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Billing code 86831 · Lab & pathology

86831 Medicaid reimbursement rate by state (2026)

Clinical lab tests. Medicaid pays a median of $73.69 for 86831 across 46 states, from $10.27 in California to $91.27 in Iowa.

Data as of Oct 5, 202646 statesEvery rate links to its official source

States publishing
46
National median
$73.69units vary by state
Lowest
$10.27California
Highest
$91.27Iowa
Answer

What does Medicaid pay for 86831?

46 state Medicaid programs publish a fee-for-service rate for 86831. The national median is $73.69 (units differ between states). Iowa pays the most, $91.27, and California the least, $10.27, a 8.9x spread.

State ranking

86831 rate by state: highest, middle and lowest

One like-for-like fee-for-service rate per state, ranked. The workspace lists all 46 states with every variant, modifier and effective date.

#StateMedicaid rateUnitPer hourManaged-care plans% of Medicare
1Iowa Source · since 2013-07-01$91.27——Plans must pay at least this—
2Arkansas Source · since 2025-03-26$88.14——Not classified—
3Wyoming Source · since 2021-01-01$83.48——Not classified—
23Mississippi Source · since 2022-07-01$73.69——Plans must pay at least this—
24West Virginia Source · since 2023-04-01$73.69——Plans negotiate; applies out of network—
25Oklahoma Source · since 2024-01-01$72.83——Plans must pay at least this—
45Illinois Source · since 2024-04-01$55.77——Plans negotiate; applies out of network—
46California Source · since 2026-10-01$10.27——Plans negotiate; applies out of network—
See all 46 states for 86831 — start free

38 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 86831 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 86831?

It depends on the state. Of the 46 states with a published fee-for-service rate, the median is $73.69. Iowa pays the most ($91.27) and California the least ($10.27).

Which state pays the highest Medicaid rate for 86831?

Iowa, at $91.27, effective 2013-07-01.

Do managed-care plans pay the same rate for 86831?

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.