Pennsylvania Medicaid Reimbursement Rates
What Medicaid pays for medical procedures and services in Pennsylvania, based on 2024 claims data.
2024 Overview
Procedures
2.8K
Total Claims
65.4M
Total Paid
$5.8B
Popular Services
Procedures
Showing 101–150 of 2,827 procedures, sorted by most claims.
| HCPCS Code | Description | Total Claims | Avg Payment | Min Payment | Max Payment |
|---|---|---|---|---|---|
| A7038 | Pos airway pressure filter | 143,948 | $5.69 | $0.16 | $27.72 |
| D1208 | Topical app fluorid ex vrnsh | 141,898 | $19.38 | $0.00 | $124.46 |
| 99393 | Prev visit est age 5-11 | 138,359 | $72.52 | $0.00 | $192.19 |
| 87591 | N.gonorrhoeae dna amp prob | 137,492 | $20.02 | $0.00 | $258.05 |
| 87880 | Strep a assay w/optic | 136,035 | $8.44 | $0.00 | $96.25 |
| S5125 | Attendant care service /15m | 133,252 | $97.96 | $82.29 | $210.93 |
| H2034 | A/d halfway house, per diem | 132,840 | $423.50 | $154.32 | $5,693.49 |
| D2391 | Post 1 srfc resinbased cmpst | 131,679 | $55.73 | $0.00 | $1,594.06 |
| 90792 | Psych diag eval w/med srvcs | 127,910 | $231.88 | $0.00 | $895.26 |
| A0434 | Specialty care transport | 127,552 | $24.64 | $0.88 | $1,265.76 |
| A0427 | Als1-emergency | 127,433 | $452.76 | $14.13 | $831.86 |
| 99391 | Per pm reeval est pat infant | 121,276 | $75.45 | $0.00 | $181.13 |
| 99308 | Sbsq nf care low mdm 20 | 118,951 | $18.98 | $0.00 | $113.38 |
| 87086 | Urine culture/colony count | 117,530 | $5.90 | $0.00 | $113.96 |
| 96374 | Ther/proph/diag inj iv push | 116,376 | $26.96 | $0.00 | $305.43 |
| 88305 | Tissue exam by pathologist | 116,185 | $42.88 | $0.00 | $398.59 |
| J1100 | Dexamethasone sodium phos | 115,244 | $0.02 | $0.00 | $9.51 |
| D9230 | Analgesia | 114,976 | $47.06 | $0.00 | $120.00 |
| 70450 | Ct head/brain w/o dye | 114,132 | $40.74 | $0.00 | $680.67 |
| 96110 | Developmental screen w/score | 112,063 | $3.91 | $0.00 | $28.41 |
| 74177 | Ct abd & pelvis w/contrast | 110,572 | $81.49 | $0.00 | $865.24 |
| 90460 | Im admin 1st/only component | 108,920 | $17.60 | $0.00 | $88.19 |
| J2704 | Inj, propofol, 10 mg | 106,701 | $0.07 | $0.00 | $8.91 |
| Q9967 | Locm 300-399mg/ml iodine,1ml | 106,246 | $0.12 | $0.00 | $76.09 |
| 97151 | Bhv id assmt by phys/qhp | 105,291 | $211.44 | $28.44 | $633.92 |
| T4535 | Disposable liner/shield/pad | 104,519 | $34.07 | $15.99 | $145.41 |
| 99204 | Office o/p new mod 45 min | 103,338 | $96.75 | $0.00 | $236.17 |
| D0140 | Limit oral eval problm focus | 102,455 | $38.60 | $0.00 | $110.44 |
| G9920 | Scrning perf and negative | 101,784 | $0.05 | $0.00 | $12.74 |
| 98940 | Chiropract manj 1-2 regions | 100,435 | $11.88 | $0.00 | $21.07 |
| G8510 | Scr dep neg, no plan reqd | 100,270 | $0.00 | $0.00 | $8.75 |
| 90656 | Iiv3 vacc no prsv 0.5 ml im | 97,269 | $5.86 | $0.00 | $49.52 |
| G0299 | Hhs/hospice of rn ea 15 min | 96,323 | $104.67 | $0.00 | $599.18 |
| D8670 | Periodic orthodontc tx visit | 95,653 | $266.04 | $0.00 | $630.72 |
| J7030 | Normal saline solution infus | 95,389 | $0.06 | $0.00 | $213.58 |
| J3010 | Fentanyl citrate injection | 93,612 | $0.03 | $0.00 | $8.48 |
| E0601 | Continuous positive airway pressure (cpap) device | 92,905 | $52.27 | $8.32 | $330.99 |
| D2930 | Prefab stnlss steel crwn pri | 90,109 | $183.42 | $0.00 | $2,302.27 |
| 83735 | Assay of magnesium | 90,058 | $4.65 | $0.00 | $43.49 |
| 97154 | Grp adapt bhv tx by tech | 89,697 | $228.04 | $0.00 | $567.27 |
| 82306 | Vitamin d 25 hydroxy | 87,093 | $22.62 | $0.00 | $117.72 |
| T4537 | Reusable underpad bed size | 86,808 | $36.51 | $15.77 | $139.43 |
| 3079F | Diast bp 80-89 mm hg | 86,643 | $0.95 | $0.00 | $25.00 |
| 90847 | Family psytx w/pt 50 min | 85,705 | $102.69 | $0.00 | $203.87 |
| G0481 | Drug test def 8-14 classes | 85,535 | $83.82 | $0.00 | $940.82 |
| 81025 | Urine pregnancy test | 85,407 | $4.08 | $0.00 | $227.03 |
| 92004 | Compre oph exam new pt 1/> | 84,869 | $46.32 | $0.00 | $193.42 |
| 98941 | Chiropract manj 3-4 regions | 84,084 | $11.22 | $0.00 | $38.53 |
| 99233 | Sbsq hosp ip/obs high 50 | 82,767 | $87.83 | $0.00 | $222.66 |
| E0431 | Portable gaseous oxygen system, rental; includes portable container, regulator, | 81,845 | $15.07 | $0.55 | $231.12 |