North Carolina Medicaid Reimbursement Rates
What Medicaid pays for medical procedures and services in North Carolina, based on 2024 claims data.
2024 Overview
Procedures
2.8K
Total Claims
153.2M
Total Paid
$6.4B
Popular Services
Procedures
Showing 51–100 of 2,810 procedures, sorted by most claims.
| HCPCS Code | Description | Total Claims | Avg Payment | Min Payment | Max Payment |
|---|---|---|---|---|---|
| 92508 | Tx sp lang voice comm group | 439,269 | $23.62 | $0.00 | $23.88 |
| J3490 | Drugs unclassified injection | 431,784 | $6.76 | $0.00 | $751.08 |
| 71045 | X-ray exam chest 1 view | 426,606 | $11.01 | $0.00 | $189.49 |
| G0463 | Hospital outpt clinic visit | 411,582 | $35.12 | $0.00 | $336.61 |
| 90471 | Immunization admin | 410,459 | $16.02 | $0.00 | $494.31 |
| 1160F | Rvw meds by rx/dr in rcrd | 409,184 | $0.00 | $0.00 | $6.91 |
| D1351 | Dental sealant per tooth | 396,435 | $25.01 | $0.00 | $265.96 |
| 84439 | Assay of free thyroxine | 393,372 | $4.37 | $0.00 | $16.72 |
| 1159F | Med list docd in rcrd | 367,920 | $0.00 | $0.00 | $6.91 |
| S5145 | Child fostercare th per diem | 363,537 | $233.79 | $4.36 | $5,016.94 |
| 96110 | Developmental screen w/score | 362,522 | $8.94 | $0.00 | $97.79 |
| 86592 | Syphilis test non-trep qual | 352,378 | $2.23 | $0.00 | $49.40 |
| H0040 | Assert comm tx pgm per diem | 352,048 | $284.23 | $0.00 | $2,154.20 |
| H2022 | Com wrap-around sv, per diem | 348,829 | $347.28 | $0.00 | $17,384.80 |
| 99173 | Visual acuity screen | 347,928 | $0.98 | $0.00 | $10.65 |
| G0480 | Drug test def 1-7 classes | 344,790 | $51.09 | $0.00 | $106.76 |
| D0272 | Dental bitewings two images | 339,869 | $15.91 | $0.00 | $312.72 |
| 99232 | Sbsq hosp ip/obs moderate 35 | 338,343 | $41.24 | $0.00 | $94.56 |
| 86803 | Hepatitis c ab test | 337,589 | $7.33 | $0.00 | $26.49 |
| D2392 | Post 2 srfc resinbased cmpst | 335,874 | $98.10 | $0.00 | $225.98 |
| 87804 | Influenza assay w/optic | 334,160 | $12.07 | $0.00 | $39.86 |
| 85027 | Complete cbc automated | 332,519 | $4.51 | $0.00 | $225.26 |
| D0150 | Comprehensve oral evaluation | 331,926 | $38.82 | $0.00 | $49.07 |
| T1000 | Private duty/independent nsg | 328,619 | $473.34 | $0.00 | $720.67 |
| 87880 | Strep a assay w/optic | 324,453 | $11.76 | $0.00 | $21.31 |
| 81003 | Urinalysis auto w/o scope | 308,696 | $1.66 | $0.00 | $36.73 |
| D0274 | Bitewings four images | 292,310 | $27.92 | $0.00 | $39.30 |
| 93010 | Electrocardiogram report | 289,367 | $4.13 | $0.00 | $10.55 |
| D8670 | Periodic orthodontc tx visit | 288,655 | $94.15 | $0.00 | $1,000.00 |
| D1208 | Topical app fluorid ex vrnsh | 287,534 | $15.65 | $0.00 | $447.08 |
| S5150 | Unskilled respite care /15m | 279,233 | $106.01 | $17.23 | $239.57 |
| A9270 | Non-covered item or service | 279,146 | $0.63 | $0.00 | $48.61 |
| 71046 | X-ray exam chest 2 views | 278,620 | $18.60 | $0.00 | $299.60 |
| 99309 | Sbsq nf care moderate mdm 30 | 275,284 | $17.25 | $0.00 | $81.50 |
| A0425 | Ground mileage | 269,498 | $5.82 | $0.00 | $168.58 |
| 82607 | Vitamin b-12 | 269,222 | $7.02 | $0.00 | $27.51 |
| H2035 | A/d tx program, per hour | 268,519 | $193.82 | $0.00 | $719.00 |
| 83540 | Assay of iron | 262,727 | $2.81 | $0.00 | $14.27 |
| T4535 | Disposable liner/shield/pad | 260,982 | $53.10 | $6.13 | $77.64 |
| V2020 | Vision svcs frames purchases | 257,114 | $8.92 | $0.00 | $99.65 |
| 92551 | Pure tone hearing test air | 256,659 | $1.04 | $0.00 | $11.12 |
| D0330 | Panoramic image | 256,279 | $45.32 | $0.00 | $88.52 |
| 82728 | Assay of ferritin | 248,564 | $6.67 | $0.00 | $73.17 |
| T2016 | Habil res waiver per diem | 246,983 | $209.31 | $0.00 | $6,974.51 |
| T4541 | Large disposable underpad | 244,984 | $43.96 | $42.96 | $66.22 |
| 97155 | Adapt behavior tx phys/qhp | 244,919 | $211.21 | $0.00 | $469.78 |
| 90460 | Im admin 1st/only component | 244,026 | $41.60 | $0.00 | $118.19 |
| 82570 | Assay of urine creatinine | 238,564 | $2.43 | $0.00 | $17.62 |
| 87801 | Detect agnt mult dna ampli | 235,859 | $35.61 | $0.00 | $89.78 |
| D9230 | Analgesia | 233,603 | $40.91 | $0.00 | $47.27 |