The Rates plan
$29/mo7-day free trialThe table on this page is a common-procedure sample. The full Indiana physician schedule has 6,764 codes.
- Every code on all 51 published schedules
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Published codes
6,764
Physician procedures on the 2026 schedule
Median % of Medicare
94.6%
vs national Medicare, GPCI-neutral
PA required
393
codes flagged by the state
Common physician procedures and what Indiana Medicaid pays
A curated sample of recognizable procedures from the 6,764-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.
| Code | Procedure | Indiana rate | % of Medicare |
|---|---|---|---|
| 10021 | Fine needle aspiration biopsy, first lesion, no imaging | $92.41 | 91.6% |
| 10060 | Drainage of a skin abscess, simple | $116.88 | 90.9% |
| 10061 | Drainage of a skin abscess, complicated or multiple | $197.01 | 89.5% |
| 10120 | Removal of a foreign body from tissue, simple | $139.54 | 88.7% |
| 10140 | Drainage of a blood or fluid collection under the skin | $155.60 | 89.2% |
| 11042 | Wound debridement, skin and tissue below, first 20 sq cm | $118.46 | 89.3% |
| 11043 | Wound debridement to muscle, first 20 sq cm | $212.20 | 88.6% |
| 11044 | Wound debridement to bone, first 20 sq cm | $283.31 | 88.4% |
| 11102 | Skin biopsy, tangential, first lesion | $91.86 | 96.2% |
| 11104 | Skin biopsy, punch, first lesion | $114.20 | 94.2% |
| 11106 | Skin biopsy, incisional, first lesion | $141.71 | 93.7% |
| 11200 | Removal of skin tags, up to 15 | $85.04 | 92.3% |
| 11300 | Shave removal of a skin lesion, trunk/arm/leg, 0.5 cm or less | $91.71 | 95% |
| 11305 | Shave removal of a skin lesion, scalp/neck/genitals, 0.5 cm or less | $96.44 | 95.3% |
| 11400 | Removal of a benign skin growth, trunk/arm/leg, 0.5 cm or less | $117.42 | 91.8% |
| 11402 | Removal of a benign skin growth, trunk/arm/leg, 1.1-2 cm | $157.67 | 92.2% |
| 11720 | Trimming of thickened nails, 1-5 | $13.21 | 40.4% |
| 11721 | Trimming of thickened nails, 6 or more | $21.97 | 48.7% |
| 11730 | Removal of a nail plate, partial or complete | $105.85 | 94.9% |
| 11750 | Permanent removal of part or all of a nail | $148.30 | 94.1% |
| 11976 | Removal of a contraceptive implant | $132.18 | 90.1% |
| 11981 | Insertion of a medication-releasing implant | $91.38 | 85% |
| 12001 | Simple wound repair, scalp/trunk/limbs, 2.5 cm or less | $85.60 | 75.2% |
| 12002 | Simple wound repair, scalp/trunk/limbs, 2.6-7.5 cm | $103.62 | 74.4% |
| 12011 | Simple wound repair, face/ears/lips, 2.5 cm or less | $101.77 | 72.9% |
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 Indiana Medicaid fee schedules
- Indiana lab & imaging fee schedule · 2,177 codes
- Indiana dme & supplies fee schedule · 2,074 codes
- Indiana drugs fee schedule · 865 codes
- Indiana other services fee schedule · 595 codes
- Indiana vision fee schedule · 149 codes
- Indiana behavioral health fee schedule · 43 codes
Physician rates in neighboring states
Frequently asked questions
What does Indiana Medicaid pay for physician and professional services?
Indiana Medicaid publishes 6,764 physician procedure rates effective 2026, paying a median 94.6% 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 Indiana's physician rates compare with Medicare?
Across physician codes with a national Medicare comparator, Indiana Medicaid pays a median 94.6% 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 Indiana?
Indiana publishes prior-authorization flags on its schedule: 393 physician codes are marked as always requiring PA. Codes without a flag carry no published PA indicator.
Where do these rates come from?
Directly from Indiana'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.
Get an email the next time Indiana changes these rates.