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Billing code 82777 · Lab & pathology

82777 Medicaid reimbursement rate by state (2026)

Clinical lab tests. Medicaid pays a median of $38.24 for 82777 across 35 states, from $10.68 in Rhode Island to $53.10 in New Mexico.

Data as of Oct 5, 202635 statesEvery rate links to its official source

States publishing
35
National median
$38.24units vary by state
Lowest
$10.68Rhode Island
Highest
$53.10New Mexico
Answer

What does Medicaid pay for 82777?

35 state Medicaid programs publish a fee-for-service rate for 82777. The national median is $38.24 (units differ between states). New Mexico pays the most, $53.10, and Rhode Island the least, $10.68, a 5.0x spread.

State ranking

82777 rate by state: highest, middle and lowest

One like-for-like fee-for-service rate per state, ranked. The workspace lists all 35 states with every variant, modifier and effective date.

#StateMedicaid rateUnitPer hourManaged-care plans% of Medicare
1New Mexico Source · since 2023-07-01$53.10——Plans must pay at least this—
2Montana Source · since 2018-07-01$44.25——Not classified—
3Arizona Source · since 2026-10-01$44.25——Plans negotiate; applies out of network—
17New Hampshire Source · since 2025-01-01$38.28——Plans negotiate; applies out of network—
18Idaho Source · since 2025-09-01$38.24——Not classified—
19Louisiana Source · since 2025-07-01$37.61——Plans must pay at least this—
34Pennsylvania Source · since 2013-06-24$14.24——Plans negotiate; applies out of network—
35Rhode Island Source · since 2013-01-01$10.68——Plans negotiate; applies out of network—
See all 35 states for 82777 — start free

27 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 82777 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 82777, 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. 9 of the 35 states list more than one rate for 82777, 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 35 schedules prints a separate unit for 82777, so each amount is a flat payment for one service as the code defines it.
  • Per hour. 82777 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 82777, 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 82777 rates differ between states

Published rates for 82777 run from $10.68 in Rhode Island to $53.10 in New Mexico, a 5.0x gap in the same unit. Half the states pay more than the median of $38.24 and half pay less. The usual reasons for a spread like this in lab & pathology rates:

  • Fees for newer molecular and genetic tests are often set case by case, so fewer states publish them and the published amounts spread widely.
  • Many states set clinical laboratory fees with reference to the Medicare Clinical Laboratory Fee Schedule, but at different percentages and from different update years.
  • Some states bundle certain tests into panels or into facility payments, so the separately billable amount differs.

Timing matters too. 8 states set the current rate for 82777 in 2026 or later, while 12 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 82777

No managed-care plan publishes what it pays for 82777. What is public is the rule each state's plan contracts set, and that rule decides how much the published rate matters when you contract with a plan.

In 5 states, the published rate binds plans: a floor, a pass-through or a state-set rate. In 18 states, plans negotiate and the published rate is a benchmark or out-of-network default. The rule for the remaining 12 states is not classified yet.

  • Plans negotiate; the published rate applies out of network (18 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 (5 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 New Mexico managed care.

Billing

Units and billing for 82777

82777 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 82777?

It depends on the state. Of the 35 states with a published fee-for-service rate, the median is $38.24. New Mexico pays the most ($53.10) and Rhode Island the least ($10.68).

Which state pays the highest Medicaid rate for 82777?

New Mexico, at $53.10, effective 2023-07-01.

Which state pays the lowest Medicaid rate for 82777?

Rhode Island, at $10.68, effective 2013-01-01.

What unit is 82777 billed in?

None of the 35 schedules prints a separate unit for 82777, so each amount is a flat payment for one service as the code defines it.

Do managed-care plans pay the same rate for 82777?

Not necessarily. In 5 states, the published rate binds plans: a floor, a pass-through or a state-set rate. In 18 states, plans negotiate and the published rate is a benchmark or out-of-network default. The rule for the remaining 12 states is not classified yet. Each rule is cited to the plan contract, statute or notice in the workspace.