South Dakota Medicaid Reimbursement Rates
What Medicaid pays for medical procedures and services in South Dakota, based on 2024 claims data.
2024 Overview
Procedures
1.1K
Total Claims
3.9M
Total Paid
$498.7M
Popular Services
Procedures
Showing 101–150 of 1,069 procedures, sorted by most claims.
| HCPCS Code | Description | Total Claims | Avg Payment | Min Payment | Max Payment |
|---|---|---|---|---|---|
| 74018 | Radex abdomen 1 view | 8,218 | $11.52 | $4.89 | $99.02 |
| 99222 | 1st hosp ip/obs moderate 55 | 8,115 | $84.20 | $32.61 | $120.63 |
| A0429 | Bls-emergency | 7,814 | $195.06 | $83.97 | $376.21 |
| D0140 | Limit oral eval problm focus | 7,678 | $161.99 | $21.94 | $667.64 |
| D0603 | Caries risk assess high risk | 7,643 | $17.43 | $0.00 | $626.23 |
| 81003 | Urinalysis auto w/o scope | 7,514 | $2.58 | $0.00 | $156.30 |
| 97153 | Adaptive behavior tx by tech | 7,425 | $133.17 | $66.96 | $407.19 |
| 73630 | X-ray exam of foot | 7,422 | $12.96 | $4.10 | $25.03 |
| 92526 | Oral function therapy | 7,303 | $54.62 | $48.20 | $108.32 |
| 99393 | Prev visit est age 5-11 | 7,220 | $111.20 | $43.02 | $686.32 |
| 87086 | Urine culture/colony count | 7,175 | $6.89 | $0.00 | $7.69 |
| 80048 | Basic metabolic pnl total ca | 7,010 | $8.29 | $0.00 | $359.68 |
| A0120 | Noner transport mini-bus | 6,961 | $6.81 | $3.47 | $11.17 |
| 85027 | Complete cbc automated | 6,816 | $5.37 | $0.00 | $34.84 |
| 90791 | Psych diagnostic evaluation | 6,697 | $127.98 | $31.91 | $719.00 |
| 74177 | Ct abd & pelvis w/contrast | 6,677 | $91.92 | $46.85 | $242.99 |
| 99309 | Sbsq nf care moderate mdm 30 | 6,585 | $24.47 | $0.00 | $175.27 |
| T2031 | Assist living waiver/diem | 6,581 | $1,404.29 | $405.88 | $2,555.04 |
| H0019 | Alcohol and/or drug services | 6,177 | $1,064.68 | $145.67 | $8,747.03 |
| 70450 | Ct head/brain w/o dye | 6,172 | $34.16 | $0.00 | $217.87 |
| 99231 | Sbsq hosp ip/obs sf/low 25 | 6,155 | $29.03 | $16.22 | $38.71 |
| 84439 | Assay of free thyroxine | 5,992 | $7.17 | $0.00 | $9.02 |
| H0004 | Alcohol and/or drug services | 5,904 | $99.84 | $0.00 | $281.95 |
| 00170 | Anes intraoral px nos | 5,891 | $154.74 | $64.26 | $309.55 |
| T1005 | Respite care service 15 min | 5,773 | $88.39 | $44.34 | $129.77 |
| 99238 | Hosp ip/obs dschrg mgmt 30/< | 5,771 | $55.91 | $7.42 | $81.98 |
| 97139 | Unlisted therapeutic px | 5,762 | $29.31 | $3.42 | $255.48 |
| 90671 | Pcv15 vaccine im | 5,745 | $15.20 | $0.00 | $72.45 |
| 83540 | Assay of iron | 5,717 | $5.48 | $0.00 | $6.47 |
| D9230 | Analgesia | 5,679 | $35.23 | $10.84 | $45.35 |
| 36416 | Collj capillary blood spec | 5,637 | $0.13 | $0.00 | $0.70 |
| 76819 | Fetal biophys profil w/o nst | 5,467 | $42.30 | $18.52 | $62.69 |
| 83550 | Iron binding test | 5,438 | $7.36 | $0.00 | $8.74 |
| 93306 | Tte w/doppler complete | 5,320 | $65.74 | $20.24 | $128.07 |
| 99211 | Off/op est may x req phy/qhp | 5,290 | $351.61 | $0.00 | $719.00 |
| 99291 | Critical care first hour | 5,288 | $175.39 | $118.40 | $216.20 |
| D7210 | Rem imp tooth w mucoper flp | 5,245 | $200.25 | $88.12 | $404.47 |
| 90461 | Im admin each addl component | 5,128 | $0.00 | $0.00 | $0.00 |
| S9124 | Nursing care, in the home; b | 5,101 | $550.13 | $278.39 | $718.20 |
| 90680 | Rv5 vacc 3 dose live oral | 4,961 | $0.00 | $0.00 | $0.00 |
| 86780 | Treponema pallidum | 4,814 | $12.02 | $0.00 | $12.84 |
| 73610 | X-ray exam of ankle | 4,734 | $13.12 | $4.51 | $28.12 |
| E0601 | Continuous positive airway pressure (cpap) device | 4,726 | $40.88 | $14.46 | $63.81 |
| S0215 | Nonemerg transp mileage | 4,685 | $99.10 | $21.50 | $195.00 |
| 82306 | Vitamin d 25 hydroxy | 4,668 | $22.03 | $0.00 | $32.24 |
| D0210 | Intraor comprehensive series | 4,634 | $134.94 | $0.00 | $431.40 |
| J2501 | Paricalcitol | 4,626 | $1.31 | $0.00 | $4.83 |
| 87389 | Hiv-1 ag w/hiv-1&-2 ab ag ia | 4,581 | $20.02 | $0.00 | $24.08 |
| 99394 | Prev visit est age 12-17 | 4,528 | $137.05 | $55.19 | $719.00 |
| 87624 | Hpv hi-risk typ pooled rslt | 4,502 | $32.58 | $0.00 | $39.66 |