| Code | Description | States | Median rate |
|---|---|---|---|
| C9047 | Injection, caplacizumab-yhdp, 1 mg | 15 | $802.25 |
| C9250 | Human plasma fibrin sealant, vapor-heated, solvent-detergent (artiss), 2 ml | 11 | $143.09 |
| C9257 | Injection, bevacizumab, 0.25 mg | 17 | $1.85 |
| C9293 | Injection, glucarpidase, 10 units | 10 | $408.57 |
| C9363 | Skin substitute, integra meshed bilayer wound matrix, per square centimeter | 10 | $66.49 |
| C9460 | Injection, cangrelor, 1 mg | 15 | $19.94 |
| C9462 | Injection, delafloxacin, 1 mg | 11 | $0.50 |
| C9482 | Injection, sotalol hydrochloride, 1 mg | 10 | $25.07 |
| C9507 | Plasma, high titer covid-19 convalescent, each unit | 11 | $750.50 |
| C9600 | Percutaneous transcatheter placement of drug eluting intracoronary stent(s), with coronary angioplasty when performed; single major coronary artery or branch | 15 | $6,084.35 |
| C9602 | Percutaneous transluminal coronary atherectomy, with drug eluting intracoronary stent, with coronary angioplasty when performed; single major coronary artery or branch | 11 | $11,163.26 |
| 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 | 11 | $7,346.08 |
| C9607 | Percutaneous transluminal revascularization of chronic total occlusion, coronary artery, coronary artery branch, or coronary artery bypass graft, any combination of drug-eluting intracoronary stent, atherectomy and angioplasty; single vessel | 11 | $11,041.91 |
| C9725 | Placement of endorectal intracavitary applicator for high intensity brachytherapy | 12 | $408.39 |
| C9727 | Insertion of implants into the soft palate; minimum of three implants | 11 | $585.40 |
| C9728 | Placement of interstitial device(s) for radiation therapy/surgery guidance (e.g., fiducial markers, dosimeter), for other than the following sites (any approach): abdomen, pelvis, prostate, retroperitoneum, thorax, single or multiple | 13 | $673.31 |
| C9739 | Cystourethroscopy, with insertion of transprostatic implant; 1 to 3 implants | 13 | $2,864.96 |
| C9740 | Cystourethroscopy, with insertion of transprostatic implant; 4 or more implants | 13 | $6,469.68 |
| C9757 | Laminotomy (hemilaminectomy), with decompression of nerve root(s), including partial facetectomy, foraminotomy and excision of herniated intervertebral disc, and repair of annular defect with implantation of bone anchored annular closure device, including annular defect measurement, alignment and sizing assessment, and image guidance; 1 interspace, lumbar | 11 | $8,935.52 |
| C9761 | Cystourethroscopy, with ureteroscopy and/or pyeloscopy, with lithotripsy, and ureteral catheterization for steerable vacuum aspiration of the kidney, collecting system, ureter, bladder, and urethra if necessary, with use of steerable ureteral catheter or suction-integrated ureteroscope | 13 | $5,289.96 |
| C9763 | Cardiac magnetic resonance imaging for morphology and function, quantification of segmental dysfunction; with stress imaging | 10 | $291.09 |
| C9764 | Revascularization, endovascular, open or percutaneous, lower extremity artery(ies), except tibial/peroneal; with intravascular lithotripsy, includes angioplasty within the same vessel(s), when performed | 12 | $6,492.65 |
| C9765 | Revascularization, endovascular, open or percutaneous, lower extremity artery(ies), except tibial/peroneal; with intravascular lithotripsy, and transluminal stent placement(s), includes angioplasty within the same vessel(s), when performed | 12 | $10,773.94 |
| C9766 | Revascularization, endovascular, open or percutaneous, lower extremity artery(ies), except tibial/peroneal; with intravascular lithotripsy and atherectomy, includes angioplasty within the same vessel(s), when performed | 12 | $11,196.96 |
| C9767 | Revascularization, endovascular, open or percutaneous, lower extremity artery(ies), except tibial/peroneal; with intravascular lithotripsy and transluminal stent placement(s), and atherectomy, includes angioplasty within the same vessel(s), when performed | 12 | $12,510.40 |
| C9772 | Revascularization, endovascular, open or percutaneous, tibial/peroneal artery(ies), with intravascular lithotripsy, includes angioplasty within the same vessel (s), when performed | 13 | $6,399.89 |
| C9773 | Revascularization, endovascular, open or percutaneous, tibial/peroneal artery(ies); with intravascular lithotripsy, and transluminal stent placement(s), includes angioplasty within the same vessel(s), when performed | 13 | $10,842.19 |
| C9774 | Revascularization, endovascular, open or percutaneous, tibial/peroneal artery(ies); with intravascular lithotripsy and atherectomy, includes angioplasty within the same vessel (s), when performed | 13 | $10,985.77 |
| C9775 | Revascularization, endovascular, open or percutaneous, tibial/peroneal artery(ies); with intravascular lithotripsy and transluminal stent placement(s), and atherectomy, includes angioplasty within the same vessel (s), when performed | 13 | $11,704.49 |
| C9777 | Esophageal mucosal integrity testing by electrical impedance, transoral, includes esophagoscopy or esophagogastroduodenoscopy | 12 | $2,290.45 |
| C9778 | Colpopexy, vaginal; minimally invasive extra-peritoneal approach (sacrospinous) | 12 | $2,176.49 |
| C9779 | Endoscopic submucosal dissection (esd), including endoscopy or colonoscopy, mucosal closure, when performed | 12 | $1,986.55 |
| C9780 | Insertion of central venous catheter through central venous occlusion via inferior and superior approaches (e.g., inside-out technique), including imaging guidance | 10 | $5,501.37 |
| C9781 | Arthroscopy, shoulder, surgical; with implantation of subacromial spacer (e.g., balloon), includes debridement (e.g., limited or extensive), subacromial decompression, acromioplasty, and biceps tenodesis when performed | 12 | $8,364.09 |
| C9789 | Instillation of anti-neoplastic pharmacologic/biologic agent into renal pelvis, any method, including all imaging guidance, including volumetric measurement if performed | 13 | $671.83 |
| C9796 | Repair of enterocutaneous fistula small intestine or colon (excluding anorectal fistula) with plug (e.g., porcine small intestine submucosa [sis]) | 12 | $1,670.18 |
| C9797 | Vascular embolization or occlusion procedure with use of a pressure-generating catheter (e.g., one-way valve, intermittently occluding), inclusive of all radiological supervision and interpretation, intraprocedural roadmapping, and imaging guidance necessary to complete the intervention; for tumors, organ ischemia, or infarction | 13 | $11,491.78 |
| C9901 | Endoscopic defect closure within the entire gastrointestinal tract, including upper endoscopy (including diagnostic, if performed) or colonoscopy (including diagnostic, if performed), with all system and tissue anchoring components | 10 | $6,219.62 |
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.