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Billing code 80354 · Lab & pathology

80354 Medicaid reimbursement rate by state (2026)

Clinical lab tests. Medicaid pays a median of $14.45 for 80354 across 10 states, from $4.19 in Arizona to $34.72 in Pennsylvania.

Data as of Oct 5, 202610 statesEvery rate links to its official source

States publishing
10
National median
$14.45units vary by state
Lowest
$4.19Arizona
Highest
$34.72Pennsylvania
Answer

What does Medicaid pay for 80354?

10 state Medicaid programs publish a fee-for-service rate for 80354. The national median is $14.45 (units differ between states). Pennsylvania pays the most, $34.72, and Arizona the least, $4.19, a 8.3x spread.

State ranking

80354 rate by state: highest, middle and lowest

One like-for-like fee-for-service rate per state, ranked. The workspace lists all 10 states with every variant, modifier and effective date.

#StateMedicaid rateUnitPer hourManaged-care plans% of Medicare
1Pennsylvania Source · since 2015-09-01$34.72——Plans negotiate; applies out of network—
2Arkansas Source · since 2025-03-26$29.55——Not classified—
3New Jersey Source · since 2023-12-01$16.48——Not classified—
5Texas Source · since 2019-07-17$15.25——Plans negotiate; applies out of network—
6Florida Source · since 2026-01-01$13.65——Plans negotiate; applies out of network—
9New York Source · since 2020-05-29$5.05——Plans negotiate; applies out of network—
10Arizona Source · since 2026-10-01$4.19——Plans negotiate; applies out of network—
See all 10 states for 80354 — start free

3 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 80354 in your states. Get an alert when any state changes it, with every variant and the managed-care rule.
FAQ

Frequently asked questions

What does Medicaid pay for 80354?

It depends on the state. Of the 10 states with a published fee-for-service rate, the median is $14.45. Pennsylvania pays the most ($34.72) and Arizona the least ($4.19).

Which state pays the highest Medicaid rate for 80354?

Pennsylvania, at $34.72, effective 2015-09-01.

Do managed-care plans pay the same rate for 80354?

Not necessarily. Each state's plan contracts decide whether plans must pay at least the fee-for-service rate, pay a state-set rate, or negotiate their own. The workspace shows the rule for each state, cited to the contract or statute.