Every state, kept current
The Rates plan
$29/mo7-day free trialThis page shows one representative rate per state for A4263. Full schedules include every locality, modifier, and age-band variant.
- Every code on all 51 published schedules
- Full-schedule CSV export and state network lists
- Email alerts when a state changes its rates
$29/mo after the trial. Cancel anytime.
Publishing states
11
Median % of Medicare
--
Rate range
$9.50 - $78.31
A4263 rates in every publishing state
| State | Medicaid rate | % of Medicare | Prior auth | Vintage |
|---|---|---|---|---|
| Alaska | $15.21 | -- | -- | 2026 |
| Arizona | $16.92 | -- | -- | 2011 |
| Colorado | $52.17 | -- | -- | 2026 |
| Hawaii | $31.60 | -- | -- | 2025 |
| Iowa | $71.13 | -- | -- | 2024 |
| Idaho | $30.33 | -- | Not required | 2025 |
| North Carolina | $9.50 | -- | -- | 2025 |
| New Mexico | $78.31 | -- | -- | 2025 |
| Nevada | $33.56 | -- | -- | 2024 |
| South Carolina | $24.98 | -- | -- | 2017 |
| Wisconsin | $37.80 | -- | -- | 2004 |
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 dme & supplies codes
- A2001 - Innovamatrix ac, per square centimeter (add-on, list separately in addition to primary procedure)
- A2002 - Mirragen advanced wound matrix, per square centimeter (add-on, list separately in addition to primary procedure)
- A2005 - Microlyte matrix, per square centimeter (add-on, list separately in addition to primary procedure)
- A2006 - Novosorb synpath dermal matrix, per square centimeter (add-on, list separately in addition to primary procedure)
- A2007 - Restrata, per square centimeter (add-on, list separately in addition to primary procedure)
- A2008 - Theragenesis, per square centimeter (add-on, list separately in addition to primary procedure)
- A2009 - Symphony, per square centimeter (add-on, list separately in addition to primary procedure)
- A2010 - Apis, per square centimeter (add-on, list separately in addition to primary procedure)
All 238 codes from A4206 to A4932 or every dme & supplies code by number.
Frequently asked questions
How much does Medicaid pay for A4263?
11 state Medicaid programs publish a fee-for-service rate for A4263 (permanent, long term, non-dissolvable lacrimal duct implant, each), ranging from $9.50 in North Carolina to $78.31 in New Mexico. The full table on this page lists every publishing state's current rate.
Which state pays the most for A4263?
New Mexico publishes the highest Medicaid rate for A4263 at $78.31. North Carolina publishes the lowest at $9.50.
Does A4263 require prior authorization under Medicaid?
No publishing state flags A4263 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.