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 101–150 of 2,810 procedures, sorted by most claims.
| HCPCS Code | Description | Total Claims | Avg Payment | Min Payment | Max Payment |
|---|---|---|---|---|---|
| E1390 | Oxygen concentrator, single delivery port, capable of delivering 85 percent or | 228,934 | $43.04 | $4.10 | $152.97 |
| 93005 | Electrocardiogram tracing | 222,398 | $36.04 | $0.00 | $193.57 |
| 83550 | Iron binding test | 221,060 | $3.76 | $0.00 | $16.39 |
| A0427 | Als1-emergency | 220,680 | $222.79 | $0.00 | $2,028.38 |
| G2211 | Complex e/m visit add on | 219,130 | $1.93 | $0.00 | $104.30 |
| 80050 | General health panel | 217,090 | $11.30 | $0.00 | $173.82 |
| 99204 | Office o/p new mod 45 min | 212,796 | $92.83 | $0.00 | $194.58 |
| D0140 | Limit oral eval problm focus | 211,691 | $32.95 | $0.00 | $43.15 |
| 87081 | Culture screen only | 210,395 | $4.03 | $0.00 | $29.72 |
| T4534 | Youth size pull-on | 208,781 | $104.28 | $4.39 | $160.50 |
| 99203 | Office o/p new low 30 min | 207,306 | $62.37 | $0.00 | $132.48 |
| 80048 | Basic metabolic pnl total ca | 203,510 | $6.45 | $0.00 | $190.55 |
| D2391 | Post 1 srfc resinbased cmpst | 201,787 | $73.72 | $0.00 | $256.65 |
| 90472 | Immunization admin each add | 200,884 | $28.34 | $0.00 | $99.33 |
| 87340 | Hepatitis b surface ag ia | 199,597 | $5.23 | $0.00 | $16.99 |
| 99392 | Prev visit est age 1-4 | 199,146 | $94.06 | $13.39 | $510.33 |
| 82043 | Ur albumin quantitative | 198,954 | $2.47 | $0.00 | $19.81 |
| 88175 | Cytopath c/v auto fluid redo | 195,603 | $14.84 | $0.00 | $49.66 |
| T2020 | Day habil waiver per diem | 193,453 | $206.88 | $104.05 | $692.61 |
| T1019 | Personal care ser per 15 min | 189,567 | $230.39 | $0.00 | $8,482.89 |
| E0603 | Breast pump, electric (ac and/or dc), any type | 186,568 | $118.39 | $60.00 | $150.40 |
| 87651 | Strep a dna amp probe | 183,437 | $28.03 | $0.00 | $51.80 |
| 81025 | Urine pregnancy test | 183,114 | $7.72 | $0.00 | $284.22 |
| 83735 | Assay of magnesium | 183,035 | $4.19 | $0.00 | $12.43 |
| 83655 | Assay of lead | 182,713 | $8.16 | $0.00 | $22.74 |
| 96374 | Ther/proph/diag inj iv push | 178,386 | $42.82 | $0.00 | $265.26 |
| 1036F | Tobacco non-user | 177,192 | $0.00 | $0.00 | $0.08 |
| D7140 | Extraction erupted tooth/exr | 173,943 | $59.65 | $0.00 | $329.71 |
| 99391 | Per pm reeval est pat infant | 171,208 | $88.11 | $0.00 | $516.44 |
| 82746 | Assay of folic acid serum | 169,424 | $6.47 | $0.00 | $26.82 |
| 92370 | Rpr&refitg spect xcp aphakia | 165,175 | $6.16 | $0.00 | $14.30 |
| A4657 | Syringe w/wo needle | 165,146 | $0.00 | $0.00 | $0.24 |
| 99233 | Sbsq hosp ip/obs high 50 | 164,664 | $60.66 | $0.00 | $120.42 |
| 90832 | Psytx w pt 30 minutes | 163,540 | $24.46 | $0.00 | $719.00 |
| V2103 | Spherocylindr 4.00d/12-2.00d | 162,795 | $9.09 | $0.00 | $11.68 |
| 99393 | Prev visit est age 5-11 | 162,486 | $93.31 | $0.00 | $551.37 |
| 99215 | Office o/p est hi 40 min | 159,871 | $85.97 | $0.00 | $719.00 |
| T4527 | Adult size pull-on lg | 156,653 | $103.68 | $18.51 | $172.00 |
| A0120 | Noner transport mini-bus | 153,413 | $73.93 | $0.00 | $235.62 |
| 87635 | Sars-cov-2 covid-19 amp prb | 151,807 | $44.14 | $0.00 | $79.82 |
| G0483 | Drug test def 22+ classes | 149,954 | $105.39 | $0.00 | $252.09 |
| 96372 | Ther/proph/diag inj sc/im | 147,360 | $17.85 | $0.00 | $528.55 |
| H0036 | Comm psy face-face per 15min | 145,440 | $104.95 | $32.64 | $2,300.00 |
| 88305 | Tissue exam by pathologist | 144,771 | $60.68 | $0.00 | $599.16 |
| 70450 | Ct head/brain w/o dye | 144,651 | $56.45 | $0.00 | $750.36 |
| 99349 | Home/res vst est mod mdm 40 | 143,079 | $27.78 | $0.00 | $113.54 |
| 86780 | Treponema pallidum | 142,838 | $8.73 | $0.00 | $35.98 |
| 87624 | Hpv hi-risk typ pooled rslt | 142,347 | $21.69 | $0.00 | $60.61 |
| 95117 | Immunotherapy injections | 140,387 | $7.46 | $0.00 | $9.81 |
| D2930 | Prefab stnlss steel crwn pri | 139,285 | $134.30 | $0.00 | $397.12 |