G0289 Medicaid Rate by State

Arthroscopy, knee, surgical, for removal of loose body, foreign body, debridement/shaving of articular cartilage (chondroplasty) at the time of other surgical knee arthroscopy in a different compartment of the same knee

22 state Medicaid programs publish a fee-for-service rate for G0289 (arthroscopy, knee, surgical, for removal of loose body, foreign body, debridement/shaving of articular cartilage (chondroplasty) at the time of other surgical knee arthroscopy in a different compartment of the same knee), ranging from $50.94 in Minnesota to $130.19 in Alaska, with a median of 104.3% of the national Medicare amount.

Every state, kept current

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This page shows one representative rate per state for G0289. Full schedules include every locality, modifier, and age-band variant.

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Publishing states

22

Median % of Medicare

104.3%

Rate range

$50.94 - $130.19

G0289 rates in every publishing state

StateMedicaid rate% of MedicarePrior authVintage
Alaska$130.19178.8%--2026
Arizona$86.47118.8%--2025
Colorado$67.8993.2%--2026
Delaware$84.90116.6%--2026
Florida$58.3680.2%--2026
Hawaii$83.94115.3%--2025
Iowa$76.44105%--2024
Idaho$57.4778.9%Not required2026
Indiana$76.17104.6%--2025
Louisiana$78.34107.6%--2026
Minnesota$50.9470%Conditional2026
Missouri$63.8587.7%Not required2022
Montana$115.07158%--2026
North Dakota$75.47103.7%Not required2026
New Jersey$81.61112.1%Not required2026
Oklahoma$64.9589.2%--2026
Oregon$56.90*78.1%--2026
Utah$66.44*--Not required2011
Vermont$57.6379.2%--2026
Wisconsin$83.25114.3%--2008
West Virginia$53.9274.1%--2026
Wyoming$75.97104.3%--2021

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

All 136 codes from G0008 to G0659 or every physician code by number.

Frequently asked questions

How much does Medicaid pay for G0289?

22 state Medicaid programs publish a fee-for-service rate for G0289 (arthroscopy, knee, surgical, for removal of loose body, foreign body, debridement/shaving of articular cartilage (chondroplasty) at the time of other surgical knee arthroscopy in a different compartment of the same knee), ranging from $50.94 in Minnesota to $130.19 in Alaska, with a median of 104.3% of the national Medicare amount. The full table on this page lists every publishing state's current rate.

Which state pays the most for G0289?

Alaska publishes the highest Medicaid rate for G0289 at $130.19 (178.8% of the national Medicare amount). Minnesota publishes the lowest at $50.94.

Does G0289 require prior authorization under Medicaid?

1 of the 22 publishing states flag G0289 as requiring prior authorization (always or conditionally) on their fee schedules. States without a flag publish no PA indicator for this code - that means "not published", not "no PA required".