The Rates plan
$29/mo7-day free trialThis page shows one representative rate per state for 92972. 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
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Publishing states
31
Median % of Medicare
86.6%
Rate range
$61.04 - $207.54
92972 rates in every publishing state
| State | Medicaid rate | % of Medicare | Prior auth | Vintage |
|---|---|---|---|---|
| Alabama | $103.98 | 85.1% | -- | 2026 |
| Arizona | $147.84 | 120.9% | -- | 2025 |
| California | $97.92 | 80.1% | -- | 2026 |
| Colorado | $117.19 | 95.9% | -- | 2026 |
| Connecticut | $87.91 | 71.9% | -- | 2026 |
| District of Columbia | $105.23 | 86.1% | Not required | 2026 |
| Delaware | $119.36 | 97.6% | -- | 2026 |
| Georgia | $119.18 | 97.5% | -- | 2026 |
| Hawaii | $144.07 | 117.9% | -- | 2025 |
| Illinois | $98.22 | 80.4% | -- | 2024 |
| Kentucky | $122.47 | 100.2% | -- | 2026 |
| Louisiana | $122.28 | 100% | -- | 2026 |
| Massachusetts | $105.80 | 86.6% | -- | 2026 |
| Maine | $85.53 | 70% | -- | 2026 |
| Michigan | $77.96 | 63.8% | -- | 2026 |
| Missouri | $102.51 | 83.9% | Not required | 2024 |
| Mississippi | $106.07 | 86.8% | -- | 2026 |
| Montana | $195.44 | 159.9% | -- | 2026 |
| North Carolina | $115.96 | 94.9% | -- | 2025 |
| North Dakota | $132.92 | 108.7% | Not required | 2026 |
| New Hampshire | $83.39 | 68.2% | Not required | 2026 |
| New Jersey | $61.04 | 49.9% | Not required | 2026 |
| New Mexico | $207.54 | 169.8% | -- | 2025 |
| Ohio | $109.86 | 89.9% | -- | 2024 |
| Oregon | $97.72* | 79.9% | -- | 2026 |
| South Carolina | $96.30 | 78.8% | -- | 2024 |
| Utah | $94.54* | 77.3% | Not required | 2026 |
| Virginia | $105.90 | 86.6% | -- | 2026 |
| Washington | $71.47 | 58.5% | -- | 2026 |
| Wisconsin | $106.54 | 87.2% | -- | 2024 |
| West Virginia | $88.33 | 72.3% | -- | 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 92972?
31 state Medicaid programs publish a fee-for-service rate for 92972 (coronary intravascular lithotripsy (add-on)), ranging from $61.04 in New Jersey to $207.54 in New Mexico, with a median of 86.6% of the national Medicare amount. The full table on this page lists every publishing state's current rate.
Which state pays the most for 92972?
New Mexico publishes the highest Medicaid rate for 92972 at $207.54 (169.8% of the national Medicare amount). New Jersey publishes the lowest at $61.04.
Does 92972 require prior authorization under Medicaid?
No publishing state flags 92972 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.