The Rates plan
$29/mo7-day free trialThe table on this page is a common-procedure sample. The full South Carolina physician schedule has 6,584 codes.
- Every code on all 51 published schedules
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Published codes
6,584
Physician procedures on the 2026 schedule
Median % of Medicare
69.6%
vs national Medicare, GPCI-neutral
Effective vintage
2026
latest effective year on the schedule
Common physician procedures and what South Carolina Medicaid pays
A curated sample of recognizable procedures from the 6,584-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 | South Carolina rate | % of Medicare |
|---|---|---|---|
| 10021 | Fine needle aspiration biopsy, first lesion, no imaging | $66.31 | 65.7% |
| 10060 | Drainage of a skin abscess, simple | $83.48 | 64.9% |
| 10061 | Drainage of a skin abscess, complicated or multiple | $141.59 | 64.3% |
| 10120 | Removal of a foreign body from tissue, simple | $99.57 | 63.3% |
| 10140 | Drainage of a blood or fluid collection under the skin | $111.41 | 63.9% |
| 11042 | Wound debridement, skin and tissue below, first 20 sq cm | $84.54 | 63.8% |
| 11043 | Wound debridement to muscle, first 20 sq cm | $152.96 | 63.9% |
| 11044 | Wound debridement to bone, first 20 sq cm | $205.30 | 64% |
| 11102 | Skin biopsy, tangential, first lesion | $65.28 | 68.3% |
| 11104 | Skin biopsy, punch, first lesion | $81.27 | 67% |
| 11106 | Skin biopsy, incisional, first lesion | $100.89 | 66.7% |
| 11200 | Removal of skin tags, up to 15 | $60.68 | 65.8% |
| 11300 | Shave removal of a skin lesion, trunk/arm/leg, 0.5 cm or less | $65.16 | 67.5% |
| 11305 | Shave removal of a skin lesion, scalp/neck/genitals, 0.5 cm or less | $68.54 | 67.7% |
| 11400 | Removal of a benign skin growth, trunk/arm/leg, 0.5 cm or less | $83.70 | 65.4% |
| 11402 | Removal of a benign skin growth, trunk/arm/leg, 1.1-2 cm | $112.68 | 65.9% |
| 11720 | Trimming of thickened nails, 1-5 | $21.60 | 66% |
| 11721 | Trimming of thickened nails, 6 or more | $29.45 | 65.3% |
| 11730 | Removal of a nail plate, partial or complete | $75.37 | 67.6% |
| 11750 | Permanent removal of part or all of a nail | $105.65 | 67% |
| 11976 | Removal of a contraceptive implant | $95.69 | 65.3% |
| 11981 | Insertion of a medication-releasing implant | $66.16 | 61.5% |
| 12001 | Simple wound repair, scalp/trunk/limbs, 2.5 cm or less | $61.63 | 54.1% |
| 12002 | Simple wound repair, scalp/trunk/limbs, 2.6-7.5 cm | $74.84 | 53.7% |
| 12011 | Simple wound repair, face/ears/lips, 2.5 cm or less | $73.45 | 52.6% |
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 South Carolina Medicaid fee schedules
- South Carolina lab & imaging fee schedule · 1,891 codes
- South Carolina dme & supplies fee schedule · 1,486 codes
- South Carolina drugs fee schedule · 788 codes
- South Carolina other services fee schedule · 467 codes
- South Carolina anesthesia fee schedule · 273 codes
- South Carolina vision fee schedule · 113 codes
Physician rates in neighboring states
Frequently asked questions
What does South Carolina Medicaid pay for physician and professional services?
South Carolina Medicaid publishes 6,584 physician procedure rates effective 2026, paying a median 69.6% 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 South Carolina's physician rates compare with Medicare?
Across physician codes with a national Medicare comparator, South Carolina Medicaid pays a median 69.6% 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 South Carolina?
South Carolina 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 South Carolina'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 South Carolina changes these rates.