{
    "code": "78813",
    "coding_system": "CPT",
    "canonical_url": "https://localishealth.com/cpt/78813/2013/A",
    "release_specific_url": "https://localishealth.com/cpt/78813/2025/C",
    "answer": {
        "question": "What is the Medicare allowed amount for CPT 78813?",
        "text": "CPT 78813 carries status C (carrier-priced) in the Q3 2025 release, so there is no single national rate—Medicare contractors publish their own amounts. Your Medicare Administrative Contractor prices this code case by case, usually after reviewing documentation. Contractor-published amounts on file range $1,326.39–$1,624.20 across 17 localities; enter a ZIP for the exact local amount."
    },
    "release": {
        "schedule": "pfs",
        "year": 2025,
        "quarter": "C",
        "label": "Q3 2025",
        "effective": "July 1 – September 30, 2025",
        "revision": 1
    },
    "status": {
        "code": "C",
        "non_facility_payable": false,
        "facility_payable": false
    },
    "national_rates_usd": {
        "office_non_facility": null,
        "facility": null,
        "sequestration_applied": false,
        "gpci": 1
    },
    "rvus": {
        "work": null,
        "practice_expense_non_facility": null,
        "practice_expense_facility": null,
        "malpractice": null
    },
    "formula": "(work_rvu × work_gpci + pe_rvu × pe_gpci + mp_rvu × mp_gpci) × conversion_factor",
    "conversion_factor": 32.3465,
    "source": {
        "label": "Physician relative value file (Q3 2025)",
        "cms_url": "https://www.cms.gov/files/zip/rvu25c-updated-06/05/2025.zip",
        "local_source_url": "https://localishealth.com/sources/physician-fee-schedule/2025/C",
        "file": "PPRRVU2025_Jul.csv",
        "row": 9353,
        "sha256": "b7937472967288d5c4dcf43ecbc5d2d792e97d768c9f5ec9b1e88a99f3d0bbe7"
    },
    "modified_at": "2026-08-11T01:25:12+00:00"
}