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Billing code 81272 · Lab & pathology

81272 Medicaid reimbursement rate by state (2026)

Clinical lab tests. Medicaid pays a median of $290.28 for 81272 across 38 states, from $80.65 in Connecticut to $355.87 in Texas.

Data as of Oct 5, 202638 statesEvery rate links to its official source

States publishing
38
National median
$290.28units vary by state
Lowest
$80.65Connecticut
Highest
$355.87Texas
Answer

What does Medicaid pay for 81272?

38 state Medicaid programs publish a fee-for-service rate for 81272. The national median is $290.28 (units differ between states). Texas pays the most, $355.87, and Connecticut the least, $80.65, a 4.4x spread.

State ranking

81272 rate by state: highest, middle and lowest

One like-for-like fee-for-service rate per state, ranked. The workspace lists all 38 states with every variant, modifier and effective date.

#StateMedicaid rateUnitPer hourManaged-care plans% of Medicare
1Texas Source · since 2019-07-04$355.87——Plans negotiate; applies out of network—
2Arizona Source · since 2026-10-01$329.51——Plans negotiate; applies out of network—
3Indiana Source · since 2024-07-01$329.51unit—Plans must pay at least this—
19Massachusetts Source · since 2024-09-01$290.59——Plans negotiate; applies out of network—
20Virginia Source · since 2016-01-01$289.97——Plans negotiate; applies out of network—
21New Hampshire Source · since 2025-01-01$285.03——Plans negotiate; applies out of network—
37Florida Source · since 2026-01-01$158.17——Plans negotiate; applies out of network—
38Connecticut Source · since 2016-01-01$80.65——Not classified—
See all 38 states for 81272 — start free

30 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 81272 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 81272?

It depends on the state. Of the 38 states with a published fee-for-service rate, the median is $290.28. Texas pays the most ($355.87) and Connecticut the least ($80.65).

Which state pays the highest Medicaid rate for 81272?

Texas, at $355.87, effective 2019-07-04.

Do managed-care plans pay the same rate for 81272?

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.