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Billing code 80337 · Lab & pathology

80337 Medicaid reimbursement rate by state (2026)

Clinical lab tests. Medicaid pays a median of $14.75 for 80337 across 11 states, from $3.66 in Arizona to $27.18 in Arkansas.

Data as of Oct 5, 202611 statesEvery rate links to its official source

States publishing
11
National median
$14.75units vary by state
Lowest
$3.66Arizona
Highest
$27.18Arkansas
Answer

What does Medicaid pay for 80337?

11 state Medicaid programs publish a fee-for-service rate for 80337. The national median is $14.75 (units differ between states). Arkansas pays the most, $27.18, and Arizona the least, $3.66, a 7.4x spread.

State ranking

80337 rate by state: highest, middle and lowest

One like-for-like fee-for-service rate per state, ranked. The workspace lists all 11 states with every variant, modifier and effective date.

#StateMedicaid rateUnitPer hourManaged-care plans% of Medicare
1Arkansas Source · since 2025-03-26$27.18——Not classified—
2Kansas Source · since 2015-01-01$22.80——Plans must pay at least this—
3Georgia Source · since 2017-01-01$22.51——Plans negotiate; applies out of network—
5Iowa Source · since 2016-01-01$16.65——Plans must pay at least this—
6Pennsylvania Source · since 2015-09-01$14.75——Plans negotiate; applies out of network—
10New York Source · since 2020-05-29$5.05——Plans negotiate; applies out of network—
11Arizona Source · since 2026-10-01$3.66——Plans negotiate; applies out of network—
See all 11 states for 80337 — start free

4 more states, with every modifier and provider-type variant, rate history and the plan rule in each state. 14-day free trial, no credit card.

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Rates are per the unit shown for each state; units can differ between states. Medicare amounts are computed from the CMS relative value file and locality cost indices; states with several Medicare localities show a range. Confirm rates with the payer before billing.

Track 80337 in your states. Get an alert when any state changes it, with every variant and the managed-care rule.
Guide

How to read this table

  • Order. States are listed from the highest published rate to the lowest. No single unit is shared by 8 or more states for 80337, so the order is by published amount and is not a like-for-like rank.
  • Medicaid rate. The most the state's fee-for-service program pays for one unit, as published. 6 of the 11 states list more than one rate for 80337, by modifier, provider type or setting; the table shows the one that matches the provider level and setting used across states, without add-ons.
  • Unit. None of the 11 schedules prints a separate unit for 80337, so each amount is a flat payment for one service as the code defines it.
  • Per hour. 80337 is not billed in time units in these states, so no hourly figure is shown.
  • Managed-care plans. The rule the state sets for its plans on this rate. What each rule means is explained below.
  • % of Medicare. No Medicare physician fee schedule amount is on file for 80337, so there is no percentage.
  • Source and date. Each Source link opens the state's own document; “since” is the date the rate took effect.
Context

Why 80337 rates differ between states

Published rates for 80337 run from $3.66 in Arizona to $27.18 in Arkansas, a 7.4x gap in the same unit. Half the states pay more than the median of $14.75 and half pay less. The usual reasons for a spread like this in lab & pathology rates:

  • Pathology services with an interpretation have professional and technical components that states price separately.
  • Fees for newer molecular and genetic tests are often set case by case, so fewer states publish them and the published amounts spread widely.
  • Some states bundle certain tests into panels or into facility payments, so the separately billable amount differs.

Timing matters too. 2 states set the current rate for 80337 in 2026 or later, while 7 states still pay a rate that took effect in 2022 or earlier. A state that has not updated its rate in years will drift down the ranking as others raise theirs.

Managed care

What managed-care plans pay for 80337

Most Medicaid members are in managed-care plans, and plans don't publish their provider fee schedules. For 80337, the public signal is the rule each state sets for its plans, recorded on each rate above.

In 2 states, the published rate binds plans: a floor, a pass-through or a state-set rate. In 7 states, plans negotiate and the published rate is a benchmark or out-of-network default. The rule for the remaining 2 states is not classified yet.

  • Plans negotiate; the published rate applies out of network (7 states). In-network rates can be above or below the published rate. The published rate is the benchmark both sides know, and the fallback if no contract is signed.
  • Plans must pay at least the published rate (2 states). The published rate is your floor. Negotiate up from it, and if a plan pays less, the contract provision is the basis for a payment dispute.

Plan-negotiated rates are never estimated here. To see the rule and its citation for a particular state, open that state's managed-care page, for example Arkansas managed care.

Billing

Units and billing for 80337

80337 is a CPT pathology and laboratory code in the lab & pathology line, billed mostly by independent laboratories, hospital labs and pathology groups. Laboratory codes are paid per test; a panel is paid as one code, not as the sum of its tests. Pathology codes with an interpretation can be split into professional and technical components.

Pathology interpretation can be billed with modifier 26 when the laboratory and the pathologist bill separately. Laboratory tests are billed per test, and a panel is paid as a single code rather than as the sum of its component tests.

Before billing, confirm the rate, unit and any modifier with the state's current schedule or the plan: the amounts here are as published, not a guarantee of payment.

FAQ

Frequently asked questions

What does Medicaid pay for 80337?

It depends on the state. Of the 11 states with a published fee-for-service rate, the median is $14.75. Arkansas pays the most ($27.18) and Arizona the least ($3.66).

Which state pays the highest Medicaid rate for 80337?

Arkansas, at $27.18, effective 2025-03-26.

Which state pays the lowest Medicaid rate for 80337?

Arizona, at $3.66, effective 2026-10-01.

What unit is 80337 billed in?

None of the 11 schedules prints a separate unit for 80337, so each amount is a flat payment for one service as the code defines it.

Do managed-care plans pay the same rate for 80337?

Not necessarily. In 2 states, the published rate binds plans: a floor, a pass-through or a state-set rate. In 7 states, plans negotiate and the published rate is a benchmark or out-of-network default. The rule for the remaining 2 states is not classified yet. Each rule is cited to the plan contract, statute or notice in the workspace.