Lab & Imaging codes 77001 to 77799 with Medicaid rates by state

97 lab & imaging codes from 77001 to 77799 carry a published Medicaid rate in ten or more states. The median shown is across those states' unmodified published rates; open a code for the full state-by-state table with percent of Medicare and prior-authorization flags.

CodeDescriptionStatesMedian rate
77001Fluoroscopy guidance for a central line (add-on)48$79.50
77002X-ray (fluoroscopic) guidance for needle placement48$92.23
77003Fluoroscopy guidance for a spinal injection48$82.30
77011CT guidance for stereotactic targeting48$202.27
77012CT guidance for needle placement48$113.50
77013CT guidance for tissue ablation46$383.63
77014CT guidance for radiation field placement12$126.85
77021MRI guidance for needle placement48$345.23
77022MRI guidance for tissue ablation44$399.37
77046Breast MRI without contrast, one side46$198.01
77047Breast MRI without contrast, both sides46$201.12
77048Breast MRI with contrast, one side46$299.26
77049Breast MRI with contrast, both sides46$306.17
77053Breast duct X-ray with dye, one duct, reading46$48.86
77054Breast duct X-ray with dye, multiple ducts, reading46$63.64
770613D mammogram (tomosynthesis), one breast11$60.80
770623D mammogram (tomosynthesis), both breasts11$64.35
770633D screening mammogram (tomosynthesis), both breasts43$44.69
77065Diagnostic mammogram, one breast47$105.92
77066Diagnostic mammogram, both breasts47$134.11
77067Screening mammogram, both breasts47$109.32
77071Stress X-ray of a joint, manual stress applied45$42.71
77072Bone age X-ray study47$20.39
77073Leg length X-ray study47$36.13
77074X-ray survey of bones, limited47$53.48
77075X-ray survey of bones, complete47$78.68
77076X-ray survey of bones, infant47$83.93
77077Joint X-ray survey47$39.67
77078Bone density CT scan, spine or hip46$83.25
77080Bone density scan (DEXA), hip and spine47$35.55
77081Bone density DXA scan, wrist or heel47$27.10
77085Bone density DXA scan with vertebral fracture check43$44.09
77086Vertebral fracture assessment by DXA42$27.96
77089Trabecular bone score from DXA, with report31$31.77
77090Trabecular bone score, technical data preparation32$2.12
77091Trabecular bone score, calculation only32$21.83
77092Trabecular bone score, interpretation only30$8.50
77261Radiation treatment planning, simple46$59.72
77262Radiation treatment planning, intermediate46$92.79
77263Radiation treatment planning, complex46$143.00
77280Radiation field setup (simulation), simple46$213.24
77285Radiation field setup (simulation), intermediate46$351.25
77290Radiation field setup (simulation), complex46$357.66
77293Radiation planning for breathing motion (add-on)42$326.86
772953D radiation treatment planning46$438.34
77299Unlisted radiation treatment planning12$107.60
77300Radiation dose calculation46$57.08
77301IMRT radiation treatment plan47$1,500.58
77306Radiation dose plan, simple (1 or 2 fields)46$122.68
77307Radiation dose plan, complex (3 or more fields)46$235.25
77316Internal radiation (brachytherapy) dose plan, simple46$196.49
77317Internal radiation (brachytherapy) dose plan, intermediate46$257.99
77318Internal radiation (brachytherapy) dose plan, complex46$362.84
77331Special radiation dose measurement45$53.92
77332Radiation treatment devices (blocks, shields), simple46$36.89
77333Radiation treatment devices, intermediate46$108.29
77334Radiation treatment devices (custom blocks, casts), complex46$110.26
77336Radiation physics consultation, weekly46$75.54
77370Special radiation physics consultation45$118.07
77371Gamma Knife radiosurgery delivery, single session41$855.37
77372Stereotactic radiosurgery delivery, linear accelerator46$759.47
77373Stereotactic body radiation delivery, per session47$921.84
77387Image guidance for radiation targeting38$32.72
77399Unlisted radiation physics or dosimetry service12$107.60
77401Superficial radiation treatment delivery, per day11$41.84
77402Radiation treatment delivery, simple46$65.96
77407Radiation treatment delivery, intermediate46$203.24
77412Radiation treatment delivery, complex45$267.48
77417Radiation treatment port image check43$12.10
77423Neutron radiation treatment delivery40$65.56
77424Radiation delivery during surgery, X-ray, one session13$2,066.47
77425Radiation delivery during surgery, electrons, one session13$2,066.47
77427Radiation treatment management, 5 sessions46$156.97
77431Radiation therapy management, 1 or 2 session course47$86.88
77432Stereotactic brain radiosurgery management, complete course46$363.22
77435Stereotactic body radiation management, complete course46$533.85
77469Radiation treatment management during surgery42$236.32
77520Proton radiation delivery, simple, no compensator31$597.64
77522Proton radiation delivery, simple, with compensator31$685.19
77523Proton radiation delivery, intermediate32$827.71
77525Proton radiation delivery, complex31$865.50
77600Heat therapy (hyperthermia) for cancer, superficial42$383.92
77605Heat therapy (hyperthermia) for cancer, deep40$690.04
77610Heat therapy for cancer by probes, up to 542$523.96
77615Heat therapy for cancer by probes, more than 541$783.07
77620Heat therapy for cancer by body cavity probe38$487.29
77761Internal radiation placed in a body cavity, simple47$333.26
77762Internal radiation placed in a body cavity, intermediate47$440.01
77763Internal radiation placed in a body cavity, complex47$621.95
77767Skin surface radiation treatment, up to 2 cm or 1 channel43$196.92
77768Skin surface radiation treatment, over 2 cm or 2+ channels43$290.86
77770High-dose-rate internal radiation, 1 channel46$276.81
77771High-dose-rate internal radiation, 2 to 12 channels46$490.43
77772High-dose-rate internal radiation, over 12 channels46$738.72
77778Radiation seeds placed into tissue, complex47$729.21
77790Radiation source handling and loading44$16.69
77799Unlisted internal radiation (brachytherapy) procedure12$169.03

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. Descriptions are ProviderSignal's own plain-language labels or public-domain CMS text.