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Billing code 86280 · Lab & pathology

86280 Medicaid reimbursement rate by state (2026)

Clinical lab tests. Medicaid pays a median of $7.97 for 86280 across 47 states, from $4.66 in Florida to $11.69 in Arkansas.

Data as of Oct 5, 202647 statesEvery rate links to its official source

States publishing
47
National median
$7.97units vary by state
Lowest
$4.66Florida
Highest
$11.69Arkansas
Answer

What does Medicaid pay for 86280?

47 state Medicaid programs publish a fee-for-service rate for 86280. The national median is $7.97 (units differ between states). Arkansas pays the most, $11.69, and Florida the least, $4.66, a 2.5x spread.

State ranking

86280 rate by state: highest, middle and lowest

One like-for-like fee-for-service rate per state, ranked. The workspace lists all 47 states with every variant, modifier and effective date.

#StateMedicaid rateUnitPer hourManaged-care plans% of Medicare
1Arkansas Source · since 2025-03-26$11.69——Not classified—
2Kansas Source · since 1996-01-01$11.32——Plans must pay at least this—
3Georgia Source · since 2018-10-01$10.30——Plans negotiate; applies out of network—
23Vermont Source · since 2025-01-01$7.99——Not classified—
24Illinois Source · since 2024-04-01$7.97——Plans negotiate; applies out of network—
25Connecticut Source · since 2015-01-01$7.82——Not classified—
46Nevada Source · since 2017-01-01$5.59——Plans negotiate; applies out of network—
47Florida Source · since 2026-01-01$4.66——Plans negotiate; applies out of network—
See all 47 states for 86280 — start free

39 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 86280 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 86280?

It depends on the state. Of the 47 states with a published fee-for-service rate, the median is $7.97. Arkansas pays the most ($11.69) and Florida the least ($4.66).

Which state pays the highest Medicaid rate for 86280?

Arkansas, at $11.69, effective 2025-03-26.

Do managed-care plans pay the same rate for 86280?

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.