CPT 97813
No national payment amount
Status N is not separately payable under the PFS.
Did Medicare pay separately for CPT 97813 in Q3 2019?
Not at a published national rate. CPT 97813 carries status N (non-covered) in the Q3 2019 release. Medicare covers no part of this service. Treat the blank amount as unpriced, not as $0.
Source: Physician relative value file (Q3 2019) · effective July 2019 · materially updated Aug 4, 2026 · compact facts
How often 97813 is billed
Across Original Medicare in CY2024, 97813 ranked #1,953 of the 7,879 CPT codes billed to Medicare that year, ranked by patients served or total allowed dollars. Patients who received it in 2024 were billed for it an average of 6.2 times that year — more than once per patient.
2024 Medicare fee-for-service only, national totals — Medicare Advantage, Medicaid and commercial volume are excluded, so real-world use runs higher. This is a calendar-year snapshot from the CMS Physician & Other Practitioners dataset, on a different cycle from the Q3 2019 fee schedule the rates above come from.
Common questions
Why is there no payment amount for 97813?
Its status indicator is N (non-covered). Medicare covers no part of this service. The blank is deliberate: the amount is either unknown or paid under another provision, so reading it as $0 would be wrong.
Why would a Medicare claim for 97813 be denied or paid less?
Each item below comes from a CMS indicator on this page — not general billing advice.
- Its status indicator is N (non-covered) — Medicare covers no part of this service. See status indicators
Payer-specific coverage and documentation rules live outside these files, so a claim that clears every check here can still be denied on other grounds.
When does this rate change?
CMS publishes a fee schedule release every quarter (January, April, July, October), and each is versioned here. The 97813 rate last moved in Q1 2026 (+9.8% non-facility) — see its rate history or what changed each release, or get an email when a new release moves rates.
Sources: CMS Medicare Physician Fee Schedule Relative Value Files.
Saw this code on your bill?
What is a 97813 visit in patient-friendly terms?
We haven't written the plain-language description for CPT 97813 yet — ask your provider's billing office what service it covers in the meantime.
How this amount is computed
amount = (work RVU × work GPCI + PE RVU × PE GPCI + MP RVU × MP GPCI) × conversion factor. National amounts use GPCI = 1.000. To price an RVU figure of your own, use the RVU-to-dollars converter.
| Component | RVU |
|---|---|
| Work RVU | blank |
| Practice expense RVU (non-facility) | blank |
| Practice expense RVU (facility) | blank |
| Malpractice RVU | blank |
Every rate combines three parts: work (the clinician’s time, skill and effort), practice expense (office overhead — higher when the service is done in a doctor’s own office), and malpractice (the share of liability-insurance cost). A blank means CMS publishes no national number for that part. Read it as unknown, and never as zero.
Rate history by release
National non-facility amount for 97813 across quarterly releases. Up 33.7% since Q2 2020 · high $56.45 in Q1 2026
| Release | Status | Non-facility | Facility |
|---|---|---|---|
| Q3 2026 Jun 30, 2026 – present | A | $56.45 (0.0%) | $33.40 (0.0%) |
| Q2 2026 Mar 10, 2026 – Jun 29, 2026 | A | $56.45 (0.0%) | $33.40 (0.0%) |
| Q1 2026 Dec 29, 2025 – Mar 9, 2026 | A | $56.45 (+9.8%) | $33.40 (-7.8%) |
| Q4 2025 Sep 11, 2025 – Dec 28, 2025 | A | $51.43 (0.0%) | $36.23 (0.0%) |
| Q3 2025 Jun 5, 2025 – Sep 10, 2025 | A | $51.43 (0.0%) | $36.23 (0.0%) |
| Q2 2025 Jun 5, 2025 – Jun 4, 2025 | A | $51.43 (0.0%) | $36.23 (0.0%) |
| Q1 2025 Dec 23, 2024 – Jun 4, 2025 | A | $51.43 (+13.6%) | $36.23 (+10.0%) |
| Q4 2024 Aug 9, 2024 – Dec 22, 2024 | A | $45.27 (0.0%) | $32.95 (0.0%) |
| Q3 2024 May 3, 2024 – Aug 8, 2024 | A | $45.27 (0.0%) | $32.95 (0.0%) |
| Q2 2024 Mar 15, 2024 – May 2, 2024 | A | $45.27 (0.0%) | $32.95 (0.0%) |
| Q1 2024 Mar 11, 2023 – Mar 14, 2024 | A | $45.27 (-1.0%) | $32.95 (-1.8%) |
| Q4 2023 Aug 1, 2023 – Mar 10, 2023 | A | $45.75 (0.0%) | $33.55 (0.0%) |
| Q3 2023 May 10, 2023 – Jul 31, 2023 | A | $45.75 (0.0%) | $33.55 (0.0%) |
| Q2 2023 Feb 3, 2023 – May 9, 2023 | A | $45.75 (0.0%) | $33.55 (0.0%) |
| Q1 2023 Jan 30, 2023 – Feb 2, 2023 | A | $45.75 (-2.8%) | $33.55 (-2.1%) |
| Q4 2022 Jul 29, 2022 – Jan 29, 2023 | A | $47.06 (0.0%) | $34.26 (0.0%) |
| Q3 2022 Jun 17, 2022 – Jul 28, 2022 | A | $47.06 (0.0%) | $34.26 (0.0%) |
| Q2 2022 Feb 14, 2022 – Jun 16, 2022 | A | $47.06 (0.0%) | $34.26 (0.0%) |
| Q1 2022 Dec 15, 2021 – Feb 13, 2022 | A | $47.06 (+11.5%) | $34.26 (+3.3%) |
| Q4 2021 Aug 3, 2021 – Dec 14, 2021 | A | $42.22 (0.0%) | $33.15 (0.0%) |
| Q3 2021 Jun 10, 2021 – Aug 2, 2021 | A | $42.22 (0.0%) | $33.15 (0.0%) |
| Q2 2021 Feb 26, 2021 – Jun 9, 2021 | A | $42.22 (0.0%) | $33.15 (0.0%) |
| Q1 2021 Dec 29, 2020 – Feb 25, 2021 | A | $42.22 (0.0%) | $33.15 (-3.3%) |
| Q4 2020 Oct 21, 2020 – Dec 28, 2020 | A | $42.22 (0.0%) | $34.29 (0.0%) |
| Q3 2020 Jun 18, 2020 – Oct 20, 2020 | A | $42.22 (0.0%) | $34.29 (0.0%) |
| Q2 2020 Apr 30, 2020 – Jun 17, 2020 | A | $42.22 | $34.29 |
| Q1 2020 Nov 8, 2019 – Apr 29, 2020 | N | — | — |
| Q4 2019 Aug 2, 2019 – Nov 7, 2019 | N | — | — |
| Q3 2019 May 3, 2019 – Aug 1, 2019 | N | — | — |
| Q2 2019 Mar 1, 2019 – May 2, 2019 | N | — | — |
| Q1 2019 Dec 13, 2018 – Feb 28, 2019 | N | — | — |
| Q4 2018 Aug 3, 2018 – Dec 12, 2018 | N | — | — |
| Q3 2018 Apr 30, 2018 – Aug 2, 2018 | N | — | — |
| Q2 2018 Feb 12, 2018 – Apr 29, 2018 | N | — | — |
| Q1 2018 Feb 9, 2018 – Feb 11, 2018 | N | — | — |
| Q4 2017 Aug 18, 2017 – Feb 8, 2018 | N | — | — |
| Q3 2017 May 3, 2017 – Aug 17, 2017 | N | — | — |
| Q2 2017 Feb 9, 2017 – May 2, 2017 | N | — | — |
| Q1 2017 Nov 14, 2016 – Feb 8, 2017 | N | — | — |
| Q4 2016 Aug 5, 2016 – Nov 13, 2016 | N | — | — |
| Q3 2016 May 17, 2016 – Aug 4, 2016 | N | — | — |
| Q2 2016 Feb 2, 2016 – May 16, 2016 | N | — | — |
| Q1 2016 Jan 21, 2016 – Feb 1, 2016 | N | — | — |
| Q4 2015 Oct 2, 2015 – Jan 20, 2016 | N | — | — |
| Q3 2015 May 15, 2015 – Oct 1, 2015 | N | — | — |
| Q2 2015 Feb 13, 2015 – May 14, 2015 | N | — | — |
| Q1 2015 Dec 23, 2014 – Feb 12, 2015 | N | — | — |
| Q4 2014 Aug 19, 2014 – Dec 22, 2014 | N | — | — |
| Q3 2014 May 15, 2014 – Aug 18, 2014 | N | — | — |
| Q2 2014 Mar 24, 2014 – May 14, 2014 | N | — | — |
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Source & method
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This is computed from CMS's Medicare Physician Fee Schedule Q3 2019 release (schedule pfs, effective July 2019). National amounts apply a GPCI of 1.000 and leave sequestration off. The status indicator decides payability, never the RVU values, so a blank RVU stays blank. Releases are immutable: a rate retrieved for a past quarter always reflects that release. Commercial and cash-pay figures anywhere on this page are arithmetic on the Medicare amount, using commonly cited reimbursement ranges. They're illustrative, and no nationwide claims database stands behind them. Our methodology covers all of this in depth — sourcing, parsing, versioning, and how claims are cross-checked before they ship.
Conversion factor $36.0391 read from the same file, row 11, column 25.
Use the (i) buttons next to each amount above for the exact row, columns, and math.
Cite this rate
This link keeps pointing at the Q3 2019 figures, even after a newer release lands.
CPT 97813 Medicare Physician Fee Schedule rate (Q3 2019). Localis. https://localishealth.com/cpt/97813/2019/C