$418.68
Both cover the same anatomic group and complexity; choose 13131 for 1.1–2.5 cm and 13132 for 2.6–7.5 cm.
On this page
CMS RVU26D · Effective 2026-10-01
13131 Complex repair Medicare reimbursement rates in Alabama
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. Compare 13131 office and facility rates across CMS payment localities in Alabama.
Amounts below use the non-QP conversion factor for participating physicians. These are base physician payments before claim-level adjustments, not patient costs or total hospital charges.
What does Medicare pay for 13131 in Alabama?
Alabama has 1 payment locality in this comparison. Use the service location to choose the applicable amount. These are the supported base rates for the payment area shown below, using the same CMS release.
Office / nonfacility
$347.15
1 of 1 localities have a supported rate.
Payment area: Alabama
One mapped payment locality.
Facility setting
$189.33
1 of 1 localities have a supported rate.
Payment area: Alabama
One mapped payment locality.
These are locality ranges, not averages or address-specific quotes. A facility-setting amount covers the physician service; it does not include a hospital’s separate bill. Choose a locality below to inspect its calculation, compare other payment areas, or price a percentage of Medicare.
Wound repair
About 13131: Complex repair, face and related sites
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.
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.
CMS billing rules for 13131
- Global period
- Minor procedure with a 10-day global period: related postoperative visits for 10 days are included.
- Multiple procedures
- Standard multiple procedure reduction: the highest-valued procedure is paid in full and others at 50% when performed in the same session.
- Bilateral procedures
- Bilateral adjustment does not apply; the descriptor or anatomy makes modifier 50 inappropriate.
- Assistant at surgery
- Statutory restriction: assistant at surgery is not paid.
- Co-surgeons
- Co-surgeons not permitted.
- Team surgery
- Team surgery not permitted.
Where the value comes from
- Work RVU3.64 · 32%
- Practice expense (office) RVU7.44 · 65%
- Malpractice RVU0.43 · 4%
38.1K
Medicare services in 2024 · #890 by national volume
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.
13131 compared with similar codes
Office rates for Alabama, from the same CMS release.
$316.39
Use 13120 for a 1.1–2.5 cm complex repair on the scalp, arms, or legs, rather than the sites assigned to 13131.
$379.28
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.
$304.28
Use 13100 for a 1.1–2.5 cm complex repair on the trunk; 13131 applies to its specified face and related anatomic group.
Compare 13131 by payment locality
Find the payment area for your service address, then open its rate page for calculation inputs, release history and the percentage-of-Medicare tool. A city may cross payment-area boundaries; the ZIP lookup above helps resolve the location.
1 of 1 payment localities
Alabama →
Office / nonfacility
$347.15
Facility
$189.33
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How this local rate is calculated
Each RVU component is multiplied by its own geographic practice cost index (GPCI). The three adjusted components are added, then multiplied by the conversion factor. These are the inputs used for 13131 in Alabama.
PPRRVU2026_Oct_nonQPP.csv
1,439
- Code
- 13131
- Physician work
- 3.64
- Practice expense
- 7.44
- Malpractice
- 0.43
GPCI2026.csv
4
- Locality
- Alabama
- Physician work
- 1.000
- Practice expense
- 0.875
- Malpractice
- 0.566
| Component | RVU | Locality factor | Adjusted |
|---|---|---|---|
| Physician work | 3.64 | × 1.000 | 3.6400 |
| Practice expense | 7.44 | × 0.875 | 6.5100 |
| Malpractice | 0.43 | × 0.566 | 0.2434 |
| Total RVUs | 10.3934 | ||
| Conversion factor | × 33.4009 | ||
Office / nonfacility rate, Alabama$347.15
Explore RVUs, geographic factors and the full formula
Office / nonfacility
| Component | RVU | Local GPCI |
|---|---|---|
| Work | 3.64 | 1 |
| Practice expense | 7.44 | 0.875 |
| Malpractice | 0.43 | 0.566 |
(3.64 × 1 + 7.44 × 0.875 + 0.43 × 0.566) × $33.4009 = $347.15
Facility
| Component | RVU | Local GPCI |
|---|---|---|
| Work | 3.64 | 1 |
| Practice expense | 2.04 | 0.875 |
| Malpractice | 0.43 | 0.566 |
(3.64 × 1 + 2.04 × 0.875 + 0.43 × 0.566) × $33.4009 = $189.33
The office and facility calculations use their respective practice-expense RVUs. The facility amount here is the physician fee, not a separate hospital or facility bill.
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 indices and the applicable conversion factor. Unavailable or separately priced services are labeled rather than assigned a made-up amount.
Source: RVU26D. Effective 2026-10-01 through the day before 2027-01-01.
1,43613120,,Cmplx rpr s/a/l 1.1-2.5 cm,A,,3.15,6.98,,2.41,,0.38,10.51,5.94,0,010,0.10,0.80,0.10,2,0,1,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
1,43713121,,Cmplx rpr s/a/l 2.6-7.5 cm,A,,3.90,8.17,,2.11,,0.44,12.51,6.45,0,010,0.10,0.80,0.10,2,0,1,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
1,43813122,,Cmplx rpr s/a/l addl 5 cm/>,A,,1.40,2.23,,0.42,,0.21,3.84,2.03,0,ZZZ,0.00,0.00,0.00,0,0,1,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
1,43913131,,Cmplx rpr f/c/c/m/n/ax/g/h/f,A,,3.64,7.44,,2.04,,0.43,11.51,6.11,0,010,0.10,0.80,0.10,2,0,1,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
1,44013132,,Cmplx rpr f/c/c/m/n/ax/g/h/f,A,,4.66,8.67,,2.35,,0.51,13.84,7.52,0,010,0.10,0.80,0.10,2,0,1,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
1,44113133,,Cmplx rpr f/c/c/m/n/ax/g/h/f,A,,2.14,2.62,,0.65,,0.27,5.03,3.06,0,ZZZ,0.00,0.00,0.00,0,0,1,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
1,44213151,,Cmplx rpr e/n/e/l 1.1-2.5 cm,A,,4.23,7.82,,2.25,,0.50,12.55,6.98,0,010,0.10,0.80,0.10,2,0,1,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
1ADDENDUM E. FINAL CY 2026 GEOGRAPHIC PRACTICE COST INDICES (GPCIs) BY STATE AND MEDICARE LOCALITY,,,,,,
2,,,,,,
3Medicare Administrative Contractor (MAC),State,Locality Number,Locality Name,2026 PW GPCI (with 1.0 Floor)***,2026 PE GPCI,2026 MP GPCI
410112,AL,00,ALABAMA,1.000,0.875,0.566
502102,AK,01,ALASKA*,1.500,1.065,0.551
603102,AZ,00,ARIZONA,1.000,0.969,0.856
707102,AR,13,ARKANSAS,1.000,0.859,0.515