Puerto Rico Medicaid Reimbursement Rates
What Medicaid pays for medical procedures and services in Puerto Rico, based on 2024 claims data.
2024 Overview
Procedures
1.6K
Total Claims
27.8M
Total Paid
$766.9M
Popular Services
Procedures
Showing 51–100 of 1,621 procedures, sorted by most claims.
| HCPCS Code | Description | Total Claims | Avg Payment | Min Payment | Max Payment |
|---|---|---|---|---|---|
| 90471 | Immunization admin | 111,503 | $11.28 | $0.00 | $20.33 |
| 99211 | Off/op est may x req phy/qhp | 110,532 | $0.23 | $0.00 | $20.48 |
| D0150 | Comprehensve oral evaluation | 110,039 | $23.74 | $2.78 | $35.00 |
| 99233 | Sbsq hosp ip/obs high 50 | 108,803 | $103.94 | $0.00 | $943.60 |
| 1000F | Tobacco use assessed | 106,807 | $0.00 | $0.00 | $0.00 |
| 86738 | Mycoplasma antibody | 106,523 | $13.78 | $0.00 | $19.71 |
| 87491 | Chlmyd trach dna amp probe | 106,467 | $35.20 | $0.00 | $49.71 |
| 87624 | Hpv hi-risk typ pooled rslt | 105,358 | $40.85 | $14.50 | $49.71 |
| 92015 | Determine refractive state | 104,492 | $20.61 | $0.00 | $49.38 |
| 86592 | Syphilis test non-trep qual | 103,631 | $3.92 | $0.00 | $5.84 |
| 87591 | N.gonorrhoeae dna amp prob | 101,421 | $35.37 | $0.00 | $49.71 |
| D1120 | Dental prophylaxis child | 100,848 | $21.11 | $0.00 | $42.06 |
| 90832 | Psytx w pt 30 minutes | 100,730 | $2.34 | $0.00 | $75.57 |
| 97124 | Massage therapy | 100,465 | $21.06 | $0.00 | $54.99 |
| 88142 | Cytopath c/v thin layer | 99,416 | $22.77 | $0.00 | $32.00 |
| 88305 | Tissue exam by pathologist | 98,971 | $108.65 | $0.00 | $526.75 |
| D0230 | Intraoral periapical ea add | 97,794 | $9.66 | $0.35 | $38.00 |
| 3725F | Screen depression performed | 97,530 | $0.00 | $0.00 | $0.00 |
| G8510 | Scr dep neg, no plan reqd | 94,081 | $0.00 | $0.00 | $0.00 |
| 82607 | Vitamin b-12 | 92,094 | $14.33 | $0.00 | $21.04 |
| A0425 | Ground mileage | 91,365 | $52.50 | $0.00 | $355.20 |
| 97533 | Sensory integration | 91,264 | $99.41 | $6.00 | $205.48 |
| 93000 | Electrocardiogram complete | 89,678 | $19.98 | $0.00 | $100.00 |
| 1158F | Advnc care plan tlk docd | 86,830 | $0.00 | $0.00 | $0.00 |
| D0330 | Panoramic image | 85,859 | $33.76 | $0.00 | $48.48 |
| 92012 | Intrm oph exam est patient | 83,121 | $69.53 | $0.00 | $90.48 |
| 93010 | Electrocardiogram report | 82,700 | $8.88 | $0.00 | $22.59 |
| 3077F | Syst bp >= 140 mm hg | 81,466 | $0.00 | $0.00 | $0.00 |
| 76641 | Ultrasound breast complete | 80,622 | $90.95 | $0.00 | $165.24 |
| A0110 | Nonemergency transport bus | 74,891 | $40.69 | $0.00 | $71.68 |
| 87088 | Urine bacteria culture | 73,555 | $8.59 | $0.00 | $11.03 |
| 3044F | Hg a1c level lt 7.0% | 71,395 | $0.00 | $0.00 | $0.00 |
| 77067 | Scr mammo bi incl cad | 69,781 | $86.79 | $0.00 | $135.69 |
| D0220 | Intraoral periapical first | 69,731 | $8.18 | $0.61 | $12.56 |
| 84436 | Assay of total thyroxine | 68,470 | $6.33 | $0.00 | $9.56 |
| 90837 | Psytx w pt 60 minutes | 65,991 | $8.14 | $0.00 | $151.09 |
| 97140 | Manual therapy 1/> regions | 65,073 | $22.09 | $0.00 | $35.26 |
| 85027 | Complete cbc automated | 62,775 | $5.76 | $0.00 | $7.11 |
| 99215 | Office o/p est hi 40 min | 62,036 | $39.86 | $0.00 | $187.03 |
| 0521F | Plan of care 4 pain docd | 61,607 | $0.00 | $0.00 | $0.00 |
| 87276 | Influenza a ag if | 59,922 | $13.20 | $0.00 | $30.35 |
| 87661 | Trichomonas vaginalis amplif | 59,535 | $36.38 | $0.00 | $47.80 |
| 99223 | 1st hosp ip/obs high 75 | 59,123 | $123.95 | $0.00 | $288.35 |
| 84153 | Assay of psa total | 58,977 | $17.00 | $0.00 | $25.51 |
| 84479 | Assay of thyroid (t3 or t4) | 58,863 | $5.52 | $0.00 | $8.85 |
| 90472 | Immunization admin each add | 58,727 | $13.00 | $0.00 | $53.24 |
| 92526 | Oral function therapy | 58,464 | $71.42 | $29.91 | $87.15 |
| 97112 | Neuromuscular reeducation | 58,397 | $28.48 | $0.00 | $124.58 |
| 3028F | O2 saturation doc rev | 58,377 | $0.00 | $0.00 | $0.00 |
| 99393 | Prev visit est age 5-11 | 55,373 | $0.04 | $0.00 | $11.71 |