The Rates plan
$29/mo7-day free trialThis page shows one representative rate per state for 65757. 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
17
Median % of Medicare
--
Rate range
$40.22 - $739.12
65757 rates in every publishing state
| State | Medicaid rate | % of Medicare | Prior auth | Vintage |
|---|---|---|---|---|
| Alabama | $739.12 | -- | -- | 2026 |
| Arizona | $155.63 | -- | -- | 2020 |
| Colorado | $235.45 | -- | -- | 2026 |
| Connecticut | $63.55 | -- | -- | 2026 |
| Iowa | $50.94 | -- | -- | 2024 |
| Indiana | $93.13 | -- | -- | 2024 |
| Maine | $113.70 | -- | -- | 2026 |
| Michigan | $40.22 | -- | -- | 2026 |
| Minnesota | $73.58 | -- | -- | 2026 |
| Montana | $481.83 | -- | -- | 2026 |
| New Jersey | $162.84 | -- | Not required | 2026 |
| New Mexico | $137.73 | -- | -- | 2025 |
| Ohio | $102.78 | -- | -- | 2019 |
| Oklahoma | $105.79 | -- | -- | 2026 |
| Texas | $184.17* | -- | -- | 2020 |
| Washington | $110.87 | -- | -- | 2026 |
| Wisconsin | $106.18 | -- | -- | 2018 |
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 65757?
17 state Medicaid programs publish a fee-for-service rate for 65757 (donor cornea inner-layer graft preparation (add-on)), ranging from $40.22 in Michigan to $739.12 in Alabama. The full table on this page lists every publishing state's current rate.
Which state pays the most for 65757?
Alabama publishes the highest Medicaid rate for 65757 at $739.12. Michigan publishes the lowest at $40.22.
Does 65757 require prior authorization under Medicaid?
No publishing state flags 65757 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.