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Billing code 83088 · Lab & pathology

83088 Medicaid reimbursement rate by state (2026)

Clinical lab tests. Medicaid pays a median of $27.39 for 83088 across 48 states, from $9.90 in Virginia to $41.94 in Iowa.

Data as of Oct 5, 202648 statesEvery rate links to its official source

States publishing
48
National median
$27.39units vary by state
Lowest
$9.90Virginia
Highest
$41.94Iowa
Answer

What does Medicaid pay for 83088?

48 state Medicaid programs publish a fee-for-service rate for 83088. The national median is $27.39 (units differ between states). Iowa pays the most, $41.94, and Virginia the least, $9.90, a 4.2x spread.

State ranking

83088 rate by state: highest, middle and lowest

One like-for-like fee-for-service rate per state, ranked. The workspace lists all 48 states with every variant, modifier and effective date.

#StateMedicaid rateUnitPer hourManaged-care plans% of Medicare
1Iowa Source · since 2013-07-01$41.94——Plans must pay at least this—
2Arkansas Source · since 2025-03-26$39.86——Not classified—
3Georgia Source · since 2017-01-01$37.13——Plans negotiate; applies out of network—
24Connecticut Source · since 2015-01-01$28.20——Not classified—
25Arizona Source · since 2026-10-01$26.58——Plans negotiate; applies out of network—
26Missouri Source · since 2026-07-01$26.58——Plans negotiate; applies out of network—
47Rhode Island Source · since 2005-01-01$12.17——Plans negotiate; applies out of network—
48Virginia Source · since 2014-07-01$9.90——Plans negotiate; applies out of network—
See all 48 states for 83088 — start free

40 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 83088 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 83088, 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. 19 of the 48 states list more than one rate for 83088, 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 48 states, 1 publish 83088 per unit, and 47 schedules print no unit at all (a flat amount per service).
  • Per hour. 83088 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 83088, 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 83088 rates differ between states

Published rates for 83088 run from $9.90 in Virginia to $41.94 in Iowa, a 4.2x gap in the same unit. Half the states pay more than the median of $27.39 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.
  • 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.

Timing matters too. 12 states set the current rate for 83088 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 83088

What a plan pays for 83088 is negotiated privately, but the state decides how much room there is to negotiate. Here is how the rules break down across the 48 states.

In 8 states, the published rate binds plans: a floor, a pass-through or a state-set rate. In 24 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 (24 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 Iowa managed care.

Billing

Units and billing for 83088

83088 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.

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

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 83088?

It depends on the state. Of the 48 states with a published fee-for-service rate, the median is $27.39. Iowa pays the most ($41.94) and Virginia the least ($9.90).

Which state pays the highest Medicaid rate for 83088?

Iowa, at $41.94, effective 2013-07-01.

Which state pays the lowest Medicaid rate for 83088?

Virginia, at $9.90, effective 2014-07-01.

What unit is 83088 billed in?

Of the 48 states, 1 publish 83088 per unit, and 47 schedules print no unit at all (a flat amount per service).

Do managed-care plans pay the same rate for 83088?

Not necessarily. In 8 states, the published rate binds plans: a floor, a pass-through or a state-set rate. In 24 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.