Every state, kept current
The Rates plan
$29/mo7-day free trialThe table on this page is a common-procedure sample. The full Texas physician schedule has 6,550 codes.
- Every code on all 51 published schedules
- Full-schedule CSV export and state network lists
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Published codes
6,550
Physician procedures on the 2026 schedule
Median % of Medicare
84.8%
vs national Medicare, GPCI-neutral
Effective vintage
2026
latest effective year on the schedule
Common physician procedures and what Texas Medicaid pays
A curated sample of recognizable procedures from the 6,550-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 | Texas rate | % of Medicare |
|---|---|---|---|
| 10021 | Fine needle aspiration biopsy, first lesion, no imaging | $81.26* | 80.6% |
| 10060 | Drainage of a skin abscess, simple | $102.38* | 79.6% |
| 10061 | Drainage of a skin abscess, complicated or multiple | $172.95* | 78.6% |
| 10080 | Drainage of a pilonidal cyst, simple | $201.55* | 74.8% |
| 10081 | Drainage of a pilonidal cyst, complicated | $276.66* | 72.8% |
| 10120 | Removal of a foreign body from tissue, simple | $122.69* | 78% |
| 10121 | Removal of a foreign body from skin, complicated | $213.04* | 77.4% |
| 10140 | Drainage of a blood or fluid collection under the skin | $136.86* | 78.5% |
| 10160 | Needle drainage of an abscess or cyst | $104.52* | 79.4% |
| 10180 | Drainage of an infected surgical wound | $211.71* | 73.4% |
| 11000 | Removal of infected or dead skin, up to 10% of body | $47.58* | 80.5% |
| 11042 | Wound debridement, skin and tissue below, first 20 sq cm | $104.25* | 78.6% |
| 11043 | Wound debridement to muscle, first 20 sq cm | $186.85* | 78% |
| 11044 | Wound debridement to bone, first 20 sq cm | $249.93* | 77.9% |
| 11045 | Wound debridement, skin, each added 20 sq cm | $32.08* | 76.8% |
| 11055 | Trimming of one callus or corn | $57.20* | 81.6% |
| 11056 | Trimming of 2-4 calluses or corns | $66.29* | 81.7% |
| 11057 | Trimming of 5 or more calluses or corns | $72.44* | 81.5% |
| 11102 | Skin biopsy, tangential, first lesion | $80.73* | 84.5% |
| 11104 | Skin biopsy, punch, first lesion | $100.51* | 82.9% |
| 11106 | Skin biopsy, incisional, first lesion | $124.83* | 82.5% |
| 11200 | Removal of skin tags, up to 15 | $74.58* | 80.9% |
| 11201 | Removal of skin tags, each added 10 | $14.70* | 80% |
| 11300 | Shave removal of a skin lesion, trunk/arm/leg, 0.5 cm or less | $80.73* | 83.6% |
| 11305 | Shave removal of a skin lesion, scalp/neck/genitals, 0.5 cm or less | $84.47* | 83.5% |
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 Texas Medicaid fee schedules
- Texas Medicaid fee schedule 2026, all categories
- Texas lab & imaging fee schedule · 2,128 codes
- Texas dme & supplies fee schedule · 1,910 codes
- Texas drugs fee schedule · 834 codes
- Texas state-specific services fee schedule · 345 codes
- Texas vision fee schedule · 143 codes
- Texas behavioral health fee schedule · 31 codes
Physician rates in neighboring states
Frequently asked questions
What does Texas Medicaid pay for physician and professional services?
Texas Medicaid publishes 6,550 physician procedure rates effective 2026, paying a median 84.8% 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 Texas's physician rates compare with Medicare?
Across physician codes with a national Medicare comparator, Texas Medicaid pays a median 84.8% 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 Texas?
Texas 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 Texas'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.