The Rates plan
$29/mo7-day free trialThis page shows one representative rate per state for 90733. 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
19
Median % of Medicare
--
Rate range
$4.00 - $164.75
90733 rates in every publishing state
| State | Medicaid rate | % of Medicare | Prior auth | Vintage |
|---|---|---|---|---|
| Alabama | $120.83 | -- | -- | 2026 |
| Arkansas | $69.85 | -- | -- | 2026 |
| California | $126.88 | -- | -- | 2026 |
| District of Columbia | $85.19 | -- | Not required | 2015 |
| Delaware | $15.00 | -- | -- | 2026 |
| Hawaii | $4.00 | -- | -- | 2025 |
| Iowa | $107.55 | -- | -- | 2021 |
| Idaho | $92.01 | -- | Not required | 2025 |
| Kentucky | $106.49 | -- | -- | 2026 |
| Maine | $106.49 | -- | -- | 2026 |
| Mississippi | $106.49 | -- | -- | 2020 |
| New Jersey | $127.85 | -- | Not required | 2026 |
| New Mexico | $130.51 | -- | -- | 2025 |
| Oklahoma | $164.75 | -- | -- | 2026 |
| Rhode Island | $125.11 | -- | -- | 2026 |
| South Carolina | $104.66 | -- | -- | 2017 |
| Utah | $62.89* | -- | Not required | 2024 |
| Washington | $116.30 | -- | -- | 2026 |
| Wyoming | $106.49 | -- | -- | 2023 |
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 90733?
19 state Medicaid programs publish a fee-for-service rate for 90733 (meningococcal polysaccharide vaccine, 4-valent), ranging from $4.00 in Hawaii to $164.75 in Oklahoma. The full table on this page lists every publishing state's current rate.
Which state pays the most for 90733?
Oklahoma publishes the highest Medicaid rate for 90733 at $164.75. Hawaii publishes the lowest at $4.00.
Does 90733 require prior authorization under Medicaid?
No publishing state flags 90733 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.