{"headline":"Medicare (2026D) pays $98.18 non-facility and $58.02 facility for CPT 99213 in COLORADO (locality 04112-01, ZIP 80218).","data":{"code":"99213","modifier":null,"code_type":"CPT","description":null,"status":"A","status_meaning":"Active: separately paid under the fee schedule","priced":true,"release":{"id":"2026D","effective_from":"2026-10-01","effective_to":null,"released":"2026-08-26"},"locality":{"id":"04112-01","mac":"04112","locality":"01","state":"CO","name":"COLORADO","counties":"ALL COUNTIES"},"location":{"zip":"80218","plus4":null,"matched":"zip5","rural":null},"rvus":{"work":"1.30","pe_nonfacility":"1.46","pe_facility":"0.33","mp":"0.09","nonfacility_na":false,"facility_na":false},"gpci":{"work":"1.012","pe":"1.064","mp":"0.781"},"conversion_factor":{"nonqp":"33.4009","qp":"33.5675"},"nonfacility":{"amount":"98.18","amount_qp":"98.67","limiting_charge":"107.26","opps_capped":false,"fee_before_cap":null},"facility":{"amount":"58.02","amount_qp":"58.31","limiting_charge":"63.39","opps_capped":false,"fee_before_cap":null},"indicators":{"pctc":"0","global_days":"XXX","multiple_procedure":"0","bilateral_surgery":"0","assistant_surgery":"0","co_surgeons":"0","team_surgery":"0"},"history":[{"release":"2026D","effective_from":"2026-10-01","status":"A","nonfacility":"98.18","facility":"58.02"},{"release":"2026C","effective_from":"2026-07-01","status":"A","nonfacility":"98.18","facility":"58.02"},{"release":"2026B","effective_from":"2026-04-01","status":"A","nonfacility":"98.18","facility":"58.02"}]},"sources":[{"url":"https://www.cms.gov/files/zip/rvu25a-updated-01/10/2025.zip","fetched_at":"2026-10-21T05:51:18.489Z","sha256":"8871f447d1dfce9df46c155c5170f7ad68a580e49c5492a73e56d7978fd159e6","publisher":"Centers for Medicare & Medicaid Services","license":"US government work (CMS), public; CPT codes only, without AMA descriptors (D-010)"},{"url":"https://www.cms.gov/files/zip/rvu25b-updated-06/05/2025.zip","fetched_at":"2026-10-21T05:51:20.511Z","sha256":"2fbe521eb8837073f2cfcefeb4af997d2141e4577cd2040bfec83bf52c2063ef","publisher":"Centers for Medicare & Medicaid Services","license":"US government work (CMS), public; CPT codes only, without AMA descriptors (D-010)"},{"url":"https://www.cms.gov/files/zip/rvu25c-updated-06/05/2025.zip","fetched_at":"2026-10-21T05:51:22.455Z","sha256":"ab795bffde2b239fd33cf0267754ee4bc397a2ba29a57e7779b7fe42f09f4039","publisher":"Centers for Medicare & Medicaid Services","license":"US government work (CMS), public; CPT codes only, without AMA descriptors (D-010)"},{"url":"https://www.cms.gov/files/zip/rvu25d-updated-09/11/2025.zip","fetched_at":"2026-10-21T05:51:24.455Z","sha256":"ebe658d447353094aaf2068530045079b6875f76451defd163fe701b0c2adf79","publisher":"Centers for Medicare & Medicaid Services","license":"US government work (CMS), public; CPT codes only, without AMA descriptors (D-010)"},{"url":"https://www.cms.gov/files/zip/rvu26a-updated-12-29-2025.zip","fetched_at":"2026-10-21T05:51:26.618Z","sha256":"91b9bdd5459bc4c19d4f8203410b29a672db37def2e70f01ef627b8b18fc7482","publisher":"Centers for Medicare & Medicaid Services","license":"US government work (CMS), public; CPT codes only, without AMA descriptors (D-010)"},{"url":"https://www.cms.gov/files/zip/rvu26b-updated-05-01-2026.zip","fetched_at":"2026-10-21T05:51:28.548Z","sha256":"7d9a398769fc4da406aa99284f3ab1a56eb609696fcf2f6f166387574edd5728","publisher":"Centers for Medicare & Medicaid Services","license":"US government work (CMS), public; CPT codes only, without AMA descriptors (D-010)"},{"url":"https://www.cms.gov/files/zip/rvu26c-updated-06-30-2026.zip","fetched_at":"2026-10-21T05:51:30.559Z","sha256":"d45a158e02694c1539e7f88192c611883e377181eda86dc213359707bcacbacb","publisher":"Centers for Medicare & Medicaid Services","license":"US government work (CMS), public; CPT codes only, without AMA descriptors (D-010)"},{"url":"https://www.cms.gov/files/zip/rvu26d-updated-08-26-2026.zip","fetched_at":"2026-10-21T05:51:32.563Z","sha256":"521ff0f4ecbf13b5d99dc1dc04d9f82e5361e55c6b4b6b3033043598bf8406e6","publisher":"Centers for Medicare & Medicaid Services","license":"US government work (CMS), public; CPT codes only, without AMA descriptors (D-010)"},{"url":"https://www.cms.gov/files/zip/zip-code-carrier-locality-file-updated-08-13-2026.zip","fetched_at":"2026-10-21T05:51:34.538Z","sha256":"64cd98f5fd6087b9f1732a11749e48883ad26f6416cc1e26cd19af135c5b17b2","publisher":"Centers for Medicare & Medicaid Services","license":"US government work (CMS), public; CPT codes only, without AMA descriptors (D-010)"}],"as_of":"2026-10-21T15:25:15.999Z","confidence":1,"method_version":"medicare.pfs_rate@1.0.0","price_paid":null,"notices":["Medicare Physician Fee Schedule amounts computed from CMS’s published RVU, GPCI and conversion-factor files: what Original Medicare allows a participating clinician (before deductible and coinsurance), not what another payer pays; not a quote, not medical, billing or coding advice. See /terms.","CPT® codes are served as codes only: their descriptors are AMA copyright and are never included (nor dental CDT descriptors). CPT is a registered trademark of the American Medical Association. HCPCS Level II descriptions are CMS’s.","Free tier: the 3 newest of 8 releases in history.","Free tier answer capped at 3 rows: 2 of 3 free answers left today (UTC) for the medicare routes. Pay per call for more."],"view":"summary","request_id":"e931d72e-5089-4e22-9445-f572e0f78a40"}