Nebraska Medicaid Reimbursement Rates
What Medicaid pays for medical procedures and services in Nebraska, based on 2024 claims data.
2024 Overview
Procedures
1.1K
Total Claims
5.1M
Total Paid
$315.4M
Popular Services
Procedures
Showing 51–100 of 1,125 procedures, sorted by most claims.
| HCPCS Code | Description | Total Claims | Avg Payment | Min Payment | Max Payment |
|---|---|---|---|---|---|
| H0018 | Alcohol and/or drug services | 20,607 | $588.38 | $122.14 | $7,541.22 |
| 92004 | Compre oph exam new pt 1/> | 20,382 | $67.41 | $0.00 | $96.87 |
| V2100 | Lens spher single plano 4.00 | 20,307 | $36.98 | $0.00 | $162.00 |
| 88305 | Tissue exam by pathologist | 20,215 | $63.39 | $0.00 | $251.44 |
| D2392 | Post 2 srfc resinbased cmpst | 20,114 | $93.35 | $0.00 | $179.13 |
| A0427 | Als1-emergency | 19,798 | $208.32 | $4.66 | $420.61 |
| D0140 | Limit oral eval problm focus | 19,373 | $24.57 | $0.00 | $51.58 |
| 99233 | Sbsq hosp ip/obs high 50 | 19,338 | $57.19 | $16.58 | $107.05 |
| 99391 | Per pm reeval est pat infant | 19,052 | $75.73 | $0.00 | $121.62 |
| 90833 | Psytx w pt w e/m 30 min | 19,023 | $55.25 | $0.00 | $95.76 |
| 99203 | Office o/p new low 30 min | 18,899 | $63.04 | $0.00 | $229.88 |
| 74177 | Ct abd & pelvis w/contrast | 18,290 | $98.24 | $0.00 | $337.01 |
| 99392 | Prev visit est age 1-4 | 17,553 | $87.08 | $0.00 | $229.88 |
| 70450 | Ct head/brain w/o dye | 16,991 | $37.53 | $14.40 | $413.44 |
| G2211 | Complex e/m visit add on | 16,931 | $3.97 | $0.00 | $54.46 |
| 97014 | Electric stimulation therapy | 16,528 | $14.84 | $9.68 | $16.29 |
| D2930 | Prefab stnlss steel crwn pri | 16,362 | $150.02 | $0.00 | $225.28 |
| H0040 | Assert comm tx pgm per diem | 16,232 | $135.86 | $58.96 | $1,958.27 |
| D9230 | Analgesia | 16,150 | $35.08 | $0.00 | $54.77 |
| D7140 | Extraction erupted tooth/exr | 15,996 | $77.83 | $0.00 | $161.23 |
| 90656 | Iiv3 vacc no prsv 0.5 ml im | 15,985 | $10.43 | $0.00 | $26.77 |
| 97140 | Manual therapy 1/> regions | 15,216 | $25.87 | $4.89 | $63.85 |
| 87651 | Strep a dna amp probe | 15,176 | $33.19 | $0.00 | $56.83 |
| D1355 | Caries med app per tooth | 15,064 | $12.17 | $11.08 | $13.30 |
| H0019 | Alcohol and/or drug services | 14,994 | $361.78 | $123.38 | $4,595.54 |
| 3074F | Syst bp lt 130 mm hg | 14,840 | $0.00 | $0.00 | $0.01 |
| 87880 | Strep a assay w/optic | 14,526 | $16.13 | $3.38 | $51.23 |
| 3008F | Body mass index docd | 14,327 | $0.16 | $0.00 | $10.00 |
| D0240 | Intraoral occlusal film | 14,192 | $7.29 | $0.00 | $9.95 |
| 3078F | Diast bp <80 mm hg | 13,753 | $0.00 | $0.00 | $0.05 |
| A4239 | Non-adju cgm supply allow | 13,669 | $179.60 | $102.48 | $236.35 |
| G2067 | Med assist tx meth wk | 13,542 | $194.24 | $0.00 | $239.21 |
| D1208 | Topical app fluorid ex vrnsh | 12,782 | $19.16 | $0.00 | $37.99 |
| 96374 | Ther/proph/diag inj iv push | 12,655 | $2.47 | $0.00 | $49.44 |
| E1390 | Oxygen concentrator, single delivery port, capable of delivering 85 percent or | 12,606 | $40.08 | $0.00 | $185.53 |
| 99204 | Office o/p new mod 45 min | 12,396 | $87.56 | $0.00 | $254.34 |
| 90832 | Psytx w pt 30 minutes | 12,138 | $61.91 | $0.00 | $321.14 |
| H0038 | Self-help/peer svc per 15min | 11,724 | $45.58 | $0.00 | $176.91 |
| 74018 | Radex abdomen 1 view | 11,539 | $13.13 | $4.02 | $110.52 |
| V2756 | Eye glass case | 11,416 | $1.15 | $0.23 | $1.43 |
| 99215 | Office o/p est hi 40 min | 11,412 | $85.31 | $0.00 | $216.92 |
| A0120 | Noner transport mini-bus | 11,382 | $1.74 | $0.00 | $2.03 |
| 83036 | Hemoglobin glycosylated a1c | 11,293 | $5.97 | $0.00 | $37.18 |
| 90471 | Immunization admin | 10,527 | $6.04 | $0.00 | $52.39 |
| 97032 | Appl modality 1+estim ea 15 | 10,288 | $17.29 | $6.09 | $20.56 |
| 90677 | Pcv20 vaccine im | 10,206 | $14.19 | $0.00 | $209.63 |
| D2391 | Post 1 srfc resinbased cmpst | 10,162 | $72.12 | $0.00 | $137.56 |
| 93005 | Electrocardiogram tracing | 10,033 | $1.31 | $0.00 | $50.14 |
| 99212 | Office o/p est sf 10 min | 9,985 | $46.78 | $0.00 | $380.65 |
| 99282 | Emergency dept visit sf mdm | 9,858 | $109.37 | $0.00 | $470.55 |