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See a sample rate comparisonHealthcare 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 | Pathology and Laboratory Procedures Chemistry Procedures |
| Common Place of Service | 81 - Independent Laboratory 11 - Office |
| Common Modifiers | 90 - Reference Laboratory 26 - Professional component |
| Complexity Level | Low |
| Medicare Fee Schedule | $67.36 national lab fee schedule rate (2026) · View Medicare rates for 83013 |
| Medicaid Fee Schedule | $61.975 median of the 8 states in the free preview · View Medicaid rates for 83013 |
National average reimbursement for CPT 83013 by major payers:

$61.92

$47.87

$79.39

$97.76
Choose a payer to see a sample of rates for CPT 83013.
Chu Chen
Merrimack Valley Pediatric Associates, Inc.
Christopher Raio
St Joseph Hospital
Pelham Medical Center
Christopher Raio
St Joseph Hospital
E And A Medical On The Go Healthcare Of South Florida LLC, E And A Healthcare On The Go
E And A Medical On The Go Healthcare Of South Florida LLC
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Rate Benchmarking
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See a sample payer proposalCPT 83013 vs. Other Chemistry Procedures Codes
The CPT 83013 code is part of the Pathology and Laboratory Procedures services used for Chemistry Procedures. 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 83013 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 |
|---|---|---|
| 83009-CPT | Low | Stomach Ulcer Bacteria Test, Helicobacter Pylori Can Cause Stomach Ulcers And Painful Inflammation. This Test Detects An Infection And Can Be Used To Monitor Response To Treatment. |
| 83013-CPT | Low | Digestive Bacteria Breath Test, Test That Analyzes Exhaled Breath After Taking A Urea Pill To Determine If Helicobacter Pylori (H. Pylori) Bacteria Is Present In The Digestive System. This Bacteria Can Cause Stomach Ache And Ulcers. |
| 83014-CPT | Low | Drug For Bacteria Test, The Test For Helicobacter Pylori (Bacteria Associated With Ulcers) Requires Taking A Drug With A Small Amount Of Radioactive Material Followed By A Breath Test. If The Bacteria Are Present The Pill Changes The Character Of The Breath. |
| 83540-CPT | Low | Blood Test For Iron, This Test Measures The Amount Of Iron In A Blood Sample. It Is Used To Identify Iron Deficiency Or Iron Poisoning. The Test Often Is Conducted Along With Others To Evaluate Illness Or Disease. |
What is a fee schedule?
A fee schedule is a list of fixed prices that healthcare providers charge for specific services, including CPT 83013. These prices vary depending on payer type (Medicare, Medicaid, private insurance), geographic location, and provider contracts.
Understanding the 83013 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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