CPT code 13131: Complex repair, face and related sites, 1.1–2.5 cm2026 Medicare rate & RVUs in Texas
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.
Medicare pays $361.06–$397.46 for 13131 in the office in Texas, from Beaumont, TX to Austin, TX. Which amount applies depends on the service address.
Medicare allowed amount for participating (non-QP) physicians, before deductible, coinsurance and claim adjustments. Not a patient’s bill or a hospital charge.
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On this page 9 sections
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 in Texas
The same RVUs, adjusted for each area’s costs. Open a locality for its calculation, history and nearby areas.
8 payment localities
$361.06 to $397.46
8 of 8 payment localities
| Payment locality | Office | Facility |
|---|---|---|
| Austin, TX | $397.46 | $206.64 |
| Beaumont, TX | $361.06 | $196.93 |
| Brazoria, TX | $380.02 | $201.28 |
| Dallas, TX | $382.51 | $202.86 |
| Fort Worth, TX | $380.21 | $202.37 |
| Galveston, TX | $381.21 | $202.10 |
| Houston, TX | $389.08 | $209.98 |
| Rest of Texas | $370.38 | $199.21 |
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
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.
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
| Rule | CMS value | What it means |
|---|---|---|
| Global period | 010 | Minor procedure: the day of the procedure plus 10 days after are included. |
| Multiple procedures | 2 | Standard reduction: highest-valued procedure at 100%, others at 50%. |
| Bilateral (modifier 50) | 0 | The 150% bilateral adjustment doesn’t apply. |
| Assistant at surgery (80/81/82/AS) | 1 | Not paid (statutory restriction). |
| Co-surgeons (62) | 0 | Not permitted. |
| Team surgery (66) | 0 | Not permitted. |
| Professional/technical | 0 | Physician service: no professional/technical split. |
| Split (54/55/56) | 0.10/0.80/0.10 | Share 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.
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%).
13131 compared with similar codes
Compare codes · National
5 codes, side by side
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.
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
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