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

Report this code for a 1.1–2.5 cm complex wound closure on the forehead, cheek, chin, mouth, neck, axilla, genitalia, hand, or foot.

CMS RVU26DEffective Oct 1, 2026One payment locality38.1K Medicare services in 2024

In Queens, NY, Medicare pays $443.80 for 13131 in the office and $230.61 when it’s performed in a hospital or facility.

$443.80Office (non-facility)
$230.61Hospital or facility
+15.4%vs the national office rate ($384.44)

Check a contract rate as a % of Medicare · 13131 nationwide

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

We’ll open 13131 for the payment locality that covers the ZIP.

On this page 11 sections
  1. Rate in Queens, NY
  2. What 13131 covers
  3. Compared with other areas
  4. Rate map
  5. How it’s calculated
  6. Payment rules
  7. Related codes
  8. Rate history
  9. Where it applies
  10. Billing questions
  11. Sources

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.

How Queens, NY compares for 13131

Across 109 of 109 payment localities, the office rate for 13131 runs from $342.44 in Arkansas to $500.99 in San Benito County, CA. Queens, NY pays $443.80. The RVUs are the same everywhere; the geographic indexes change the dollars.

13131 in Queens, NY vs other payment areas
  1. Queens, NY · this page$443.80
  2. Manhattan, NY · New York$440.90−$2.90
  3. NYC suburbs and Long Island, NY · New York$451.50+$7.70
  4. Poughkeepsie and northern NYC suburbs, NY · New York$416.54−$27.26
  5. Rest of New York · New York$367.75−$76.05
  6. Los Angeles, CA · California$430.08−$13.72
  7. Washington, DC area · District of Columbia$436.87−$6.93

Other areas in New York first, then benchmark localities. Bars start at $0.

Every other payment area

13131 in every other Medicare payment locality
Payment localityOfficeFacility
Miami, FLFlorida$416.59$228.83
Chicago, ILIllinois$405.14$223.87
AlaskaAlaska$454.94$262.85
AlabamaAlabama$347.15$189.33
ArkansasArkansas$342.44$187.51
ArizonaArizona$374.67$199.90
Bakersfield, CACalifornia$404.99$207.32
Chico, CACalifornia$403.70$206.02

13131 rates by state

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

MEWIVTNHMTNDMNMINYMARIWAIDWYSDIAILINOHPANJCTORNVUTCONEMOKYWVVAMDDECAAZNMKSOKARTNNCSCDCTXLAMSALGAFLAKHI

Explore a state

Local rates. Clear comparisons.

Hover or focus a tile to see its rate range. Select it to open the state’s fee schedule.

$342.44

$454.94

Color shows the midpoint of each state’s locality range.

View every state and territory as a table
13131 office rate range by state
State / territoryOffice rate rangeLocalities
AK$454.941
AL$347.151
AR$342.441
AZ$374.671
CA$403.70–$500.9929
CO$398.661
CT$409.031
DC$436.871
DE$380.621
FL$380.73–$416.593
GA$360.36–$391.672
GU$412.441
HI$412.441
IA$354.661
ID$357.001
IL$370.91–$405.144
IN$358.921
KS$353.461
KY$355.641
LA$355.26–$371.742
MA$396.64–$436.062
MD$387.46–$436.873
ME$359.14–$376.912
MI$364.68–$385.602
MN$381.541
MO$349.78–$372.543
MS$346.151
MT$384.421
NC$362.611
ND$375.911
NE$356.381
NH$392.841
NJ$413.56–$432.842
NM$366.711
NV$382.291
NY$367.75–$451.505
OH$362.941
OK$354.651
OR$379.18–$410.302
PA$363.28–$399.592
PR$386.961
RI$393.401
SC$363.401
SD$374.911
TN$355.181
TX$361.06–$397.468
UT$368.071
VA$376.00–$436.872
VI$386.961
VT$374.861
WA$395.76–$444.312
WI$364.071
WV$358.081
WY$380.711

See 13131 in every payment locality

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.

How the rate is built · 13131

RVUs × geographic indexes × conversion factor

Office or facility?

Work3.64

3.64 RVUs× 1.000 GPCI

Practice expense7.44

7.44 RVUs× 1.000 GPCI

Malpractice0.43

0.43 RVUs× 1.000 GPCI

Adjusted RVUs

11.5100

Conversion factor

$33.4009

Medicare rate

$384.44

Every GPCI starts at 1.000, the national rate. Enter a ZIP or drag a slider.

The exact Queens, NY inputs and CMS source lines

PPRRVU2026_Oct_nonQPP.csv

1,439

Code
13131
Physician work
3.64
Practice expense
7.44
Malpractice
0.43

GPCI2026.csv

81

Locality
Queens, NY
Physician work
1.064
Practice expense
1.182
Malpractice
1.442
Office calculation for 13131 in Queens, NY
ComponentRVULocality factorAdjusted
Physician work3.64× 1.0643.8730
Practice expense7.44× 1.1828.7941
Malpractice0.43× 1.4420.6201
Total RVUs13.2871
Conversion factor× 33.4009

Office rate, Queens, NY$443.80

Office: (3.64 × 1.064 + 7.44 × 1.182 + 0.43 × 1.442) × $33.4009 = $443.80

Facility: (3.64 × 1.064 + 2.04 × 1.182 + 0.43 × 1.442) × $33.4009 = $230.61

Open 13131 in the RVU calculator

Payment rules and modifiers for 13131

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

CMS payment indicators · 13131

Complex repair, face and related sites, 1.1–2.5 cm

RuleCMS valueWhat it means
Global period010Minor procedure: the day of the procedure plus 10 days after are included.
Multiple procedures2Standard reduction: highest-valued procedure at 100%, others at 50%.
Bilateral (modifier 50)0The 150% bilateral adjustment doesn’t apply.
Assistant at surgery (80/81/82/AS)1Not paid (statutory restriction).
Co-surgeons (62)0Not permitted.
Team surgery (66)0Not permitted.
Professional/technical0Physician service: no professional/technical split.
Split (54/55/56)0.10/0.80/0.10Share of the payment for pre-op, the procedure itself, and post-op care.

Global surgery period · 13131

Complex repair, face and related sites, 1.1–2.5 cm

10-day global period ends

Oct 11, 2026

Covers Oct 1, 2026 through Oct 11, 2026 (11 days).

Visit on Oct 31, 2026

After the global period ends: visits and procedures are billed normally.

SurgeryVisit
Sep 28, 2026Oct 14, 2026

What modifiers do to the payment

Modifier 51 · payment effect

With and without the modifier

13131 without 51 · national office

$384.44

Complex repair, face and related sites, 1.1–2.5 cm

13131-51 · Second procedure: 50%

$192.22

When this isn’t the highest-valued procedure in the session, Medicare pays 50% of its fee schedule amount (the highest is paid at 100%).

When to use modifier 51

Codes related to 13131

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

Codes related to 13131
CodeHow it relatesOffice range, Queens, NY
Same family
13132Complex wound repair, 2.6–7.5 cm, specified sitesSame anatomic group; selected for a complex repair measuring 2.6–7.5 cm.$532.46
Used instead
13120Complex repair, scalp, arm, or leg; 1.1–2.5 cmComplex repair of the same short length on the scalp, arms, or legs.$405.82
13151Complex repair, eyelid, nose, ear, or lipComplex repair of the same short length on the eyelids, nose, ears, or lips.$483.14
13100Complex repair, trunk, 1.1–2.5 cmComplex repair of the same short length on the trunk.$391.11

How 13131 has changed in Queens, NY

13131 · Office / nonfacility

$443.80

Effective 2026-10-01

The base rate is $7.73 higher than on 2025-10-01, moving from $436.07 to $443.80 (1.8%).

It is unchanged from the immediately preceding available release, effective 2026-07-01.

Base rate by release · bars start at $0 · select a bar to compare

One bar per available release, ordered by effective date. Missing rates remain gaps. These comparisons hold the code, setting and locality identifiers constant; they do not isolate which policy or input caused a change.

What changed, release by release

  1. January 1, 2026

    RVU26A

    $436.07changed to$443.80

    • Conversion factor 32.3465 changed to 33.4009
    • Work RVU 3.73 changed to 3.64
    • Practice expense RVU 7.37 changed to 7.44
    • Malpractice RVU 0.48 changed to 0.43
    • Work GPCI 1.065 changed to 1.064
    • Practice expense GPCI 1.195 changed to 1.182
    • Malpractice GPCI 1.462 changed to 1.442

    Held through RVU26B, RVU26C, RVU26D.

  2. January 1, 2025

    RVU25A

    $451.37changed to$436.07

    • Conversion factor 33.2875 changed to 32.3465
    • Practice expense RVU 7.46 changed to 7.37
    • Malpractice RVU 0.46 changed to 0.48

    Held through RVU25B, RVU25C, RVU25D.

  3. March 9, 2024

    RVU24AR

    $444.00changed to$451.37

    • Conversion factor 32.7442 changed to 33.2875

    Held through RVU24B, RVU24C, RVU24D.

  4. January 1, 2024

    RVU24A

    $472.87changed to$444.00

    • Conversion factor 33.8872 changed to 32.7442
    • Practice expense RVU 7.50 changed to 7.46
    • Malpractice RVU 0.44 changed to 0.46
    • Work GPCI 1.061 changed to 1.065
    • Practice expense GPCI 1.212 changed to 1.195
    • Malpractice GPCI 2.061 changed to 1.462

  5. January 1, 2023

    RVU23A

    $491.16changed to$472.87

    • Conversion factor 34.6062 changed to 33.8872
    • Practice expense RVU 7.44 changed to 7.50
    • Malpractice RVU 0.42 changed to 0.44
    • Work GPCI 1.056 changed to 1.061
    • Practice expense GPCI 1.228 changed to 1.212
    • Malpractice GPCI 2.661 changed to 2.061

    Held through RVU23B, RVU23C, RVU23D.

  6. January 1, 2022

    RVU22A

    $497.02changed to$491.16

    • Conversion factor 34.8931 changed to 34.6062
    • Practice expense RVU 7.46 changed to 7.44
    • Malpractice RVU 0.43 changed to 0.42

    Held through RVU22B, RVU22C, RVU22D.

  7. January 1, 2021

    RVU21A

    $483.49changed to$497.02

    • Conversion factor 36.0896 changed to 34.8931
    • Practice expense RVU 6.95 changed to 7.46
    • Work GPCI 1.054 changed to 1.056
    • Practice expense GPCI 1.214 changed to 1.228
    • Malpractice GPCI 2.391 changed to 2.661

    Held through RVU21B, RVU21C, RVU21D.

  8. January 1, 2020

    RVU20A

    $477.97changed to$483.49

    • Conversion factor 36.0391 changed to 36.0896
    • Practice expense RVU 6.81 changed to 6.95
    • Malpractice RVU 0.55 changed to 0.43
    • Work GPCI 1.052 changed to 1.054
    • Practice expense GPCI 1.200 changed to 1.214
    • Malpractice GPCI 2.121 changed to 2.391

    Held through RVU20B, RVU20C, RVU20D.

  9. January 1, 2019

    RVU19A

    $473.02changed to$477.97

    • Conversion factor 35.9996 changed to 36.0391
    • Practice expense RVU 6.69 changed to 6.81
    • Malpractice RVU 0.56 changed to 0.55

    Held through RVU19B, RVU19C, RVU19D.

  10. January 1, 2018

    RVU18AR1

    $470.88changed to$473.02

    • Conversion factor 35.8887 changed to 35.9996
    • Practice expense RVU 6.66 changed to 6.69
    • Malpractice GPCI 2.151 changed to 2.121

    Held through RVU18B, RVU18C, RVU18D.

  11. January 1, 2017

    RVU17A

    $468.42changed to$470.88

    • Conversion factor 35.8043 changed to 35.8887
    • Practice expense RVU 6.62 changed to 6.66
    • Practice expense GPCI 1.199 changed to 1.200
    • Malpractice GPCI 2.181 changed to 2.151

    Held through RVU17B, RVU17C, RVU17D.

  12. January 1, 2016

    RVU16A

    $466.97changed to$468.42

    • Conversion factor 35.9335 changed to 35.8043
    • Malpractice RVU 0.52 changed to 0.56

    Held through RVU16B, RVU16C, RVU16D.

  13. July 1, 2015

    RVU15C

    $464.65changed to$466.97

    • Conversion factor 35.7547 changed to 35.9335

    Held through RVU15D.

  14. January 1, 2015

    RVU15A

    $454.84changed to$464.65

    • Conversion factor 35.8228 changed to 35.7547
    • Practice expense RVU 6.47 changed to 6.62
    • Malpractice RVU 0.55 changed to 0.52
    • Work GPCI 1.057 changed to 1.052
    • Practice expense GPCI 1.197 changed to 1.199
    • Malpractice GPCI 1.836 changed to 2.181

    Held through RVU15B.

  15. January 1, 2014

    RVU14A

    $459.68changed to$454.84

    • Conversion factor 34.0230 changed to 35.8228
    • Practice expense RVU 7.28 changed to 6.47
    • Malpractice RVU 0.57 changed to 0.55
    • Work GPCI 1.062 changed to 1.057
    • Practice expense GPCI 1.195 changed to 1.197
    • Malpractice GPCI 1.491 changed to 1.836

    Held through RVU14B, RVU14C, RVU14D.

  16. January 1, 2013

    RVU13AR

    Earliest loaded release: $459.68

    Held through RVU13B, RVU13C, RVU13D.

Rates in every CMS release
Effective fromOfficeFacilityCMS release
2026-10-01$443.80$230.61RVU26D
2026-07-01$443.80$230.61RVU26C
2026-04-01$443.80$230.61RVU26B
2026-01-01$443.80$230.61RVU26A
2025-10-01$436.07$269.86RVU25D
2025-07-01$436.07$269.86RVU25C
2025-04-01$436.07$269.86RVU25B
2025-01-01$436.07$269.86RVU25A
2024-10-01$451.37$274.75RVU24D
2024-07-01$451.37$274.75RVU24C
2024-04-01$451.37$274.75RVU24B
2024-03-09$451.37$274.75RVU24AR
2024-01-01$444.00$270.27RVU24A
2023-10-01$472.87$287.64RVU23D
2023-07-01$472.87$287.64RVU23C
2023-04-01$472.87$287.64RVU23B
2023-01-01$472.87$287.64RVU23A
2022-10-01$491.16$298.65RVU22D
2022-07-01$491.16$298.65RVU22C
2022-04-01$491.16$298.65RVU22B
2022-01-01$491.16$298.65RVU22A
2021-10-01$497.02$301.63RVU21D
2021-07-01$497.02$301.63RVU21C
2021-04-01$497.02$301.63RVU21B
2021-01-01$497.02$301.63RVU21A
2020-10-01$483.49$305.17RVU20D
2020-07-01$483.49$305.17RVU20C
2020-04-01$483.49$305.17RVU20B
2020-01-01$483.49$305.17RVU20A
2019-10-01$477.97$308.44RVU19D
2019-07-01$477.97$308.44RVU19C
2019-04-01$477.97$308.44RVU19B
2019-01-01$477.97$308.44RVU19A
2018-10-01$473.02$310.59RVU18D
2018-07-01$473.02$310.59RVU18C
2018-04-01$473.02$310.59RVU18B
2018-01-01$473.02$310.59RVU18AR1
2017-10-01$470.88$310.67RVU17D
2017-07-01$470.88$310.67RVU17C
2017-04-01$470.88$310.67RVU17B
2017-01-01$470.88$310.67RVU17A
2016-10-01$468.42$309.15RVU16D
2016-07-01$468.42$309.15RVU16C
2016-04-01$468.42$309.15RVU16B
2016-01-01$468.42$309.15RVU16A
2015-10-01$466.97$307.56RVU15D
2015-07-01$466.97$307.56RVU15C
2015-04-01$464.65$306.03RVU15B
2015-01-01$464.65$306.03RVU15A
2014-10-01$454.84$300.05RVU14D
2014-07-01$454.84$300.05RVU14C
2014-04-01$454.84$300.05RVU14B
2014-01-01$454.84$300.05RVU14A
2013-10-01$459.68$292.17RVU13D
2013-07-01$459.68$292.17RVU13C
2013-04-01$459.68$292.17RVU13B
2013-01-01$459.68$292.17RVU13AR

Price 13131 for an earlier date of service

Where the Queens, NY rate applies

Queens, NY is a Medicare payment area, not a city. Our Census mapping connects it to 1 cities and communities in New York. Some span more than one payment area; confirm with the service ZIP.

Browse all communities in New York

13131 billing questions

When should I report 13131 instead of 13132?

Use 13131 for a qualifying complex repair measuring 1.1–2.5 cm in its anatomic group. Code 13132 covers the same group when the repair measures 2.6–7.5 cm.

Does a layered closure qualify as complex?

Layered closure alone is not enough. The record should support additional work, such as extensive undermining, substantial debridement, scar revision, or retention sutures.

Can I add wound lengths together?

Add lengths of qualifying repairs in the same anatomic group performed at the same session. Document each wound’s location and measurement so the combined length and code selection are clear.

Can I use modifier 50 for repairs on both sides?

No. CMS identifies bilateral adjustment as inappropriate for this code; modifier 50 should not be used.

Are assistant surgeons or co-surgeons payable?

CMS does not pay an assistant at surgery for 13131. Co-surgeons and team surgery are not permitted for this code.

What postoperative care is included?

Related postoperative visits during the 10-day global period are included in the procedure’s global service.

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

Show the CMS file lines behind this rate
RVUs for 13131PPRRVU2026_Oct_nonQPP.csv, line 1,439 (RVU26D)
Geographic factors for Queens, NYGPCI2026.csv, line 81 (RVU26D)

Open CMS sourceHow we calculate rates

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