Medicare Reimbursement for CPT 17313

CPT 17313 is a physician procedure code reported under Medicare's Physician Fee Schedule (PFS). This page shows the estimated Medicare-allowed amount for this code at the national level and by locality, broken out for non-facility (e.g., office) and facility (e.g., hospital outpatient/ASC) settings.

Medicare allowed amount (2026)

Locality	Non-facility	Facility
National (unadjusted)	$626.27	$257.52
ALASKA* (AK)	$736.62	$343.91
ALABAMA (AL)	$565.14	$242.49
ARKANSAS (AR)	$557.40	$240.65
ARIZONA (AZ)	$610.46	$253.15
SAN FRANCISCO-OAKLAND-BERKELEY (SAN FRANCISCO/SAN MATEO/ALAMEDA/CONTRA COSTA CNTY) (CA)	$808.57	$288.64
SAN JOSE-SUNNYVALE-SANTA CLARA (SANTA CLARA CNTY) (CA)	$824.47	$292.74
OXNARD-THOUSAND OAKS-VENTURA (CA)	$702.47	$266.62
LOS ANGELES-LONG BEACH-ANAHEIM (LOS ANGELES/ORANGE CNTY) (CA)	$705.98	$269.75
NAPA (CA)	$764.92	$278.91
SAN FRANCISCO-OAKLAND-BERKELEY (MARIN CNTY) (CA)	$809.18	$289.24
VALLEJO (CA)	$764.05	$278.04
BAKERSFIELD (CA)	$663.83	$259.68
CHICO (CA)	$662.17	$258.03
FRESNO (CA)	$662.17	$258.03
HANFORD-CORCORAN (CA)	$662.17	$258.03
MADERA (CA)	$662.17	$258.03
MERCED (CA)	$662.17	$258.03
MODESTO (CA)	$662.17	$258.03
REDDING (CA)	$662.17	$258.03
RIVERSIDE-SAN BERNARDINO-ONTARIO (CA)	$667.97	$263.82
SACRAMENTO-ROSEVILLE-FOLSOM (CA)	$694.26	$265.41
SALINAS (CA)	$691.64	$264.27
SAN JOSE-SUNNYVALE-SANTA CLARA (SAN BENITO CNTY) (CA)	$826.94	$295.20
SANTA CRUZ-WATSONVILLE (CA)	$713.77	$265.75
SANTA ROSA-PETALUMA (CA)	$720.96	$268.14
STOCKTON (CA)	$662.17	$258.03
VISALIA (CA)	$662.17	$258.03
YUBA CITY (CA)	$662.17	$258.03
EL CENTRO (CA)	$662.26	$258.12
SAN DIEGO-CHULA VISTA-CARLSBAD (CA)	$707.39	$266.37
SAN LUIS OBISPO-PASO ROBLES (CA)	$680.56	$260.56
SANTA MARIA-SANTA BARBARA (CA)	$694.09	$264.13
REST OF CALIFORNIA (CA)	$662.17	$258.03
COLORADO (CO)	$651.92	$259.58
CONNECTICUT (CT)	$666.52	$269.39
DC + MD/VA SUBURBS (DC)	$714.14	$279.76
DELAWARE (DE)	$620.25	$255.93
FORT LAUDERDALE (FL)	$646.13	$272.59
MIAMI (FL)	$670.86	$287.00
REST OF FLORIDA (FL)	$616.36	$263.84
ATLANTA (GA)	$637.21	$262.56
REST OF GEORGIA (GA)	$583.49	$254.57
HAWAII, GUAM (HI)	$677.39	$258.12
IOWA (IA)	$579.25	$241.85
IDAHO (ID)	$582.74	$243.49
EAST ST. LOUIS (IL)	$610.01	$270.77
SUBURBAN CHICAGO (IL)	$652.74	$274.04
CHICAGO (IL)	$652.60	$282.01
REST OF ILLINOIS (IL)	$599.04	$262.37
INDIANA (IN)	$585.96	$244.13
KANSAS (KS)	$576.44	$243.10
KENTUCKY (KY)	$577.31	$249.49
NEW ORLEANS (LA)	$603.45	$256.46
REST OF LOUISIANA (LA)	$576.36	$250.02
METROPOLITAN BOSTON (MA)	$714.68	$274.40
REST OF MASSACHUSETTS (MA)	$648.23	$259.94
BALTIMORE/SURR. CNTYS (MD)	$664.57	$268.90
REST OF MARYLAND (MD)	$631.76	$258.59
SOUTHERN MAINE (ME)	$615.89	$250.46
REST OF MAINE (ME)	$585.37	$246.13
DETROIT (MI)	$623.45	$267.61
REST OF MICHIGAN (MI)	$591.36	$254.69
MINNESOTA (MN)	$626.20	$246.76
METROPOLITAN ST. LOUIS (MO)	$605.78	$254.73
METROPOLITAN KANSAS CITY (MO)	$599.78	$253.53
REST OF MISSOURI (MO)	$566.81	$248.95
MISSISSIPPI (MS)	$562.22	$244.73
MONTANA** (MT)	$626.23	$257.49
NORTH CAROLINA (NC)	$591.23	$247.19
NORTH DAKOTA** (ND)	$615.75	$247.01
NEBRASKA (NE)	$582.34	$241.98
NEW HAMPSHIRE (NH)	$641.58	$257.72
NORTHERN NJ (NJ)	$707.28	$279.54
REST OF NEW JERSEY (NJ)	$674.56	$271.89
NEW MEXICO (NM)	$594.34	$256.20
NEVADA** (NV)	$623.74	$254.62
MANHATTAN (NY)	$717.49	$289.00
NYC SUBURBS/LONG ISLAND (NY)	$733.83	$295.39
POUGHKPSIE/N NYC SUBURBS (NY)	$678.75	$274.97
QUEENS (NY)	$723.49	$287.63
REST OF NEW YORK (NY)	$599.63	$249.32
OHIO (OH)	$589.21	$252.55
OKLAHOMA (OK)	$576.57	$247.28
PORTLAND (OR)	$672.09	$262.41
REST OF OREGON (OR)	$619.30	$252.03
METROPOLITAN PHILADELPHIA (PA)	$650.47	$266.61
REST OF PENNSYLVANIA (PA)	$590.24	$251.73
PUERTO RICO (PR)	$630.70	$257.90
RHODE ISLAND (RI)	$641.90	$260.99
SOUTH CAROLINA (SC)	$591.12	$250.40
SOUTH DAKOTA** (SD)	$614.51	$245.77
TENNESSEE (TN)	$579.17	$243.98
BRAZORIA (TX)	$619.97	$254.55
DALLAS (TX)	$623.67	$256.40
GALVESTON (TX)	$621.68	$255.51
HOUSTON (TX)	$631.38	$265.21
BEAUMONT (TX)	$586.53	$250.97
FORT WORTH (TX)	$619.63	$256.04
AUSTIN (TX)	$649.41	$259.27
REST OF TEXAS (TX)	$602.75	$252.81
UTAH (UT)	$598.81	$252.19
VIRGINIA (VA)	$613.79	$251.32
VIRGIN ISLANDS (VI)	$630.70	$257.90
VERMONT (VT)	$613.25	$248.19
SEATTLE (KING CNTY) (WA)	$729.13	$276.68
REST OF WASHINGTON (WA)	$647.05	$258.76
WISCONSIN (WI)	$596.06	$242.80
WEST VIRGINIA (WV)	$577.89	$257.45
WYOMING** (WY)	$621.66	$252.92

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Maximum units per day (MUE)

Medicare’s Medically Unlikely Edit caps this code at 3 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 allowed amount is built from three Relative Value Units (RVUs) assigned to a code: physician work, practice expense, and malpractice risk. Each RVU component is adjusted using the Geographic Practice Cost Indices (GPCIs) for the specific locality where the service is performed, reflecting regional cost differences. The adjusted RVUs are summed and multiplied by the annual Medicare conversion factor to produce a dollar amount. Non-facility and facility amounts differ primarily because the practice-expense RVU is lower in facility settings, where the facility itself bears more of the overhead and equipment cost.

RVUs — work 5.42, practice expense 12.8 (non-facility) / 1.76 (facility), malpractice 0.53 — × the locality GPCIs × the 2026 conversion factor of $33.40.

Good to know

This is an estimate only — actual Medicare payment can vary.
Medicare typically pays 80% of the allowed amount after the annual Part B deductible is met; the patient or secondary insurer may owe the rest.
Modifiers, multiple-procedure reductions, bilateral billing, and other claim-specific factors can change the final payment.
National Medicare sequestration cuts and annual budget-neutrality adjustments can affect the final paid amount.
Locality-specific GPCIs mean the same code can price differently across regions — always confirm with your Medicare Administrative Contractor (MAC) for the applicable locality.

Frequently asked

Why does the facility amount differ from the non-facility amount for this code?

The practice-expense RVU is lower in the facility setting because the facility (not the billing physician) absorbs a larger share of overhead, supplies, and equipment costs for the service.

Does this amount reflect what Medicare actually pays?

It reflects the Medicare PFS allowed amount estimate. Medicare generally reimburses 80% of the allowed amount after the patient's deductible is met, and the final paid amount can be affected by sequestration and other adjustments.

Why might the amount I see on a remittance differ from this estimate?

Actual payment can differ due to the specific locality GPCIs applied, modifiers reported, multiple-procedure payment reductions, and yearly PFS updates, including budget-neutrality adjustments.

Where can I verify the exact rate for my locality?

Check the current year's Medicare Physician Fee Schedule lookup tool or contact your Medicare Administrative Contractor (MAC) for the locality-specific rate.

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.