What does insurance pay for CPT 97813 in Pennsylvania?
Anonymized historical claim benchmarks for acupuncture w/ e-stim (initial 15 min) in Pennsylvania. Actual payment varies by payer, contract terms, modifiers, and documentation.
Updated April 23, 2026
How these numbers are calculated
Based on anonymized claims from practices over Apr 2025 – Apr 2026. Sample density is currently limited sample.
These numbers reflect anonymized historical claim patterns and are not a guarantee of future payment. Actual reimbursement varies by payer, contract terms, modifiers, and documentation.
Historical payment range
How billed, allowed, and paid amounts distribute across the sample.
| Metric | Average | Median |
|---|---|---|
| Billed amount | $100 | $100 |
| Allowed amount | $43 | $43 |
| Paid amount | $26 | $41 |
Claim performance
Anonymized historical signals on how cleanly these claims tend to get paid.
Frequently asked questions
What does insurance typically pay for CPT 97813 in Pennsylvania?+
These benchmarks reflect anonymized historical claim payments. Actual reimbursement depends on the payer, contract, modifiers, and documentation.
Are these numbers a guarantee of payment?+
No. They are directional benchmarks based on historical data and should be used to set expectations, not as a payment guarantee.
Related reimbursement pages
Explore other CPT codes and states with anonymized historical benchmarks.
- 97813 · Acupuncture w/ e-stim (initial 15 min)CPT 97813 reimbursement in Maryland
Acupuncture benchmarks for Acupuncture w/ e-stim (initial 15 min) in Maryland.
- 97810 · Acupuncture (initial 15 min)CPT 97810 reimbursement in Pennsylvania
Acupuncture benchmarks for Acupuncture (initial 15 min) in Pennsylvania.
- 97811 · Acupuncture (additional 15 min)CPT 97811 reimbursement in Pennsylvania
Acupuncture benchmarks for Acupuncture (additional 15 min) in Pennsylvania.
- 97810 · Acupuncture (initial 15 min)CPT 97810 reimbursement in Oregon
Acupuncture benchmarks for Acupuncture (initial 15 min) in Oregon.
- 97811 · Acupuncture (additional 15 min)CPT 97811 reimbursement in Oregon
Acupuncture benchmarks for Acupuncture (additional 15 min) in Oregon.
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