Not required | 2025 |
| Kentucky | $100.00 | -- | Required | 2026 |
| Maine | $116.53 | -- | -- | 2026 |
| Michigan | $484.63 | -- | -- | 2026 |
| Missouri | $817.60 | -- | Not required | 2026 |
| Mississippi | $688.78 | -- | -- | 2026 |
| Montana | $1,027.21 | -- | -- | 2026 |
| Rhode Island | $839.97 | -- | -- | 2026 |
| South Carolina | $822.23 | -- | -- | 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
All 109 codes from 43191 to 43999 or every physician code by number.
Frequently asked questions
How much does Medicaid pay for 43999?
11 state Medicaid programs publish a fee-for-service rate for 43999 (unlisted stomach procedure), ranging from $100.00 in Kentucky to $1,027.21 in Montana. The full table on this page lists every publishing state's current rate.
Which state pays the most for 43999?
Montana publishes the highest Medicaid rate for 43999 at $1,027.21. Kentucky publishes the lowest at $100.00.
Does 43999 require prior authorization under Medicaid?
2 of the 11 publishing states flag 43999 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".