Medicare Reimbursement for CPT 13133

This page covers a CPT procedure code (descriptor not shown due to AMA licensing restrictions). It displays the Medicare Physician Fee Schedule (PFS) allowed amount at the national level, with figures broken out for non-facility and facility settings. Actual payment varies by locality and other adjustments.

Medicare allowed amount (2026)

Locality	Non-facility	Facility
National (unadjusted)	$168.01	$102.21
ALASKA* (AK)	$205.38	$135.31
ALABAMA (AL)	$153.15	$95.58
ARKANSAS (AR)	$151.29	$94.77
ARIZONA (AZ)	$164.00	$100.24
SAN FRANCISCO-OAKLAND-BERKELEY (SAN FRANCISCO/SAN MATEO/ALAMEDA/CONTRA COSTA CNTY) (CA)	$205.49	$112.71
SAN JOSE-SUNNYVALE-SANTA CLARA (SANTA CLARA CNTY) (CA)	$209.11	$114.23
OXNARD-THOUSAND OAKS-VENTURA (CA)	$182.53	$104.76
LOS ANGELES-LONG BEACH-ANAHEIM (LOS ANGELES/ORANGE CNTY) (CA)	$183.92	$106.08
NAPA (CA)	$195.90	$109.18
SAN FRANCISCO-OAKLAND-BERKELEY (MARIN CNTY) (CA)	$205.80	$113.02
VALLEJO (CA)	$195.46	$108.73
BAKERSFIELD (CA)	$174.24	$102.12
CHICO (CA)	$173.44	$101.32
FRESNO (CA)	$173.44	$101.32
HANFORD-CORCORAN (CA)	$173.44	$101.32
MADERA (CA)	$173.44	$101.32
MERCED (CA)	$173.44	$101.32
MODESTO (CA)	$173.44	$101.32
REDDING (CA)	$173.44	$101.32
RIVERSIDE-SAN BERNARDINO-ONTARIO (CA)	$176.37	$104.25
SACRAMENTO-ROSEVILLE-FOLSOM (CA)	$180.66	$104.13
SALINAS (CA)	$179.95	$103.69
SAN JOSE-SUNNYVALE-SANTA CLARA (SAN BENITO CNTY) (CA)	$210.36	$115.48
SANTA CRUZ-WATSONVILLE (CA)	$184.14	$104.19
SANTA ROSA-PETALUMA (CA)	$185.92	$105.12
STOCKTON (CA)	$173.44	$101.32
VISALIA (CA)	$173.44	$101.32
YUBA CITY (CA)	$173.44	$101.32
EL CENTRO (CA)	$173.48	$101.37
SAN DIEGO-CHULA VISTA-CARLSBAD (CA)	$183.17	$104.48
SAN LUIS OBISPO-PASO ROBLES (CA)	$177.20	$102.26
SANTA MARIA-SANTA BARBARA (CA)	$180.35	$103.63
REST OF CALIFORNIA (CA)	$173.44	$101.32
COLORADO (CO)	$172.49	$102.48
CONNECTICUT (CT)	$178.07	$107.20
DC + MD/VA SUBURBS (DC)	$188.46	$110.95
DELAWARE (DE)	$166.40	$101.39
FORT LAUDERDALE (FL)	$176.43	$109.78
MIAMI (FL)	$185.38	$116.89
REST OF FLORIDA (FL)	$168.69	$105.79
ATLANTA (GA)	$171.43	$104.58
REST OF GEORGIA (GA)	$160.29	$101.59
HAWAII, GUAM (HI)	$176.20	$101.38
IOWA (IA)	$155.13	$94.92
IDAHO (ID)	$156.25	$95.72
EAST ST. LOUIS (IL)	$170.15	$109.61
SUBURBAN CHICAGO (IL)	$177.83	$110.26
CHICAGO (IL)	$180.62	$114.49
REST OF ILLINOIS (IL)	$165.47	$105.40
INDIANA (IN)	$156.98	$95.99
KANSAS (KS)	$155.13	$95.65
KENTUCKY (KY)	$157.53	$99.03
NEW ORLEANS (LA)	$164.07	$102.15
REST OF LOUISIANA (LA)	$157.56	$99.33
METROPOLITAN BOSTON (MA)	$186.92	$108.36
REST OF MASSACHUSETTS (MA)	$171.96	$102.67
BALTIMORE/SURR. CNTYS (MD)	$177.68	$107.07
REST OF MARYLAND (MD)	$169.03	$102.44
SOUTHERN MAINE (ME)	$163.89	$98.68
REST OF MAINE (ME)	$157.60	$97.06
DETROIT (MI)	$171.13	$107.63
REST OF MICHIGAN (MI)	$161.56	$101.48
MINNESOTA (MN)	$164.20	$96.49
METROPOLITAN ST. LOUIS (MO)	$163.82	$101.18
METROPOLITAN KANSAS CITY (MO)	$162.46	$100.67
REST OF MISSOURI (MO)	$155.70	$98.98
MISSISSIPPI (MS)	$153.49	$96.84
MONTANA** (MT)	$167.99	$102.19
NORTH CAROLINA (NC)	$158.89	$97.50
NORTH DAKOTA** (ND)	$162.65	$96.85
NEBRASKA (NE)	$155.66	$94.93
NEW HAMPSHIRE (NH)	$170.47	$101.97
NORTHERN NJ (NJ)	$187.12	$110.80
REST OF NEW JERSEY (NJ)	$179.79	$107.94
NEW MEXICO (NM)	$162.56	$102.22
NEVADA** (NV)	$166.59	$100.72
MANHATTAN (NY)	$192.04	$115.58
NYC SUBURBS/LONG ISLAND (NY)	$196.85	$118.61
POUGHKPSIE/N NYC SUBURBS (NY)	$181.43	$109.38
QUEENS (NY)	$192.49	$114.72
REST OF NEW YORK (NY)	$160.95	$98.44
OHIO (OH)	$160.47	$100.39
OKLAHOMA (OK)	$156.63	$97.87
PORTLAND (OR)	$176.56	$103.45
REST OF OREGON (OR)	$164.98	$99.44
METROPOLITAN PHILADELPHIA (PA)	$174.62	$106.12
REST OF PENNSYLVANIA (PA)	$160.33	$99.93
PUERTO RICO (PR)	$168.83	$102.31
RHODE ISLAND (RI)	$171.28	$103.31
SOUTH CAROLINA (SC)	$160.00	$99.20
SOUTH DAKOTA** (SD)	$162.02	$96.22
TENNESSEE (TN)	$155.87	$96.06
BRAZORIA (TX)	$165.81	$100.60
DALLAS (TX)	$167.02	$101.48
GALVESTON (TX)	$166.41	$101.08
HOUSTON (TX)	$171.36	$106.02
BEAUMONT (TX)	$159.49	$99.61
FORT WORTH (TX)	$166.26	$101.38
AUSTIN (TX)	$172.20	$102.58
REST OF TEXAS (TX)	$162.67	$100.22
UTAH (UT)	$161.84	$99.98
VIRGINIA (VA)	$163.87	$99.19
VIRGIN ISLANDS (VI)	$168.83	$102.31
VERMONT (VT)	$162.68	$97.53
SEATTLE (KING CNTY) (WA)	$189.79	$109.06
REST OF WASHINGTON (WA)	$171.42	$102.13
WISCONSIN (WI)	$158.09	$95.05
WEST VIRGINIA (WV)	$160.43	$103.25
WYOMING** (WY)	$165.66	$99.86

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Maximum units per day (MUE)

Medicare’s Medically Unlikely Edit caps this code at 7 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 (PE), and malpractice (MP). Each RVU component is adjusted by Geographic Practice Cost Indices (GPCIs) specific to the provider's locality, then the adjusted RVUs are summed and multiplied by the annual conversion factor to produce a dollar amount. The non-facility PE RVU applies when the service is furnished in a physician's office, while the facility PE RVU (typically lower) applies when furnished in a hospital or other facility setting, since Medicare assumes the facility bears more of the overhead cost. This is why the same code often has two different allowed amounts depending on place of service.

RVUs — work 2.14, practice expense 2.62 (non-facility) / 0.65 (facility), malpractice 0.27 — × 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 payer is responsible for the remainder.
Actual payment can vary by locality-specific GPCIs, applicable modifiers, sequestration reductions, and annual budget-neutrality adjustments.
Always confirm the current allowed amount and coverage criteria with your Medicare Administrative Contractor (MAC) before billing.

Frequently asked

Why does the facility amount differ from the non-facility amount?

The facility amount uses a lower practice-expense RVU because Medicare assumes the hospital or facility — not the physician's practice — absorbs most overhead costs (equipment, staff, supplies) when the service is performed there.

Does this amount reflect what my practice will actually be paid?

No. The figure shown is the national or locality-adjusted PFS allowed amount before the 80/20 split, deductible status, modifiers, and any sequestration or contractual adjustments are applied.

Why isn't the CPT code description shown on this page?

CPT codes and their descriptors are copyrighted and licensed by the American Medical Association (AMA), so this page cannot reproduce the official descriptor text.

How often do these amounts change?

The conversion factor, RVUs, and GPCIs are updated annually (and sometimes mid-year) through CMS rulemaking, so amounts can change from year to year.

More free billing tools: all Medicare fees · fee calculator · denial code decoder

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.