CPT code 13131: Complex repair, face and related sites, 1.1–2.5 cm2026 Medicare rate & RVUs

Medicare pays $384.44 for 13131 nationally in the office and $204.08 in a hospital or facility. Local office rates run $342.44–$500.99.

Medicare allowed amount for participating (non-QP) physicians, before deductible, coinsurance and claim adjustments. Not a patient’s bill or a hospital charge.

What 13131 covers

This code covers complex closure of a short wound on the forehead, cheek, chin, mouth, neck, axilla, genitalia, hand, or foot. The repair must involve work beyond routine layered closure, such as extensive undermining, substantial wound-edge debridement, scar revision, or retention sutures. Plastic surgeons, dermatologic surgeons, and other physicians may perform these repairs for traumatic wounds or after excision of a lesion in an office, outpatient department, or hospital setting.

Choose the code by the repaired length in this anatomic group; when qualifying wounds in the same group are repaired at the same session, add their lengths. Document the site, measured length, closure technique, and the work that makes the repair complex. CMS assigns a 10-day global period, which includes related postoperative visits during that period. When multiple procedures are performed in one session, the highest-valued procedure is paid in full and others are subject to the standard 50% reduction. Modifier 50 is inappropriate. CMS does not pay an assistant at surgery for this code, and co-surgeon and team-surgery billing are not permitted.

This summary was written with AI assistance from CMS physician fee schedule data and checked against the CMS billing rules shown here. Rates on this page come directly from CMS files.

Where 13131 pays more and less

The same RVUs, adjusted for each area’s costs. Open a locality for its calculation, history and nearby areas.

109 of 109 payment localities

13131 rates by state

Office rate range in each state. Select a state to see its payment localities.

How the 13131 rate is calculated

Each of 13131’s three RVUs is multiplied by a geographic index (GPCI) for the payment locality, added up, and multiplied by the conversion factor. Drag the indexes or enter a ZIP to see what moves the rate.

Payment rules and modifiers for 13131

13131 has a 10-day global period: related visits in that window are included in the surgery payment.

What modifiers do to the payment

When to use modifier 51

13131 compared with similar codes

How to choose

13132Complex wound repair2.6–7.5 cm, specified sites

Both cover the same anatomic group and complexity; choose 13131 for 1.1–2.5 cm and 13132 for 2.6–7.5 cm.

13120Complex repairScalp, arm, or leg; 1.1–2.5 cm

Use 13120 for a 1.1–2.5 cm complex repair on the scalp, arms, or legs, rather than the sites assigned to 13131.

13151Complex repairEyelid, nose, ear, or lip

Use 13151 for a 1.1–2.5 cm complex repair of the eyelids, nose, ears, or lips; 13131 covers other specified face and related sites.

13100Complex repairTrunk, 1.1–2.5 cm

Use 13100 for a 1.1–2.5 cm complex repair on the trunk; 13131 applies to its specified face and related anatomic group.

Codes related to 13131

Related codes aren’t interchangeable: bill the code that matches the service performed.

Where these rates come from

FeeBase calculates base physician payments from CMS work, practice-expense and malpractice RVUs, adjusted by each locality’s geographic indexes and the conversion factor. Services without a published rate are labeled, never given a made-up amount. Amounts are Medicare allowed amounts before claim adjustments: not a patient’s bill or a commercial rate.

CMS RVU26D · effective Oct 1, 2026 through the day before Jan 1, 2027

Open CMS sourceHow we calculate rates