$364.38
Both codes describe complex trunk repair; 13101 applies to a longer initial repair length than this code.
On this page
CMS RVU26D · Effective 2026-10-01
13100 Complex repair Medicare reimbursement rates in Indiana
Report this code for a complex repair of a trunk wound measuring 1.1–2.5 cm, when closure requires work beyond routine layered repair. Compare 13100 office and facility rates across CMS payment localities in Indiana.
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 13100 in Indiana?
Indiana 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
$315.18
1 of 1 localities have a supported rate.
Payment area: Indiana
One mapped payment locality.
Facility setting
$160.68
1 of 1 localities have a supported rate.
Payment area: Indiana
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 13100: Complex trunk wound repair, short length
Report this code for a complex repair of a trunk wound measuring 1.1–2.5 cm, when closure requires work beyond routine layered repair.
This service closes a short wound on the torso, such as the chest, abdomen, or back, when the repair requires more than routine layered closure. A physician or other qualified practitioner may perform it in an office, emergency department, or outpatient surgical setting after trauma, lesion removal, or another procedure. Complex work may include extensive undermining, debridement, scar revision, or retention sutures.
Select the code by the wound’s anatomic region, complexity, and repaired length; document the site, final length, and work supporting complex repair. The 10-day global period includes related postoperative visits during that period. When multiple procedures occur in one session, the highest-valued procedure is paid in full and others are reduced. Medicare does not pay an assistant at surgery for this service; co-surgeons and team surgery are not permitted. Modifier 50 is inappropriate for this trunk repair.
CMS billing rules for 13100
- 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 RVU2.93 · 29%
- Practice expense (office) RVU6.83 · 67%
- Malpractice RVU0.36 · 4%
5.5K
Medicare services in 2024 · #1814 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.
13100 compared with similar codes
Office rates for Indiana, from the same CMS release.
$111.47
13102 reports additional repair length as an add-on after an eligible primary code; it does not represent the initial repair.
$327.50
13120 covers complex repair in a different anatomic grouping, such as scalp, axilla, or extremities. Choose by wound site, not by length alone.
$242.26
12031 is for intermediate trunk repair of a different length range. This code requires complex repair work beyond routine layered closure.
Compare 13100 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
Indiana →
Office / nonfacility
$315.18
Facility
$160.68
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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 13100 in Indiana.
PPRRVU2026_Oct_nonQPP.csv
1,433
- Code
- 13100
- Physician work
- 2.93
- Practice expense
- 6.83
- Malpractice
- 0.36
GPCI2026.csv
52
- Locality
- Indiana
- Physician work
- 1.000
- Practice expense
- 0.927
- Malpractice
- 0.486
| Component | RVU | Locality factor | Adjusted |
|---|---|---|---|
| Physician work | 2.93 | × 1.000 | 2.9300 |
| Practice expense | 6.83 | × 0.927 | 6.3314 |
| Malpractice | 0.36 | × 0.486 | 0.1750 |
| Total RVUs | 9.4364 | ||
| Conversion factor | × 33.4009 | ||
Office / nonfacility rate, Indiana$315.18
Explore RVUs, geographic factors and the full formula
Office / nonfacility
| Component | RVU | Local GPCI |
|---|---|---|
| Work | 2.93 | 1 |
| Practice expense | 6.83 | 0.927 |
| Malpractice | 0.36 | 0.486 |
(2.93 × 1 + 6.83 × 0.927 + 0.36 × 0.486) × $33.4009 = $315.18
Facility
| Component | RVU | Local GPCI |
|---|---|---|
| Work | 2.93 | 1 |
| Practice expense | 1.84 | 0.927 |
| Malpractice | 0.36 | 0.486 |
(2.93 × 1 + 1.84 × 0.927 + 0.36 × 0.486) × $33.4009 = $160.68
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.
13100 billing questions
How is this code distinguished from an intermediate repair?
Use this code when the trunk wound requires work beyond routine layered closure, not merely layered suturing. An intermediate repair code applies when layered closure is appropriate but the additional complexity criteria are not met.
What length qualifies for this code?
The repaired trunk wound must measure 1.1–2.5 cm. Document the final repair length and the anatomic site.
Can the repair be reported with a lesion excision?
A qualifying complex repair may be reported with an excision when the repair is separately reportable; routine closure is included in the excision. Document the complexity that supports separate reporting.
When is code 13102 reported?
Code 13102 is an add-on for additional repair length after an eligible primary complex repair code. It is not reported by itself.
Should modifier 50 be used for trunk wounds on both sides?
No. Medicare identifies bilateral adjustment as inappropriate for this code. Do not use modifier 50 to represent bilateral trunk repair.
Are postoperative visits separately paid during the global period?
Related postoperative visits during the 10-day global period are included in the procedure payment.
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.
1,43012057,,Intmd rpr face/mm >30.0 cm,A,,5.85,12.48,,4.51,,1.09,19.42,11.45,0,010,0.10,0.80,0.10,2,0,2,1,0,9,,33.4009,09,0,99,0.00,0.00,0.00
1,4311205F,,Epi etiol synd rvwd and docd,I,,0.00,0.00,,0.00,,0.00,0.00,0.00,9,XXX,0.00,0.00,0.00,9,9,9,9,9,9,,33.4009,09,0,99,0.00,0.00,0.00
1,4321220F,,Pt screened for depression,I,,0.00,0.00,,0.00,,0.00,0.00,0.00,9,XXX,0.00,0.00,0.00,9,9,9,9,9,9,,33.4009,09,0,99,0.00,0.00,0.00
1,43313100,,Cmplx rpr trunk 1.1-2.5 cm,A,,2.93,6.83,,1.84,,0.36,10.12,5.13,0,010,0.10,0.80,0.10,2,0,1,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
1,43413101,,Cmplx rpr trunk 2.6-7.5 cm,A,,3.41,7.88,,2.48,,0.40,11.69,6.29,0,010,0.10,0.80,0.10,2,0,1,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
1,43513102,,Cmplx rpr trunk addl 5cm/<,A,,1.21,2.19,,0.38,,0.20,3.60,1.79,0,ZZZ,0.00,0.00,0.00,0,0,1,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
1,43613120,,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
4906102,IL,12,EAST ST. LOUIS,1.000,0.920,2.014
5006102,IL,15,SUBURBAN CHICAGO,1.007,1.027,1.772
5106102,IL,99,REST OF ILLINOIS,1.000,0.913,1.563
5208102,IN,00,INDIANA,1.000,0.927,0.486
5305102,IA,00,IOWA,1.000,0.915,0.397
5405202,KS,00,KANSAS,1.000,0.904,0.504
5515102,KY,00,KENTUCKY,1.000,0.889,0.915