Q4170 Medicaid Rate by State

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

17 state Medicaid programs publish a fee-for-service rate for Q4170 (cygnus, per square centimeter (add-on, list separately in addition to primary procedure)), ranging from $39.31 in Virginia to $131.94 in New Mexico, with a median of 63.8% of the national Medicare amount.

Every state, kept current

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This page shows one representative rate per state for Q4170. Full schedules include every locality, modifier, and age-band variant.

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Publishing states

17

Median % of Medicare

63.8%

Rate range

$39.31 - $131.94

Q4170 rates in every publishing state

StateMedicaid rate% of MedicarePrior authVintage
Arkansas$120.78*----2026
California$46.1636.3%--2026
District of Columbia$119.9394.2%Required2026
Indiana$50.5539.7%--2026
Kentucky$124.11----2026
Michigan$81.1563.8%--2026
Minnesota$131.93103.7%--2024
Missouri$112.18--Not required2026
Montana$39.3130.9%--2026
New Mexico$131.94103.7%--2024
Oregon$103.91*81.7%--2026
South Carolina$83.4965.6%--2026
Texas$40.72*32%--2026
Utah$66.23*--Not required2026
Virginia$39.3130.9%--2025
West Virginia$80.7663.5%--2026
Wyoming$122.6396.4%--2020

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 Q4170?

17 state Medicaid programs publish a fee-for-service rate for Q4170 (cygnus, per square centimeter (add-on, list separately in addition to primary procedure)), ranging from $39.31 in Virginia to $131.94 in New Mexico, with a median of 63.8% of the national Medicare amount. The full table on this page lists every publishing state's current rate.

Which state pays the most for Q4170?

New Mexico publishes the highest Medicaid rate for Q4170 at $131.94 (103.7% of the national Medicare amount). Virginia publishes the lowest at $39.31.

Does Q4170 require prior authorization under Medicaid?

1 of the 17 publishing states flag Q4170 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".