Texas Medicaid rate for CPT 12001
Texas Medicaid pays a median of $77.81 across its rate types for CPT 12001 in its September 2026 fee-for-service schedule: the 19th-lowest of 45 state Medicaid programs, at 90% of the $86.45 median.
- Non-facility rate
- $77.81
- Rank
- 27 of 45
- vs. state median
- 90%
- vs. TX Medicare
- 66-73%
What Texas Medicaid publishes for 12001
19th-lowest of 45 · 90% of median
- Schedule
- September 2026
- In effect since
- Mar 1, 2025
$75.91 to $79.71 across 2 rate types
- Surgery · Under 21
- $79.71
- Surgery · Ages 21+
- $75.91
Unmodified non-facility fee-for-service rate from the state's published file. Managed-care contracts, supplemental payments, and claim-specific adjustments can change what is paid. TMHP Static Fee Schedules
12001 in neighboring states
Each state's comparable non-facility rate for 12001 in its current schedule.
| State | Rate | vs. Texas |
|---|---|---|
| Arkansas | $51.93 | -33% |
| Louisiana | $96.98 | +25% |
| New Mexico | $132.53 | +70% |
| Oklahoma | $97.32 | +25% |
12001 in every state
Map and ranking of every state program that prices 12001.
Compare 12001 across states12001 under Medicare
Medicare's 2026 non-facility payment for 12001 in Texas is $106.23 to $117.94 across its 8 payment localities; Texas Medicaid's rate is 66-73% of that. The national amount before geographic adjustment is $113.897.
See 12001 Medicare ratesSee Texas's full schedule: all 8,435 codes, every published period, and commercial payer rates for 12001.
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