Code Reality Check
80053 reimbursement rate: Comprehensive metabolic panel
Comprehensive metabolic panel (CPT 80053) pays a median $11.32 in North Carolina and $4.43 in Colorado, against a Medicare anchor of $11.99. 49 of 51 states clear the publication floor.
spread 2.6x top to bottom
Medicare anchor $11.99
49/51 states published
The 50-state spread
as of 2026-07-15| State | Median | vs Medicare | Band | Rate points | Tier |
|---|---|---|---|---|---|
| North Carolina | $11.32 | 0.94x | $10–$20 · P90 $50 | 142,446 | Benchmark |
| Michigan | $10.56 | 0.88x | $6–$13 · P90 $26 | 4,836 | Benchmark |
| South Carolina | $10.56 | 0.88x | $10–$11 · P90 $21 | 8,036 | Benchmark |
| Wisconsin | $10.56 | 0.88x | $6–$24 · P90 $49 | 26,612 | Benchmark |
| Delaware | $10.49 | 0.87x | $6–$18 · P90 $30 | 567 | Benchmark |
| Mississippi | $10.36 | 0.86x | $6–$15 · P90 $24 | 625 | Benchmark |
| Arkansas | $10.36 | 0.86x | $6–$19 · P90 $25 | 1,064 | Benchmark |
| South Dakota | $10.36 | 0.86x | $6–$20 · P90 $30 | 222 | Benchmark |
| Pennsylvania | $10.36 | 0.86x | $6–$16 · P90 $29 | 9,621 | Benchmark |
| Hawaii | $10.34 | 0.86x | $6–$12 · P90 $28 | 774 | Benchmark |
| Louisiana | $10.25 | 0.85x | $6–$18 · P90 $30 | 1,197 | Benchmark |
| Oregon | $10.21 | 0.85x | $6–$15 · P90 $30 | 1,672 | Benchmark |
| California | $10.20 | 0.85x | $6–$27 · P90 $50 | 95,147 | Benchmark |
| Arizona | $9.52 | 0.79x | $6–$16 · P90 $27 | 2,873 | Benchmark |
| Nevada | $9.44 | 0.79x | $6–$16 · P90 $35 | 1,196 | Benchmark |
| Illinois | $9.40 | 0.78x | $6–$19 · P90 $36 | 10,255 | Benchmark |
| Oklahoma | $9.21 | 0.77x | $6–$15 · P90 $26 | 1,043 | Benchmark |
| New Jersey | $8.82 | 0.74x | $5–$20 · P90 $30 | 13,464 | Benchmark |
| Tennessee | $8.15 | 0.68x | $6–$11 · P90 $22 | 5,941 | Benchmark |
| Alabama | $8.10 | 0.68x | $6–$14 · P90 $23 | 2,160 | Benchmark |
| Connecticut | $7.92 | 0.66x | $5–$20 · P90 $30 | 3,727 | Benchmark |
| Georgia | $7.82 | 0.65x | $6–$17 · P90 $23 | 70,176 | Benchmark |
| Idaho | $7.64 | 0.64x | $6–$13 · P90 $24 | 640 | Benchmark |
| Nebraska | $7.64 | 0.64x | $6–$15 · P90 $27 | 446 | Benchmark |
| Florida | $7.64 | 0.64x | $5–$15 · P90 $23 | 13,451 | Benchmark |
| Utah | $7.43 | 0.62x | $6–$14 · P90 $41 | 838 | Benchmark |
| Wyoming | $7.15 | 0.60x | $5–$7 · P90 $13 | 729 | Benchmark |
| New Mexico | $7.10 | 0.59x | $6–$12 · P90 $26 | 882 | Benchmark |
| Montana | $6.86 | 0.57x | $6–$12 · P90 $26 | 458 | Benchmark |
| North Dakota | $6.86 | 0.57x | $6–$17 · P90 $25 | 251 | Benchmark |
| Massachusetts | $6.86 | 0.57x | $6–$11 · P90 $28 | 7,549 | Benchmark |
| Alaska | $6.86 | 0.57x | $6–$11 · P90 $24 | 322 | Benchmark |
| Vermont | $6.86 | 0.57x | $5–$7 · P90 $13 | 1,049 | Benchmark |
| Washington | $6.55 | 0.55x | $7–$12 · P90 $14 | 11,496 | Benchmark |
| Ohio | $6.11 | 0.51x | $6–$13 · P90 $26 | 61,232 | Benchmark |
| Missouri | $6.08 | 0.51x | $6–$15 · P90 $27 | 49,504 | Benchmark |
| Kentucky | $5.99 | 0.50x | $6–$8 · P90 $16 | 17,299 | Benchmark |
| Kansas | $5.99 | 0.50x | $6–$12 · P90 $21 | 1,460 | Benchmark |
| Iowa | $5.99 | 0.50x | $6–$14 · P90 $27 | 1,148 | Benchmark |
| West Virginia | $5.99 | 0.50x | $6–$10 · P90 $19 | 1,538 | Benchmark |
| Maryland | $5.99 | 0.50x | $5–$11 · P90 $25 | 4,174 | Benchmark |
| Minnesota | $5.99 | 0.50x | $6–$16 · P90 $42 | 5,378 | Benchmark |
| Rhode Island | $5.94 | 0.50x | $5–$8 · P90 $17 | 8,434 | Benchmark |
| Texas | $5.59 | 0.47x | $5–$9 · P90 $17 | 38,703 | Benchmark |
| Virginia | $5.22 | 0.44x | $5–$8 · P90 $11 | 19,037 | Benchmark |
| District of Columbia | $5.22 | 0.44x | $5–$10 · P90 $22 | 1,489 | Benchmark |
| Maine | $5.22 | 0.44x | $4–$6 · P90 $11 | 9,969 | Benchmark |
| New York | $5.22 | 0.44x | $5–$20 · P90 $30 | 177,803 | Benchmark |
| Colorado | $4.43 | 0.37x | $4–$8 · P90 $15 | 8,215 | Benchmark |
Payer-blind local peer percentiles per state, full verified distribution. Publication floor: 11 verified rate points and a non-degenerate spread; the P25–P75 band unlocks at 25 points, P90 at 100 (a smaller cell's P90 is one contract, not a statistic).
Documented reimbursement figures are modeled, not guaranteed. Derived from federally mandated Transparency in Coverage data (45 CFR 147.212). No PHI.
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Cite this page
Source: Reddenda Code Reality Check, CPT 80053. Reddenda. https://reddenda.health/code/80053/
Derivation federally mandated TiC MRFs, verified to provider identity847,148 verified rate points across 49 statesas of 2026-07-15 · methodology v1.0