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
- Full state Medicaid dental network lists
- Email alerts when a state changes its rates
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Publishing states
10
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 |
| 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
Frequently asked questions
How much does Medicaid pay for 43999?
10 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?
1 of the 10 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".