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Billing code 83050 · Lab & pathology

83050 Medicaid reimbursement rate by state (2026)

Clinical lab tests. Medicaid pays a median of $7.21 for 83050 across 50 states, from $3.00 in Pennsylvania to $9.84 in New Mexico.

Data as of Oct 5, 202650 statesEvery rate links to its official source

States publishing
50
National median
$7.21units vary by state
Lowest
$3.00Pennsylvania
Highest
$9.84New Mexico
Answer

What does Medicaid pay for 83050?

50 state Medicaid programs publish a fee-for-service rate for 83050. The national median is $7.21 (units differ between states). New Mexico pays the most, $9.84, and Pennsylvania the least, $3.00, a 3.3x spread.

State ranking

83050 rate by state: highest, middle and lowest

One like-for-like fee-for-service rate per state, ranked. The workspace lists all 50 states with every variant, modifier and effective date.

#StateMedicaid rateUnitPer hourManaged-care plans% of Medicare
1New Mexico Source · since 2023-07-01$9.84——Plans must pay at least this—
2Georgia Source · since 2017-01-01$9.21——Plans negotiate; applies out of network—
3North Carolina Source · since 2025-10-01$9.03——Plans must pay at least this—
25Massachusetts Source · since 2024-09-01$7.23——Plans negotiate; applies out of network—
26Maryland Source · since 2026-02-01$7.19——Not classified—
27New Hampshire Source · since 2025-01-01$7.09——Plans negotiate; applies out of network—
49Virginia Source · since 2016-01-01$3.33——Plans negotiate; applies out of network—
50Pennsylvania Source · since 2010-07-03$3.00——Plans negotiate; applies out of network—
See all 50 states for 83050 — start free

42 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.

  • Source for every rate
  • Full rate history
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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 83050 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 83050, 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. 22 of the 50 states list more than one rate for 83050, 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. Of the 50 states, 1 publish 83050 per unit, and 49 schedules print no unit at all (a flat amount per service).
  • Per hour. 83050 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 83050, 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 83050 rates differ between states

Published rates for 83050 run from $3.00 in Pennsylvania to $9.84 in New Mexico, a 3.3x gap in the same unit. Half the states pay more than the median of $7.21 and half pay less. The usual reasons for a spread like this in lab & pathology rates:

  • Some states bundle certain tests into panels or into facility payments, so the separately billable amount differs.
  • 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.

Timing matters too. 12 states set the current rate for 83050 in 2026 or later, while 21 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 83050

No managed-care plan publishes what it pays for 83050. 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 8 states, the published rate binds plans: a floor, a pass-through or a state-set rate. In 26 states, plans negotiate and the published rate is a benchmark or out-of-network default. The rule for the remaining 16 states is not classified yet.

  • Plans negotiate; the published rate applies out of network (26 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 (8 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 83050

83050 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 83050?

It depends on the state. Of the 50 states with a published fee-for-service rate, the median is $7.21. New Mexico pays the most ($9.84) and Pennsylvania the least ($3.00).

Which state pays the highest Medicaid rate for 83050?

New Mexico, at $9.84, effective 2023-07-01.

Which state pays the lowest Medicaid rate for 83050?

Pennsylvania, at $3.00, effective 2010-07-03.

What unit is 83050 billed in?

Of the 50 states, 1 publish 83050 per unit, and 49 schedules print no unit at all (a flat amount per service).

Do managed-care plans pay the same rate for 83050?

Not necessarily. In 8 states, the published rate binds plans: a floor, a pass-through or a state-set rate. In 26 states, plans negotiate and the published rate is a benchmark or out-of-network default. The rule for the remaining 16 states is not classified yet. Each rule is cited to the plan contract, statute or notice in the workspace.