How much does Medicare pay for CPT 77013?

Medicare allowed an average of $179.39 per service and paid $143.11 of that, the balance being the patient's coinsurance and deductible (2024 data). Providers submitted an average of $969.84, which is what they billed rather than what they received — Medicare pays its fee schedule regardless of the charge.

What is CPT code 77013?

Ct guidance for tissue removal. It was billed 2,044 times to 1,934 Medicare beneficiaries by 122 providers in 2024.

Does 77013 pay differently in an office than a hospital?

Yes. The allowed amount averaged $322.57 in an office setting and $178.48 in a facility. The office rate is generally higher because the practice supplies the room, staff and equipment out of that single payment; in a hospital those are billed separately by the facility.

Which specialty bills 77013 most?

Diagnostic Radiology, with 1,121 services from 65 clinicians. Next are Interventional Radiology, Urology.

CPT 77013

Ct guidance for tissue removal

$179.39Medicare-allowed amount per service, averaged across 2,044 services

Providers submitted

$969.84

Asking price, not received

Medicare allowed

$179.39

The fee schedule figure

Medicare paid

$143.11

Balance is patient coinsurance

Providers submitted an average of $969.84 for this code and Medicare allowed $179.39 — 5.4× less. That gap is normal and means nothing on its own: Medicare pays its fee schedule regardless of what is billed, so the submitted figure describes a hospital chargemaster, not a price anyone paid. Of the allowed amount Medicare paid $143.11 (80%); the rest is the patient’s coinsurance and deductible.

Office pays differently to hospital

Office / non-facility: $322.57
Hospital / facility: $178.48

The office rate is higher because the practice supplies the room, staff and equipment out of that payment. In a hospital the facility bills those separately, so the clinician's share is smaller — the total cost to Medicare is usually higher, not lower. 13 services were billed in an office setting and 2,031 in a facility.

Services: 2,044
Beneficiaries: 1,934
Providers billing it: 122
Total allowed: $366,673

What Medicare pays for CPT 77013

Across 2,044 services billed by 122 providers to 1,934 beneficiaries, Medicare allowed an average of $179.39 per service. The allowed amount is the figure that matters: it is what Medicare and the patient together owe, set by the fee schedule and adjusted for local practice costs. What a provider chose to submit has no bearing on it.

Who bills 77013

Specialty	Services	Beneficiaries	Avg allowed	Providers
Diagnostic Radiology	1,121	1,057	$177.45	65
Interventional Radiology	865	822	$180.86	54
Urology	58	55	$195.03	3

77013 reimbursement by state

Two different numbers. Allowed is what Medicare actually allowed in that state, which includes the local practice-cost adjustment. Standardized strips that geographic adjustment out of the payment, so it is the column to use when comparing states — a difference there reflects how the code was billed, not what it costs to run a practice locally.

State	Services	Allowed	Standardized pmt	Providers
California	213	$187.77	$139.92	13
Minnesota	200	$177.32	$139.08	10
Florida	186	$179.27	$139.94	14
Texas	161	$177.31	$139.10	12
Maryland	151	$181.25	$139.67	7
Massachusetts	112	$182.74	$140.42	5
Arizona	104	$172.44	$139.57	6
Illinois	85	$188.29	$139.82	4
Georgia	73	$179.27	$139.77	4
Kansas	66	$167.78	$141.02	3
North Carolina	66	$169.98	$139.69	4
Missouri	59	$174.22	$139.79	4
South Carolina	58	$175.23	$139.67	4
Tennessee	52	$171.91	$139.70	4
Arkansas	49	$210.30	$170.91	3
New Hampshire	48	$168.33	$138.13	2
Virginia	44	$173.08	$139.31	2
New York	42	$205.29	$139.59	2
Pennsylvania	39	$182.04	$132.54	3
Ohio	34	$177.72	$139.94	2
Rhode Island	28	$177.97	$139.57	1
Nebraska	27	$162.98	$141.18	2
Oregon	23	$181.89	$139.84	2
Alabama	19	$167.86	$139.42	1
Michigan	15	$168.08	$139.83	1
Mississippi	14	$167.66	$139.49	1
Connecticut	14	$183.42	$139.49	1
Delaware	13	$175.69	$139.61	1
South Dakota	13	$170.62	$139.96	1
Kentucky	12	$170.73	$128.51	1
West Virginia	12	$180.26	$139.95	1
Wisconsin	12	$177.14	$139.95	1

Related codes

77067Screening mammography$65.10
77063Screening 3d breast mammography$34.08
77080Dxa bone density measurement of hip$21.30
77014Ct guidance for insertion of radiation therapy fields$70.52
77065Diagnostic mammography of 1 breast$64.22
77066Diagnostic mammography of both breasts$84.05
77002Fluoroscopic guidance for needle placement$90.55
77001Fluoroscopic guidance for insertion or removal of central vein access$21.63
77049Mri scan of both breasts$196.04
77081Dxa bone density measurement of forearm$19.89
77012Review by radiologist of ct guidance for needle placement$69.78
77085Dxa bone density measurement of hip$38.47

Billing this code is not the same as earning it

An allowed amount is revenue to a practice, not income to a clinician. It funds staff, premises, equipment and supplies before anyone is paid. What clinicians actually earn is published separately by the Department of Labor, and what industry pays them is published separately again by CMS — this site carries both.

What doctors are paid →·Look up a clinician →·All procedure codes →

Where this comes from. CMS Medicare Physician & Other Practitioners, by Provider and Service, 2024. It covers fee-for-service Original Medicare Part B only — not Medicare Advantage, not Medicaid, and not commercial insurance, which typically pays more for the same code.

How it is averaged. CMS publishes one average per provider per code. Every figure here is re-weighted by the number of services, so a clinician who billed the code 4,000 times counts 4,000 times more than one who billed it twice. CMS also suppresses any provider-code pair with fewer than 11 beneficiaries, so low-volume practice is missing from these totals by design.