$311.69
Both describe complex trunk repair; choose 13100 for 1.1–2.5 cm and 13101 for 2.6–7.5 cm.
On this page
CMS RVU26D · Effective 2026-10-01
13101 Complex repair Medicare reimbursement rates in Tennessee
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. Compare 13101 office and facility rates across CMS payment localities in Tennessee.
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 13101 in Tennessee?
Tennessee 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
$360.32
1 of 1 localities have a supported rate.
Payment area: Tennessee
One mapped payment locality.
Facility setting
$196.37
1 of 1 localities have a supported rate.
Payment area: Tennessee
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 13101: Complex trunk wound repair
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.
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.
CMS billing rules for 13101
- 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 RVU3.41 · 29%
- Practice expense (office) RVU7.88 · 67%
- Malpractice RVU0.40 · 3%
96.2K
Medicare services in 2024 · #573 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.
13101 compared with similar codes
Office rates for Tennessee, from the same CMS release.
$110.49
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.
$386.21
13121 is for complex repair in a different anatomical group, not the trunk, even when the wound length is 2.6–7.5 cm.
$276.89
12032 describes intermediate repair of a similar-length trunk wound. Use 13101 only when the documented repair meets complex-repair criteria.
Compare 13101 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
Tennessee →
Office / nonfacility
$360.32
Facility
$196.37
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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 13101 in Tennessee.
PPRRVU2026_Oct_nonQPP.csv
1,434
- Code
- 13101
- Physician work
- 3.41
- Practice expense
- 7.88
- Malpractice
- 0.40
GPCI2026.csv
95
- Locality
- Tennessee
- Physician work
- 1.000
- Practice expense
- 0.909
- Malpractice
- 0.537
| Component | RVU | Locality factor | Adjusted |
|---|---|---|---|
| Physician work | 3.41 | × 1.000 | 3.4100 |
| Practice expense | 7.88 | × 0.909 | 7.1629 |
| Malpractice | 0.40 | × 0.537 | 0.2148 |
| Total RVUs | 10.7877 | ||
| Conversion factor | × 33.4009 | ||
Office / nonfacility rate, Tennessee$360.32
Explore RVUs, geographic factors and the full formula
Office / nonfacility
| Component | RVU | Local GPCI |
|---|---|---|
| Work | 3.41 | 1 |
| Practice expense | 7.88 | 0.909 |
| Malpractice | 0.4 | 0.537 |
(3.41 × 1 + 7.88 × 0.909 + 0.4 × 0.537) × $33.4009 = $360.32
Facility
| Component | RVU | Local GPCI |
|---|---|---|
| Work | 3.41 | 1 |
| Practice expense | 2.48 | 0.909 |
| Malpractice | 0.4 | 0.537 |
(3.41 × 1 + 2.48 × 0.909 + 0.4 × 0.537) × $33.4009 = $196.37
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.
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 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.
1,4311205F,,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
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
9214412,RI,01,RHODE ISLAND,1.019,1.033,0.892
9311202,SC,01,SOUTH CAROLINA,1.000,0.924,0.850
9403402,SD,02,SOUTH DAKOTA**,1.000,1.000,0.336
9510312,TN,35,TENNESSEE,1.000,0.909,0.537
9604412,TX,31,AUSTIN,1.002,1.058,0.886
9704412,TX,20,BEAUMONT,1.000,0.910,0.929
9804412,TX,09,BRAZORIA,1.008,0.991,0.780