Q4153 Medicaid Rate by State

Dermavest and plurivest, per square centimeter (add-on, list separately in addition to primary procedure)

14 state Medicaid programs publish a fee-for-service rate for Q4153 (dermavest and plurivest, per square centimeter (add-on, list separately in addition to primary procedure)), ranging from $50.55 in Indiana to $232.71 in New Mexico, with a median of 83.6% of the national Medicare amount.

Every state, kept current

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This page shows one representative rate per state for Q4153. Full schedules include every locality, modifier, and age-band variant.

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Publishing states

14

Median % of Medicare

83.6%

Rate range

$50.55 - $232.71

Q4153 rates in every publishing state

StateMedicaid rate% of MedicarePrior authVintage
Arkansas$120.78*----2026
District of Columbia$119.9394.2%Required2026
Indiana$50.5539.7%--2026
Kentucky$124.11----2026
Michigan$81.1563.8%--2026
Missouri$112.18--Not required2026
Montana$137.93108.4%--2026
New Mexico$232.71182.9%--2025
Oregon$103.91*81.7%--2026
South Carolina$83.4965.6%--2026
Texas$106.43*83.6%--2026
Utah$66.23*--Not required2026
Virginia$137.92108.4%--2025
West Virginia$80.7663.5%--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 state-specific services codes

All 325 codes from Q4001 to Q4420 or every state-specific services code by number.

Frequently asked questions

How much does Medicaid pay for Q4153?

14 state Medicaid programs publish a fee-for-service rate for Q4153 (dermavest and plurivest, per square centimeter (add-on, list separately in addition to primary procedure)), ranging from $50.55 in Indiana to $232.71 in New Mexico, with a median of 83.6% of the national Medicare amount. The full table on this page lists every publishing state's current rate.

Which state pays the most for Q4153?

New Mexico publishes the highest Medicaid rate for Q4153 at $232.71 (182.9% of the national Medicare amount). Indiana publishes the lowest at $50.55.

Does Q4153 require prior authorization under Medicaid?

1 of the 14 publishing states flag Q4153 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".