Georgia Medicaid Physician Fee Schedule 2026

Georgia Medicaid publishes 6,372 physician procedure rates effective 2026, paying a median 85.5% of the national Medicare amount for the same services. This page shows published rates for common physician procedures with plain-language descriptions and, where a comparator exists, each rate as a percentage of national Medicare.

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The table on this page is a common-procedure sample. The full Georgia physician schedule has 6,372 codes.

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Published codes

6,372

Physician procedures on the 2026 schedule

Median % of Medicare

85.5%

vs national Medicare, GPCI-neutral

Effective vintage

2026

latest effective year on the schedule

Common physician procedures and what Georgia Medicaid pays

A curated sample of recognizable procedures from the 6,372-code schedule. Rates are the state's published fee-for-service amounts; the percentage compares each rate with the national Medicare amount for the same code.

CodeProcedureGeorgia rate% of Medicare
10021Fine needle aspiration biopsy, first lesion, no imaging$83.4682.7%
10060Drainage of a skin abscess, simple$66.7251.9%
10061Drainage of a skin abscess, complicated or multiple$121.5555.2%
10120Removal of a foreign body from tissue, simple$76.5648.7%
10140Drainage of a blood or fluid collection under the skin$80.4346.1%
11042Wound debridement, skin and tissue below, first 20 sq cm$62.5747.2%
11043Wound debridement to muscle, first 20 sq cm$150.5462.9%
11044Wound debridement to bone, first 20 sq cm$202.9463.3%
11102Skin biopsy, tangential, first lesion$85.4789.5%
11104Skin biopsy, punch, first lesion$107.4488.6%
11106Skin biopsy, incisional, first lesion$130.0485.9%
11200Removal of skin tags, up to 15$49.5453.7%
11300Shave removal of a skin lesion, trunk/arm/leg, 0.5 cm or less$42.1043.6%
11305Shave removal of a skin lesion, scalp/neck/genitals, 0.5 cm or less$43.8643.3%
11400Removal of a benign skin growth, trunk/arm/leg, 0.5 cm or less$77.8660.9%
11402Removal of a benign skin growth, trunk/arm/leg, 1.1-2 cm$108.8863.7%
11720Trimming of thickened nails, 1-5$22.7469.5%
11721Trimming of thickened nails, 6 or more$35.6479%
11730Removal of a nail plate, partial or complete$56.5150.7%
11750Permanent removal of part or all of a nail$121.7677.2%
11976Removal of a contraceptive implant$106.1172.4%
11981Insertion of a medication-releasing implant$100.9093.8%
12001Simple wound repair, scalp/trunk/limbs, 2.5 cm or less$103.8891.2%
12002Simple wound repair, scalp/trunk/limbs, 2.6-7.5 cm$114.3082.1%
12011Simple wound repair, face/ears/lips, 2.5 cm or less$110.5479.2%

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 * show the schedule's representative published variant.

More Georgia Medicaid fee schedules

Physician rates in neighboring states

Frequently asked questions

What does Georgia Medicaid pay for physician and professional services?

Georgia Medicaid publishes 6,372 physician procedure rates effective 2026, paying a median 85.5% of the national Medicare amount for the same services. The schedule covers office visits, preventive care, surgery, and evaluation and management services. The table on this page shows published rates for common procedures; the complete all-codes schedule is available as a CSV download with a ProviderSignal Rates subscription.

How do Georgia's physician rates compare with Medicare?

Across physician codes with a national Medicare comparator, Georgia Medicaid pays a median 85.5% of the Medicare amount (GPCI-neutral national comparison). Individual codes vary widely, so check the per-code percentage in the table.

Do physician services need prior authorization in Georgia?

Georgia does not publish prior-authorization indicators on this fee schedule, so PA requirements must be confirmed through the state's provider manual or portal. Absence of a flag here means "not published", never "no PA required".

Where do these rates come from?

Directly from Georgia's published Medicaid fee-for-service schedule (effective 2026), collected and normalized by ProviderSignal across all 50 states + DC. Rates are re-collected on a rolling schedule and this page updates automatically. Procedure descriptions are ProviderSignal's own plain-language labels or public-domain CMS text.

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