The Rates plan
$29/mo7-day free trialThis page shows one representative rate per state for 45999. 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
$29/mo after the trial. Cancel anytime.
Publishing states
10
Median % of Medicare
--
Rate range
$100.00 - $865.98
45999 rates in every publishing state
| State | Medicaid rate | % of Medicare | Prior auth | Vintage |
|---|---|---|---|---|
| Arizona | $575.40 | -- | -- | 2021 |
| District of Columbia | $100.00 | -- | Not required | 2018 |
| Maine | $332.32 | -- | -- | 2026 |
| Michigan | $496.90 | -- | -- | 2026 |
| Missouri | $838.31 | -- | Not required | 2026 |
| Mississippi | $706.22 | -- | -- | 2026 |
| Montana | $865.98 | -- | -- | 2026 |
| New Mexico | $361.63 | -- | -- | 2026 |
| Rhode Island | $568.12 | -- | -- | 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 45999?
10 state Medicaid programs publish a fee-for-service rate for 45999 (unlisted rectum procedure), ranging from $100.00 in District of Columbia to $865.98 in Montana. The full table on this page lists every publishing state's current rate.
Which state pays the most for 45999?
Montana publishes the highest Medicaid rate for 45999 at $865.98. District of Columbia publishes the lowest at $100.00.
Does 45999 require prior authorization under Medicaid?
No publishing state flags 45999 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.