C9604 Medicaid Rate by State

Percutaneous transluminal revascularization of or through coronary artery bypass graft (internal mammary, free arterial, venous), any combination of drug-eluting intracoronary stent, atherectomy and angioplasty, including distal protection when performed; single vessel

11 state Medicaid programs publish a fee-for-service rate for C9604 (percutaneous transluminal revascularization of or through coronary artery bypass graft (internal mammary, free arterial, venous), any combination of drug-eluting intracoronary stent, atherectomy and angioplasty, including distal protection when performed; single vessel), ranging from $258.22 in Texas to $10,568.13 in Rhode Island, with a median of 83.7% of the national Medicare amount.

Every state, kept current

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This page shows one representative rate per state for C9604. Full schedules include every locality, modifier, and age-band variant.

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Publishing states

11

Median % of Medicare

83.7%

Rate range

$258.22 - $10,568.13

C9604 rates in every publishing state

StateMedicaid rate% of MedicarePrior authVintage
Arkansas$6,986.58*95%--2026
Arizona$6,153.1083.7%--2026
Idaho$9,081.03123.5%Not required2025
Michigan$6,168.38----2026
Missouri$10,406.49--Varies2026
Montana$7,354.29100%--2026
New Mexico$7,337.86----2026
Oregon$5,883.43*80%--2026
Rhode Island$10,568.13----2026
Texas$258.22*3.5%--2025
Utah$463.90*6.3%Not required2015

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 state-specific services codes

All 38 codes from C9047 to C9901 or every state-specific services code by number.

Frequently asked questions

How much does Medicaid pay for C9604?

11 state Medicaid programs publish a fee-for-service rate for C9604 (percutaneous transluminal revascularization of or through coronary artery bypass graft (internal mammary, free arterial, venous), any combination of drug-eluting intracoronary stent, atherectomy and angioplasty, including distal protection when performed; single vessel), ranging from $258.22 in Texas to $10,568.13 in Rhode Island, with a median of 83.7% of the national Medicare amount. The full table on this page lists every publishing state's current rate.

Which state pays the most for C9604?

Rhode Island publishes the highest Medicaid rate for C9604 at $10,568.13. Texas publishes the lowest at $258.22.

Does C9604 require prior authorization under Medicaid?

No publishing state flags C9604 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.