Medicare Reimbursement for CPT 13102

CPT 13102 is a procedure code defined by the American Medical Association; its specific descriptor is not reproduced here due to licensing. This page shows the Medicare Physician Fee Schedule (PFS) estimated allowed amount for this code, both nationally and adjustable by locality, with separate figures for non-facility and facility settings.

Medicare allowed amount (2026)

Locality	Non-facility	Facility
National (unadjusted)	$120.24	$59.79
ALASKA* (AK)	$142.21	$77.82
ALABAMA (AL)	$108.20	$55.30
ARKANSAS (AR)	$106.69	$54.76
ARIZONA (AZ)	$117.01	$58.43
SAN FRANCISCO-OAKLAND-BERKELEY (SAN FRANCISCO/SAN MATEO/ALAMEDA/CONTRA COSTA CNTY) (CA)	$150.23	$64.99
SAN JOSE-SUNNYVALE-SANTA CLARA (SANTA CLARA CNTY) (CA)	$152.99	$65.82
OXNARD-THOUSAND OAKS-VENTURA (CA)	$132.17	$60.71
LOS ANGELES-LONG BEACH-ANAHEIM (LOS ANGELES/ORANGE CNTY) (CA)	$133.04	$61.52
NAPA (CA)	$142.76	$63.08
SAN FRANCISCO-OAKLAND-BERKELEY (MARIN CNTY) (CA)	$150.46	$65.22
VALLEJO (CA)	$142.44	$62.76
BAKERSFIELD (CA)	$125.42	$59.16
CHICO (CA)	$124.85	$58.59
FRESNO (CA)	$124.85	$58.59
HANFORD-CORCORAN (CA)	$124.85	$58.59
MADERA (CA)	$124.85	$58.59
MERCED (CA)	$124.85	$58.59
MODESTO (CA)	$124.85	$58.59
REDDING (CA)	$124.85	$58.59
RIVERSIDE-SAN BERNARDINO-ONTARIO (CA)	$127.01	$60.75
SACRAMENTO-ROSEVILLE-FOLSOM (CA)	$130.52	$60.21
SALINAS (CA)	$130.03	$59.96
SAN JOSE-SUNNYVALE-SANTA CLARA (SAN BENITO CNTY) (CA)	$153.92	$66.74
SANTA CRUZ-WATSONVILLE (CA)	$133.72	$60.27
SANTA ROSA-PETALUMA (CA)	$135.03	$60.79
STOCKTON (CA)	$124.85	$58.59
VISALIA (CA)	$124.85	$58.59
YUBA CITY (CA)	$124.85	$58.59
EL CENTRO (CA)	$124.89	$58.63
SAN DIEGO-CHULA VISTA-CARLSBAD (CA)	$132.73	$60.43
SAN LUIS OBISPO-PASO ROBLES (CA)	$128.00	$59.14
SANTA MARIA-SANTA BARBARA (CA)	$130.42	$59.93
REST OF CALIFORNIA (CA)	$124.85	$58.59
COLORADO (CO)	$123.95	$59.62
CONNECTICUT (CT)	$128.09	$62.98
DC + MD/VA SUBURBS (DC)	$136.20	$64.98
DELAWARE (DE)	$118.89	$59.16
FORT LAUDERDALE (FL)	$126.59	$65.35
MIAMI (FL)	$133.46	$70.52
REST OF FLORIDA (FL)	$120.38	$62.59
ATLANTA (GA)	$122.88	$61.45
REST OF GEORGIA (GA)	$113.63	$59.70
HAWAII, GUAM (HI)	$127.45	$58.71
IOWA (IA)	$110.00	$54.68
IDAHO (ID)	$110.87	$55.25
EAST ST. LOUIS (IL)	$121.17	$65.55
SUBURBAN CHICAGO (IL)	$127.66	$65.57
CHICAGO (IL)	$129.54	$68.78
REST OF ILLINOIS (IL)	$117.64	$62.44
INDIANA (IN)	$111.47	$55.43
KANSAS (KS)	$109.91	$55.26
KENTUCKY (KY)	$111.56	$57.81
NEW ORLEANS (LA)	$116.84	$59.95
REST OF LOUISIANA (LA)	$111.55	$58.05
METROPOLITAN BOSTON (MA)	$135.36	$63.17
REST OF MASSACHUSETTS (MA)	$123.41	$59.75
BALTIMORE/SURR. CNTYS (MD)	$127.81	$62.94
REST OF MARYLAND (MD)	$120.98	$59.80
SOUTHERN MAINE (ME)	$117.12	$57.21
REST OF MAINE (ME)	$111.87	$56.25
DETROIT (MI)	$122.27	$63.93
REST OF MICHIGAN (MI)	$114.74	$59.55
MINNESOTA (MN)	$117.66	$55.45
METROPOLITAN ST. LOUIS (MO)	$116.75	$59.19
METROPOLITAN KANSAS CITY (MO)	$115.63	$58.86
REST OF MISSOURI (MO)	$109.98	$57.86
MISSISSIPPI (MS)	$108.33	$56.28
MONTANA** (MT)	$120.23	$59.77
NORTH CAROLINA (NC)	$112.93	$56.53
NORTH DAKOTA** (ND)	$116.28	$55.82
NEBRASKA (NE)	$110.46	$54.66
NEW HAMPSHIRE (NH)	$122.41	$59.47
NORTHERN NJ (NJ)	$134.95	$64.82
REST OF NEW JERSEY (NJ)	$129.24	$63.22
NEW MEXICO (NM)	$115.51	$60.08
NEVADA** (NV)	$119.20	$58.68
MANHATTAN (NY)	$138.59	$68.34
NYC SUBURBS/LONG ISLAND (NY)	$142.38	$70.50
POUGHKPSIE/N NYC SUBURBS (NY)	$130.41	$64.21
QUEENS (NY)	$139.10	$67.64
REST OF NEW YORK (NY)	$114.60	$57.17
OHIO (OH)	$113.93	$58.74
OKLAHOMA (OK)	$110.93	$56.94
PORTLAND (OR)	$127.30	$60.13
REST OF OREGON (OR)	$117.97	$57.75
METROPOLITAN PHILADELPHIA (PA)	$125.26	$62.32
REST OF PENNSYLVANIA (PA)	$113.88	$58.38
PUERTO RICO (PR)	$120.95	$59.83
RHODE ISLAND (RI)	$122.70	$60.25
SOUTH CAROLINA (SC)	$113.68	$57.82
SOUTH DAKOTA** (SD)	$115.81	$55.35
TENNESSEE (TN)	$110.49	$55.54
BRAZORIA (TX)	$118.44	$58.53
DALLAS (TX)	$119.37	$59.15
GALVESTON (TX)	$118.91	$58.87
HOUSTON (TX)	$122.57	$62.53
BEAUMONT (TX)	$113.19	$58.17
FORT WORTH (TX)	$118.72	$59.11
AUSTIN (TX)	$123.81	$59.84
REST OF TEXAS (TX)	$115.86	$58.49
UTAH (UT)	$115.17	$58.34
VIRGINIA (VA)	$117.04	$57.61
VIRGIN ISLANDS (VI)	$120.95	$59.83
VERMONT (VT)	$116.21	$56.36
SEATTLE (KING CNTY) (WA)	$137.65	$63.47
REST OF WASHINGTON (WA)	$123.05	$59.39
WISCONSIN (WI)	$112.55	$54.63
WEST VIRGINIA (WV)	$113.54	$61.00
WYOMING** (WY)	$118.51	$58.05

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Maximum units per day (MUE)

Medicare’s Medically Unlikely Edit caps this code at 9 units per patient per day — Date of Service Edit: Clinical. Units above the MUE are denied; some MUEs can be exceeded only with appropriate documentation and modifiers where policy allows.

How the amount is calculated

Medicare's PFS amount is built from three Relative Value Units (RVUs) — physician work, practice expense, and malpractice — assigned to each code. Each RVU component is adjusted by Geographic Practice Cost Indices (GPCIs) that reflect local cost differences, then the adjusted RVUs are summed and multiplied by the annual conversion factor to produce a dollar amount. Practice-expense RVUs differ between non-facility (e.g., office) and facility (e.g., hospital) settings because overhead costs differ, which is why the same code can have two different allowed amounts depending on place of service.

RVUs — work 1.21, practice expense 2.19 (non-facility) / 0.38 (facility), malpractice 0.2 — × the locality GPCIs × the 2026 conversion factor of $33.40.

Good to know

This is an estimate only, not a guarantee of payment.
Medicare typically pays 80% of the allowed amount after the annual Part B deductible is met; the patient or secondary insurer is responsible for the remainder.
Actual payment varies by locality, applicable modifiers, claims-processing adjustments, sequestration, and annual budget-neutrality changes to RVUs or the conversion factor.
Always verify final amounts with your Medicare Administrative Contractor (MAC) before billing or appealing a denial.

Frequently asked

Why does CPT 13102 have two different national amounts?

The non-facility amount applies when the service is performed in a setting like a physician's office, where the practice bears more overhead cost. The facility amount applies when performed in a hospital or other facility that bears its own overhead, so the practice-expense RVU component is lower.

Will my locality's reimbursement match the national figure?

Not necessarily. The national amount uses a GPCI value of 1.0 for all components; most localities have different GPCIs, which raise or lower the final adjusted amount.

Does this amount reflect what Medicare actually pays?

It reflects the Medicare-allowed amount before the standard 80/20 split and deductible are applied, and before any modifier-based or sequestration-related adjustments to the specific claim.

Why might this figure change next year?

The conversion factor and RVUs are updated annually through rulemaking, and budget-neutrality adjustments can shift relative values across codes even if this specific code's RVUs are unchanged.

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Estimated Medicare Physician Fee Schedule amount. Medicare generally pays 80% after the deductible; actual amounts vary by locality, modifiers, sequestration, and annual updates. Verify with your MAC.