Billing code 13101: Complex repairMedicare rate & RVUs
Report this code for a complex repair of a trunk wound measuring 2.6–7.5 cm when closure requires more than routine layered approximation.
Medicare pays $390.46 for 13101 nationally in the office and $210.09 in a hospital or facility. Local office rates run $346.87–$513.12.
Medicare rate · 13101
Complex repair
Swap in your local Medicare rate.
- Work RVUs
- 3.41
- Total RVUs
- 11.69
- Global days
- 010
National rate · 2026
$390.46
Office setting, before claim adjustments.
See every locality for 13101 → · Billed by an NP, PA or therapist? →
Medicare allowed amount for participating (non-QP) physicians, before deductible, coinsurance and claim adjustments. Not a patient’s bill or a hospital charge.
On this page 10 sections
What 13101 covers
This code covers complex repair of a wound on the trunk, such as the chest, abdomen, or back, when the work goes beyond routine layered closure. A surgeon or other qualified clinician may perform it after trauma or removal of a lesion. Complex work can include extensive undermining, substantial wound-edge preparation, or retention sutures when needed to achieve closure; layered suturing alone does not make a repair complex.
Select the code by the trunk site, documented complexity, and length of the repaired wound. The operative note should describe the wound, the additional work required, and the closure length; report 13102 for qualifying additional length beyond this code’s range. Related postoperative visits during the 10-day global period are included. When multiple procedures occur in one session, the highest-valued procedure is paid in full and other procedures are subject to the standard 50% reduction. Modifier 50 is inappropriate. Assistant-at-surgery services are not paid, and co-surgeons and team surgery 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 13101 pays more and less
The same RVUs, adjusted for each area’s costs. Open a locality for its calculation, history and nearby areas.
109 payment localities
$346.87 to $513.12
109 of 109 payment localities
| Payment locality | Office | Facility |
|---|---|---|
| Alabama | $351.76 | $193.94 |
| Alaska* | $458.51 | $266.43 |
| Arizona | $380.37 | $205.60 |
| Arkansas | $346.87 | $191.93 |
| Atlanta | $397.69 | $214.44 |
| Austin | $404.43 | $213.60 |
| Bakersfield | $412.66 | $214.98 |
| Baltimore/Surr. Cntys | $414.66 | $221.13 |
| Beaumont | $365.82 | $201.69 |
| Brazoria | $386.06 | $207.32 |
| Chicago | $409.87 | $228.60 |
| Chico | $411.46 | $213.78 |
| Colorado | $405.74 | $213.83 |
| Connecticut | $415.81 | $221.55 |
| Dallas | $388.53 | $208.89 |
| Dc + Md/Va Suburbs | $444.97 | $232.50 |
| Delaware | $386.52 | $208.32 |
| Detroit | $390.41 | $216.36 |
| East St. Louis | $382.95 | $217.01 |
| El Centro | $411.53 | $213.85 |
| Fort Lauderdale | $404.67 | $221.96 |
| Fort Worth | $386.07 | $208.23 |
| Fresno | $411.46 | $213.78 |
| Galveston | $387.23 | $208.13 |
| Hanford-Corcoran | $411.46 | $213.78 |
| Hawaii, Guam | $420.89 | $215.82 |
| Houston | $394.55 | $215.45 |
| Idaho | $362.36 | $196.42 |
| Indiana | $364.38 | $197.18 |
| Iowa | $360.03 | $194.99 |
| Kansas | $358.56 | $195.51 |
| Kentucky | $360.11 | $199.76 |
| Los Angeles-Long Beach-Anaheim (Los Angeles/Orange Cnty) | $438.80 | $225.43 |
| Madera | $411.46 | $213.78 |
| Manhattan | $448.21 | $238.63 |
| Merced | $411.46 | $213.78 |
| Metropolitan Boston | $444.72 | $229.36 |
| Metropolitan Kansas City | $374.09 | $204.73 |
| Metropolitan Philadelphia | $405.88 | $218.12 |
| Metropolitan St. Louis | $377.85 | $206.14 |
| Miami | $421.68 | $233.92 |
| Minnesota | $388.68 | $203.09 |
| Mississippi | $350.38 | $195.09 |
| Modesto | $411.46 | $213.78 |
| Montana** | $390.43 | $210.06 |
| Napa | $474.76 | $237.04 |
| Nebraska | $361.88 | $195.40 |
| Nevada** | $388.49 | $207.94 |
| New Hampshire | $399.58 | $211.82 |
| New Mexico | $371.30 | $205.90 |
| New Orleans | $376.74 | $207.02 |
| North Carolina | $368.00 | $199.72 |
| North Dakota** | $382.52 | $202.16 |
| Northern Nj | $440.65 | $231.43 |
| Nyc Suburbs/Long Island | $458.94 | $244.49 |
| Ohio | $367.67 | $202.99 |
| Oklahoma | $359.31 | $198.25 |
| Oxnard-Thousand Oaks-Ventura | $436.51 | $223.32 |
| Portland | $418.07 | $217.69 |
| Poughkpsie/N Nyc Suburbs | $423.39 | $225.89 |
| Puerto Rico | $393.15 | $210.80 |
| Queens | $451.55 | $238.36 |
| Redding | $411.46 | $213.78 |
| Rest Of California | $411.46 | $213.78 |
| Rest Of Florida | $385.60 | $213.17 |
| Rest Of Georgia | $364.60 | $203.71 |
| Rest Of Illinois | $375.08 | $210.41 |
| Rest Of Louisiana | $359.63 | $200.00 |
| Rest Of Maine | $364.35 | $198.41 |
| Rest Of Maryland | $393.66 | $211.13 |
| Rest Of Massachusetts | $403.52 | $213.59 |
| Rest Of Michigan | $369.28 | $204.61 |
| Rest Of Missouri | $353.79 | $198.31 |
| Rest Of New Jersey | $420.52 | $223.56 |
| Rest Of New York | $373.33 | $201.98 |
| Rest Of Oregon | $385.44 | $205.79 |
| Rest Of Pennsylvania | $368.14 | $202.56 |
| Rest Of Texas | $375.74 | $204.57 |
| Rest Of Washington | $402.69 | $212.77 |
| Rhode Island | $399.86 | $213.55 |
| Riverside-San Bernardino-Ontario | $415.81 | $218.13 |
| Sacramento-Roseville-Folsom | $431.26 | $221.49 |
| Salinas | $429.64 | $220.59 |
| San Diego-Chula Vista-Carlsbad | $439.34 | $223.63 |
| San Francisco-Oakland-Berkeley (Marin Cnty) | $501.96 | $247.65 |
| San Francisco-Oakland-Berkeley (San Francisco/San Mateo/Alameda/Contra Costa Cnty) | $501.51 | $247.19 |
| San Jose-Sunnyvale-Santa Clara (San Benito Cnty) | $513.12 | $253.03 |
| San Jose-Sunnyvale-Santa Clara (Santa Clara Cnty) | $511.26 | $251.18 |
| San Luis Obispo-Paso Robles | $422.78 | $217.34 |
| Santa Cruz-Watsonville | $443.24 | $224.09 |
| Santa Maria-Santa Barbara | $431.14 | $220.83 |
| Santa Rosa-Petaluma | $447.68 | $226.20 |
| Seattle (King Cnty) | $453.45 | $232.14 |
| South Carolina | $368.45 | $201.79 |
| South Dakota** | $381.59 | $201.22 |
| Southern Maine | $383.16 | $204.42 |
| Stockton | $411.46 | $213.78 |
| Suburban Chicago | $408.67 | $223.44 |
| Tennessee | $360.32 | $196.37 |
| Utah | $373.30 | $203.76 |
| Vallejo | $474.10 | $236.38 |
| Vermont | $381.22 | $202.66 |
| Virgin Islands | $393.15 | $210.80 |
| Virginia | $382.05 | $204.76 |
| Visalia | $411.46 | $213.78 |
| West Virginia | $361.74 | $205.00 |
| Wisconsin | $370.16 | $197.37 |
| Wyoming** | $386.98 | $206.62 |
| Yuba City | $411.46 | $213.78 |
13101 rates by state
Office rate range in each state. Select a state to see its payment localities.
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.
$346.87
$462.29
Color shows the midpoint of each state’s locality range.
View every state and territory as a table
| State / territory | Office rate range | Localities |
|---|---|---|
| AK | $458.51 | 1 |
| AL | $351.76 | 1 |
| AR | $346.87 | 1 |
| AZ | $380.37 | 1 |
| CA | $411.46–$513.12 | 29 |
| CO | $405.74 | 1 |
| CT | $415.81 | 1 |
| DC | $444.97 | 1 |
| DE | $386.52 | 1 |
| FL | $385.60–$421.68 | 3 |
| GA | $364.60–$397.69 | 2 |
| GU | $420.89 | 1 |
| HI | $420.89 | 1 |
| IA | $360.03 | 1 |
| ID | $362.36 | 1 |
| IL | $375.08–$409.87 | 4 |
| IN | $364.38 | 1 |
| KS | $358.56 | 1 |
| KY | $360.11 | 1 |
| LA | $359.63–$376.74 | 2 |
| MA | $403.52–$444.72 | 2 |
| MD | $393.66–$444.97 | 3 |
| ME | $364.35–$383.16 | 2 |
| MI | $369.28–$390.41 | 2 |
| MN | $388.68 | 1 |
| MO | $353.79–$377.85 | 3 |
| MS | $350.38 | 1 |
| MT | $390.43 | 1 |
| NC | $368.00 | 1 |
| ND | $382.52 | 1 |
| NE | $361.88 | 1 |
| NH | $399.58 | 1 |
| NJ | $420.52–$440.65 | 2 |
| NM | $371.30 | 1 |
| NV | $388.49 | 1 |
| NY | $373.33–$458.94 | 5 |
| OH | $367.67 | 1 |
| OK | $359.31 | 1 |
| OR | $385.44–$418.07 | 2 |
| PA | $368.14–$405.88 | 2 |
| PR | $393.15 | 1 |
| RI | $399.86 | 1 |
| SC | $368.45 | 1 |
| SD | $381.59 | 1 |
| TN | $360.32 | 1 |
| TX | $365.82–$404.43 | 8 |
| UT | $373.30 | 1 |
| VA | $382.05–$444.97 | 2 |
| VI | $393.15 | 1 |
| VT | $381.22 | 1 |
| WA | $402.69–$453.45 | 2 |
| WI | $370.16 | 1 |
| WV | $361.74 | 1 |
| WY | $386.98 | 1 |
How the 13101 rate is calculated
Each of 13101’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 · 13101
RVUs × geographic indexes × conversion factor
Swap in your local Medicare rate.
Work 3.41Practice expense 7.88Malpractice 0.40
All indexes start at 1.000 (the national rate). Enter a ZIP or drag a slider.
Payment rules and modifiers for 13101
13101 has a 10-day global period: related visits in that window are included in the surgery payment.
CMS payment indicators · 13101
Complex repair
| 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 · 13101
Complex repair
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
13101 without 51 · national office
$390.46
Complex repair
13101-51 · Second procedure: 50%
$195.23
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%).
13101 compared with similar codes
Compare codes
13101 vs 13100 vs 13102 vs 13121 vs 12032: national Medicare rates
Swap in your local Medicare rate.
How to choose
- 13100Complex repair
- Both describe complex trunk repair; choose 13100 for 1.1–2.5 cm and 13101 for 2.6–7.5 cm.
- 13102Complex repair
- 13102 reports qualifying additional trunk repair length beyond the range covered by the primary repair code; it is not the stand-alone code for the initial length.
- 13121Complex repair
- 13121 is for complex repair in a different anatomical group, not the trunk, even when the wound length is 2.6–7.5 cm.
- 12032Intermediate repair
- 12032 describes intermediate repair of a similar-length trunk wound. Use 13101 only when the documented repair meets complex-repair criteria.
13101 billing questions
When is 13101 chosen instead of 13100?
Use 13101 for a complex trunk repair measuring 2.6–7.5 cm. Code 13100 is for the shorter 1.1–2.5 cm range.
Can layered closure alone support complex repair?
No. The documentation should show work beyond routine layered approximation, such as extensive undermining or substantial wound-edge preparation.
When is 13102 reported with 13101?
Report 13102 for qualifying additional trunk repair length beyond the 13101 range. Document the total repaired length and the additional work.
Should modifier 50 be used for wounds on both sides of the trunk?
No. CMS identifies bilateral adjustment as inappropriate for this code; report based on the repair site and length.
Are postoperative visits separately payable during the global period?
Related postoperative visits during the 10-day global period are included in the procedure payment.
How are other procedures in the same session paid?
The highest-valued procedure is paid in full, and other procedures are subject to the standard multiple-procedure reduction.
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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