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Billing code 87472 · Lab & pathology

87472 Medicaid reimbursement rate by state (2026)

Clinical lab tests. Medicaid pays a median of $41.30 for 87472 across 44 states, from $10.00 in Kansas to $60.87 in Iowa.

Data as of Oct 5, 202644 statesEvery rate links to its official source

States publishing
44
National median
$41.30units vary by state
Lowest
$10.00Kansas
Highest
$60.87Iowa
Answer

What does Medicaid pay for 87472?

44 state Medicaid programs publish a fee-for-service rate for 87472. The national median is $41.30 (units differ between states). Iowa pays the most, $60.87, and Kansas the least, $10.00, a 6.1x spread.

State ranking

87472 rate by state: highest, middle and lowest

One like-for-like fee-for-service rate per state, ranked. The workspace lists all 44 states with every variant, modifier and effective date.

#StateMedicaid rateUnitPer hourManaged-care plans% of Medicare
1Iowa Source · since 2013-07-01$60.87——Plans must pay at least this—
2Georgia Source · since 2018-10-01$53.87——Plans negotiate; applies out of network—
3Wyoming Source · since 2021-01-01$52.51——Not classified—
22Illinois Source · since 2024-04-01$41.68——Plans negotiate; applies out of network—
23Connecticut Source · since 2015-01-01$40.91——Not classified—
24North Carolina Source · since 2025-10-01$40.17——Plans must pay at least this—
43Florida Source · since 2026-01-01$26.25——Plans negotiate; applies out of network—
44Kansas Source · since 1998-01-01$10.00——Plans must pay at least this—
See all 44 states for 87472 — start free

36 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 87472 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 87472?

It depends on the state. Of the 44 states with a published fee-for-service rate, the median is $41.30. Iowa pays the most ($60.87) and Kansas the least ($10.00).

Which state pays the highest Medicaid rate for 87472?

Iowa, at $60.87, effective 2013-07-01.

Do managed-care plans pay the same rate for 87472?

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.