CPT 13100 Fee Schedule
Healthcare providers use this code to document and receive reimbursement for visits that address moderate-level medical decision-making, often including multiple diagnoses or prescription management.
| Key Fact | Detail |
|---|---|
| Service Type | • Surgery • Surgical Procedures on the Integumentary System |
| Common Place of Service | • 11 - Office • 81 - Independent Laboratory |
| Common Modifiers | • None • 59 - Distinct Procedural Service • QW - CLIA Waived Tests |
| Complexity Level | Moderate |
National average reimbursement for CPT 13100 by major payers:

$371.60

$417.00

$424.02

$553.95
| Payer | Code | Rate | NPI | Tax ID | State | Specialty |
|---|---|---|---|---|---|---|
Select a payer to view fee schedule data Choose a payer from the options above to see rates for CPT 13100 | ||||||
United | 13100 | $395.00 | 1841782539 - MILE HIGH SURGICENTER, LLC | 830543458 | CO | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 13100 | $312.00 | 1467629147 - PACIFIC CATARACT AND LASER INSTITUTE, INC., P.C. | 911394965 - PACIFIC CATARACT AND LASER INSTITUTE, INC., PC | WA | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 13100 | $110.00 | 1578917035 - HABANA AMBULATORY SURGERY CENTER LLC | 475162374 - (FL) HABANA AMBULATORY SURGERY CENTER LLC | FL | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 13100 | $935.00 | 1760518609 - NORTH POINT SURGERY CENTER, INC | 770557917 - (CA) NORTH POINT SURGERY CENTER | CA | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 13100 | $430.00 | 1639553779 - UNIVERSITY OF MINNESOTA HEALTH CLINICS AND SURGERY CENTER, INC., M HEALTH CLINICS AND SURGERY CENTER | 465444821 - (MN) UNIVERSITY OF MINNESOTA HEALTH CLINICS AND SURGERY CENTER INC | MN | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 13100 | $935.00 | 1225275688 - MAIN STREET SPECIALTY SURGERY CENTER, LLC | 954813223 - (CA) MAIN STREET SPECIALTY SURGERY CENTER | CA | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 13100 | $531.00 | 1821453796 - MASON RIDGE AMBULATORY SURGERY CENTER LP, GATEWAY ENDOSCOPY CENTER | 205953364 | MO | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 13100 | $1306.00 | 1144291261 - OCEAN SURGICAL PAVILION, PC, OCEAN SURGICAL PAVILION | 223182653 | NJ | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 13100 | $349.00 | 1386858595 - ALDERWOOD SURGERY CENTER LLC | 204979154 - (WA) ALDERWOOD SURGICAL CENTER | WA | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 13100 | $306.00 | 1083659866 - ORTHOPAEDIC SURGERY CENTER OF SAN ANTONIO LP, FOUNDATION SURGERY AFFILIATE OF SAN ANTONIO LP | 742976746 - (TX) ORTHOPAEDIC SURGERY CENTER OF SAN ANTONIO LP | TX | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 13100 | $1469.00 | 1649482449 - METHODIST HEALTHCARE SYSTEM OF SAN ANTONIO, LTD., L.L.P., METHODIST HOSPITAL | 742730328 | TX | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 13100 | $182.00 | 1174850176 - SOUTHWEST OHIO PAIN MANAGEMENT LLC | 300571536 - (OH) SOUTHWEST OHIO PAIN MANAGEMENT | OH | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 13100 | $248.00 | 1720125156 - SCOTTSDALE EYE INSTITUTE, PLC, SCOTTSDALE EYE INSTITUTE, PLC | 61692976 - (AZ) SCOTTSDALE EYE INSTITUTE PLC | AZ | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 13100 | $673.00 | 1205845740 - THE UROLOGY CENTER LLC | 311579733 - (OH) THE UROLOGY CENTER LLC | OH | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 13100 | $1473.00 | 1831274208 - MT KISCO SURGERY CENTER LLC, THE AMBULATORY SURGERY CENTER OF WESTCHESTER | 134158313 - (NY) MOUNT KISCO SURGERY CENTER, L.L.C. | NY | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 99202 | $100.00 | 1234567890 | 1234567890 | CA | Cardiologist |
United | 99202 | $100.00 | 1234567890 | 1234567890 | CA | Cardiologist |
United | 99202 | $100.00 | 1234567890 | 1234567890 | CA | Cardiologist |
United | 99202 | $100.00 | 1234567890 | 1234567890 | CA | Cardiologist |
United | 99202 | $100.00 | 1234567890 | 1234567890 | CA | Cardiologist |
United | 99202 | $100.00 | 1234567890 | 1234567890 | CA | Cardiologist |
United | 99202 | $100.00 | 1234567890 | 1234567890 | CA | Cardiologist |
United | 99202 | $100.00 | 1234567890 | 1234567890 | CA | Cardiologist |
United | 99202 | $100.00 | 1234567890 | 1234567890 | CA | Cardiologist |
United | 99202 | $100.00 | 1234567890 | 1234567890 | CA | Cardiologist |
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CPT 13100 vs. Other Surgical Procedures on the Integumentary System Codes
The CPT 13100 code is part of the Surgery services used for Surgical Procedures on the Integumentary System. It represents a moderate-complexity encounter and is one of several codes that vary based on time spent, level of medical decision-making, and documentation requirements.
The CPT 13100 code involves more provider time and moderate medical decision-making, unlike lower-level codes that require less time and simpler assessments. It typically includes multiple diagnoses, medication management, or test interpretation, leading to higher reimbursement and more detailed documentation requirements.
What is a fee schedule?
A fee schedule is a list of fixed prices that healthcare providers charge for specific services, including CPT 13100. These prices vary depending on payer type (Medicare, Medicaid, private insurance), geographic location, and provider contracts.
Understanding the 13100 fee schedule helps patients estimate costs and providers optimize billing for accurate reimbursements.
Factors that affect fee schedules
Medicare & Medicaid Rates
Government-set reimbursement amounts
Private Insurance Rates
Negotiated rates between providers and insurance companies
Geographic Location
Costs may be higher in urban areas.
Provider Type
Hospital providers may have different rates than private practice.
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