The Rates plan
$29/mo7-day free trialThis page shows one representative rate per state for 55559. 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
11
Median % of Medicare
--
Rate range
$225.95 - $5,449.73
55559 rates in every publishing state
| State | Medicaid rate | % of Medicare | Prior auth | Vintage |
|---|---|---|---|---|
| Arizona | $262.55* | -- | -- | 2000 |
| Idaho | $427.51 | -- | Not required | 2025 |
| Maine | $225.95 | -- | -- | 2026 |
| Michigan | $3,230.29 | -- | -- | 2026 |
| Missouri | $5,449.73 | -- | Not required | 2026 |
| Mississippi | $4,591.06 | -- | -- | 2026 |
| Montana | $496.11 | -- | -- | 2026 |
| New Mexico | $2,565.07 | -- | -- | 2026 |
| Oklahoma | $5,444.03 | -- | -- | 2026 |
| Rhode Island | $3,678.21 | -- | -- | 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 55559?
11 state Medicaid programs publish a fee-for-service rate for 55559 (unlisted laparoscopic spermatic cord procedure), ranging from $225.95 in Maine to $5,449.73 in Missouri. The full table on this page lists every publishing state's current rate.
Which state pays the most for 55559?
Missouri publishes the highest Medicaid rate for 55559 at $5,449.73. Maine publishes the lowest at $225.95.
Does 55559 require prior authorization under Medicaid?
No publishing state flags 55559 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.