CPT 1013T Fee Schedule
Healthcare providers use this code to document and receive reimbursement for visits that address moderate-level medical decision-making, often including multiple diagnoses or prescription management.
| Key Fact | Detail |
|---|---|
| Service Type | Lower Esophageal Sphincter (LES) Neurostimulator Pulse Generator Procedures with Electronic Analysis Category III Codes |
| Complexity Level | Moderate |
| Medicare Fee Schedule | View Medicare rates for 1013T |
National average reimbursement for CPT 1013T by major payers:
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| Payer | Code | Rate | NPI | Tax ID | State | Specialty |
|---|---|---|---|---|---|---|
No data found No fee schedule data available for the selected payer and code combination | ||||||
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CPT 1013T vs. Other Category III Codes Codes
The CPT 1013T code is part of the Lower Esophageal Sphincter (LES) Neurostimulator Pulse Generator Procedures with Electronic Analysis services used for Category III Codes. It represents a moderate-complexity encounter and is one of several codes that vary based on time spent, level of medical decision-making, and documentation requirements.
The CPT 1013T code involves more provider time and moderate medical decision-making, unlike lower-level codes that require less time and simpler assessments. It typically includes multiple diagnoses, medication management, or test interpretation, leading to higher reimbursement and more detailed documentation requirements.
| Code | Complexity | Description |
|---|---|---|
| 1013T-CPT | Moderate | Lap Srg Imp/Rpl Eso Nea&Pg/R, Laparoscopy Srgcl Impltn Or Rplcmt Of Lwr Esophageal Sphnctr Neurostmltr Elctrd Array And Neurostmltr Plse Gnrtr Or Rcvr Rqng Pkt Creation And Connection Btwn Elctrd Array And Plse Gnrtr Or Rcvr Including Cruroplasty And/Or Elctrnc Analysis Whn Performed (Do Not Rprt 1013t In Cnjctn W 64590 1016t) (For Laparoscopic Implntn Or Rplcmt Of Gstrc Neurostmltr Electrodes Use 43647) (For Laparoscopic Implntn Rvsn Or Rmvl Of Gstrc Neurostmltr Electrodes Lesser Curvature [Morbid Obesity] Use 43659) (For Rvsn Or Rmvl Of Gstrc Neurostmltr Plse Gnrtr Use 64595) (For Opn Implntn Or Rplcmt Of Lwr Esophageal Sphnctr Neurostmltr Elctrd Array And Neurostmltr Plse Gnrtr Or Rcvr Rqng Pkt Creation And Cnctn Btwn Elctrde Array And Plse Gnrtr Or Rcvr |
What is a fee schedule?
A fee schedule is a list of fixed prices that healthcare providers charge for specific services, including CPT 1013T. These prices vary depending on payer type (Medicare, Medicaid, private insurance), geographic location, and provider contracts.
Understanding the 1013T fee schedule helps patients estimate costs and providers optimize billing for accurate reimbursements.
Factors that affect fee schedules
Medicare & Medicaid Rates
Government-set reimbursement amounts
Private Insurance Rates
Negotiated rates between providers and insurance companies
Geographic Location
Costs may be higher in urban areas.
Provider Type
Hospital providers may have different rates than private practice.
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