How much does Medicare pay for CPT 83013?

Medicare allowed an average of $65.81 per service and paid $65.81 of that, the balance being the patient's coinsurance and deductible (2024 data). Providers submitted an average of $270.08, which is what they billed rather than what they received — Medicare pays its fee schedule regardless of the charge.

What is CPT code 83013?

Breath test analysis for helicobacter pylori. It was billed 72,273 times to 68,105 Medicare beneficiaries by 202 providers in 2024.

Which specialty bills 83013 most?

Clinical Laboratory, with 68,642 services from 127 clinicians. Next are Gastroenterology, Pathology, Family Practice.

CPT 83013

Breath test analysis for helicobacter pylori

$65.81Medicare-allowed amount per service, averaged across 72,273 services

Providers submitted

$270.08

Asking price, not received

Medicare allowed

$65.81

The fee schedule figure

Medicare paid

$65.81

Balance is patient coinsurance

Providers submitted an average of $270.08 for this code and Medicare allowed $65.81 — 4.1× 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 $65.81 (100%); the rest is the patient’s coinsurance and deductible.

Services: 72,273
Beneficiaries: 68,105
Providers billing it: 202
Total allowed: $4,756,286

What Medicare pays for CPT 83013

Across 72,273 services billed by 202 providers to 68,105 beneficiaries, Medicare allowed an average of $65.81 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 83013

Specialty	Services	Beneficiaries	Avg allowed	Providers
Clinical Laboratory	68,642	64,703	$65.86	127
Gastroenterology	1,144	1,082	$65.61	32
Pathology	937	902	$65.31	4
Family Practice	434	407	$62.41	11
Internal Medicine	308	289	$65.61	9
Hematology-Oncology	195	185	$65.77	2
Pulmonary Disease	146	101	$66.01	1
Nurse Practitioner	145	134	$64.33	7
Otolaryngology	138	124	$65.53	2
Endocrinology	57	55	$66.01	1
Physician Assistant	44	42	$66.01	2
Pediatric Medicine	39	38	$64.52	1
Colorectal Surgery (Proctology)	17	17	$66.01	1
Cardiology	16	15	$19.60	1
Emergency Medicine	11	11	$66.01	1

83013 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	16,507	$65.82	$66.01	56
North Carolina	8,232	$65.93	$66.01	3
Texas	7,774	$65.95	$66.01	19
New Jersey	7,407	$65.44	$66.01	8
Arizona	5,516	$65.93	$66.01	4
Florida	5,002	$65.99	$66.01	3
Alabama	2,562	$65.59	$66.01	5
Massachusetts	2,193	$66.01	$66.01	9
New York	2,013	$65.93	$66.01	13
Illinois	1,974	$65.98	$66.01	4
Ohio	1,936	$65.85	$66.01	6
Washington	1,789	$66.00	$66.01	5
Tennessee	1,516	$65.75	$66.01	4
Maryland	1,454	$65.74	$66.01	5
Colorado	1,000	$66.01	$66.01	3
Kansas	794	$65.99	$66.01	4
Nevada	688	$65.93	$66.01	1
Oklahoma	641	$66.01	$66.01	3
Virginia	445	$63.48	$66.01	2
Wisconsin	402	$64.57	$66.01	2
Michigan	345	$65.57	$66.01	7
Pennsylvania	293	$66.01	$66.01	4
Hawaii	284	$65.67	$66.01	2
Oregon	280	$65.84	$66.01	1
Indiana	198	$65.19	$66.01	2
Minnesota	196	$66.01	$66.01	3
U.S. Virgin Islands	163	$65.61	$66.01	3
Utah	150	$65.31	$66.01	4
Georgia	103	$65.37	$66.01	3
Rhode Island	78	$66.01	$66.01	1
Connecticut	74	$65.16	$66.01	2
South Dakota	73	$65.29	$66.01	1
Mississippi	68	$66.01	$66.01	4
Kentucky	56	$64.95	$66.01	2
Missouri	23	$63.14	$66.01	1
Louisiana	17	$66.01	$66.01	1
Iowa	16	$66.01	$66.01	1
North Dakota	11	$66.01	$66.01	1

Related codes

83036Hemoglobin a1c level$9.49
83090Homocysteine (amino acid) level$17.55
83001Gonadotropin, follicle stimulating (reproductive hormone) level$18.16
83002Gonadotropin, luteinizing (reproductive hormone) level$18.11
83010Haptoglobin (serum protein) level$12.31
83037Hemoglobin a1c level$9.30
83021Hemoglobin analysis and measurement$17.69
83069Urine hemoglobin level$3.85
83014Administration of drug for helicobacter pylori$7.69
83020Hemoglobin analysis and measurement$14.03
83003Human growth hormone level$16.31
83018Heavy metal level$19.57

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.