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Billing code 87523 · Lab & pathology

87523 Medicaid reimbursement rate by state (2026)

Clinical lab tests. Medicaid pays a median of $38.11 for 87523 across 41 states, from $25.70 in Rhode Island to $46.26 in Texas.

Data as of Oct 5, 202641 statesEvery rate links to its official source

States publishing
41
National median
$38.11units vary by state
Lowest
$25.70Rhode Island
Highest
$46.26Texas
Answer

What does Medicaid pay for 87523?

41 state Medicaid programs publish a fee-for-service rate for 87523. The national median is $38.11 (units differ between states). Texas pays the most, $46.26, and Rhode Island the least, $25.70, a 1.8x spread.

State ranking

87523 rate by state: highest, middle and lowest

One like-for-like fee-for-service rate per state, ranked. The workspace lists all 41 states with every variant, modifier and effective date.

#StateMedicaid rateUnitPer hourManaged-care plans% of Medicare
1Texas Source · since 2019-07-04$46.26——Plans negotiate; applies out of network—
2Montana Source · since 2024-01-01$42.84——Not classified—
3Arizona Source · since 2026-10-01$42.84——Plans negotiate; applies out of network—
20West Virginia Source · since 2024-01-01$38.56——Plans negotiate; applies out of network—
21Oklahoma Source · since 2024-01-01$38.11——Plans must pay at least this—
22Massachusetts Source · since 2024-09-01$37.78——Plans negotiate; applies out of network—
40Maine Source · since 2024-01-01$29.99——Not classified—
41Rhode Island Source · since 2024-01-01$25.70——Plans negotiate; applies out of network—
See all 41 states for 87523 — start free

33 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 87523 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 87523?

It depends on the state. Of the 41 states with a published fee-for-service rate, the median is $38.11. Texas pays the most ($46.26) and Rhode Island the least ($25.70).

Which state pays the highest Medicaid rate for 87523?

Texas, at $46.26, effective 2019-07-04.

Do managed-care plans pay the same rate for 87523?

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.