The Rates plan
$29/mo7-day free trialThis page shows one representative rate per state for 86153. Full schedules include every locality, modifier, and age-band variant.
- Every code on all 51 published schedules
- Full-schedule CSV export
- Full state Medicaid dental network lists
- Email alerts when a state changes its rates
$29/mo after the trial. Cancel anytime.
Publishing states
22
Median % of Medicare
--
Rate range
$14.98 - $131.39
86153 rates in every publishing state
| State | Medicaid rate | % of Medicare | Prior auth | Vintage |
|---|---|---|---|---|
| Alaska | $62.12* | -- | -- | 2026 |
| Arkansas | $41.80 | -- | -- | 2026 |
| Connecticut | $14.98 | -- | -- | 2013 |
| District of Columbia | $28.90* | -- | Not required | 2026 |
| Idaho | $27.57* | -- | Not required | 2026 |
| Massachusetts | $24.53 | -- | -- | 2025 |
| Maine | $22.79* | -- | -- | 2026 |
| Michigan | $21.09* | -- | -- | 2026 |
| Missouri | $29.33* | -- | Not required | 2026 |
| Montana | $44.50* | -- | -- | 2026 |
| North Dakota | $36.80* | -- | Not required | 2026 |
| Nebraska | $131.39 | -- | -- | 2026 |
| New Hampshire | $27.17 | -- | Not required | 2026 |
| New Jersey | $29.60 | -- | Not required | 2026 |
| New Mexico | $42.79 | -- | -- | 2025 |
| Ohio | $25.67 | -- | -- | 2019 |
| Oklahoma | $29.82 | -- | -- | 2026 |
| Oregon | $26.75* | -- | -- | 2026 |
| Rhode Island | $17.32 | -- | -- | 2026 |
| South Carolina | $27.10 | -- | -- | 2026 |
| Virginia | $28.65* | -- | -- | 2013 |
| West Virginia | $23.18* | -- | -- | 2026 |
Published Medicaid fee-for-service schedule amounts, not a coverage or eligibility guarantee. Managed-care plan rates can differ. Where no prior-authorization flag is shown, the state does not publish one. Rows marked * are representative published variants or methodology-derived rates. "--" in the prior-auth column means the state publishes no PA flag.
Related lab & imaging codes
- 70030 - X-ray of the eye for a foreign body
- 70100 - Jaw (mandible) X-ray, up to 3 views
- 70110 - Jaw (mandible) X-ray, 4 or more views
- 70120 - X-ray of the mastoids, under 3 views per side
- 70130 - X-ray of the mastoids, complete
- 70134 - X-ray of the inner ear canals, complete
- 70140 - Facial bone X-ray, under 3 views
- 70150 - Facial bone X-ray, complete, 3 or more views
Frequently asked questions
How much does Medicaid pay for 86153?
22 state Medicaid programs publish a fee-for-service rate for 86153 (circulating tumor cell count, physician interpretation), ranging from $14.98 in Connecticut to $131.39 in Nebraska. The full table on this page lists every publishing state's current rate.
Which state pays the most for 86153?
Nebraska publishes the highest Medicaid rate for 86153 at $131.39. Connecticut publishes the lowest at $14.98.
Does 86153 require prior authorization under Medicaid?
No publishing state flags 86153 with a prior-authorization indicator on its fee schedule. Absence of a flag means the state publishes none, not that PA is never required - confirm through the state's provider manual.