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CPT 13100 Fee Schedule

Last Verified: February 2026

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.

Complx Rpr Trnk 1.1-2.5 Cm
Key FactDetail
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 LevelModerate
Medicare Fee ScheduleView Medicare rates for 13100

National average reimbursement for CPT 13100 by major payers:

bcbs

$371.60

uhc

$417.00

aetna

$424.02

cigna

$553.95

Preview provider-level rates for...
For billing codeCPT 13100
PayerCodeRateNPITax IDStateSpecialty

Select a payer to view fee schedule data

Choose a payer from the options above to see rates for CPT 13100

United
13100$206.001528462819 - THE ENDOSCOPY CENTER, INC.471907162 - (CA) THE ENDOSCOPY CENTER INCCAAmbulatory Surgical Clinic/Center (261QA1903X)
United
13100$258.001023001377 - SOUTHERN ILLINOIS ORTHOPEDIC CENTER,LLC371377370 - (IL) SOUTHERN ILLINOIS ORTHOPEDIC CENTERLLCILAmbulatory Surgical Clinic/Center (261QA1903X)
United
13100$118.001659340404 - LITTLE ROCK SURGERY CENTER, LLC203687986 - (AR) LITTLE ROCK SURGERY CENTERARAmbulatory Surgical Clinic/Center (261QA1903X)
United
13100$241.001306556907 - THE VANCOUVER CLINIC INC PS, SALMON CREEK 2 AMBULATORY SURGERY CENTER910851599 - THE VANCOUVER CLINIC, INC., PSWAAmbulatory Surgical Clinic/Center (261QA1903X)
United
13100$176.001366449910 - OREGON ENDOSCOPY CENTER, LLC931311609 - (OR) OREGON ENDOSCOPY CENTER LLCORAmbulatory Surgical Clinic/Center (261QA1903X)
United
13100$1306.001144291261 - OCEAN SURGICAL PAVILION, PC, OCEAN SURGICAL PAVILION223182653NJAmbulatory Surgical Clinic/Center (261QA1903X)
United
13100$100.001669437109 - MARIETTA OUTPATIENT SURGERY, LTD752160466 - (GA) MARIETTA OUTPATIENT SURGERY LTDGAAmbulatory Surgical Clinic/Center (261QA1903X)
United
13100$531.001487716650 - CARONDELET ST. MARY'S NORTHWEST, LLC, CARONDELET FOOTHILLS SURGERY CENTER201086556 - (AZ) CAMP LOWELL SURGERY CENTERAZAmbulatory Surgical Clinic/Center (261QA1903X)
United
13100$633.001831180272 - ADVANCED ENDOSCOPY CENTER LLC861083384 - (MO) ADVANCED ENDOSCOPY CENTER, LLCMOAmbulatory Surgical Clinic/Center (261QA1903X)
United
13100$500.001265931653 - HEALTHCARE ENTERPRISES LLC, THE SURGERY CENTER471428524 - (MA) HEALTHCARE ENTERPRISES LLCMAAmbulatory Surgical Clinic/Center (261QA1903X)
United
13100$692.001750386918 - MIDTOWN SURGERY CENTER LP621826300TNAmbulatory Surgical Clinic/Center (261QA1903X)
United
13100$879.001598039125 - ROOSEVELT SURGERY CENTER, LLC271778024 - (NY) ROOSEVELT SURGERY CENTER, LLCNYAmbulatory Surgical Clinic/Center (261QA1903X)
United
13100$1446.001396742029 - GARLAND SURGICARE PARTNERS, LTD., BAYLOR SURGICARE AT GARLAND752764855 - (TX) GARLAND SURGICARE PARTNERS LTDTXAmbulatory Surgical Clinic/Center (261QA1903X)
United
13100$541.001679523351 - SURGERY CENTER OF PORT CHARLOTTE LTD201327093 - (FL) SURGERY CENTER OF PORT CHARLOTTE LTDFLAmbulatory Surgical Clinic/Center (261QA1903X)
United
13100$688.001902302961 - HILL COUNTRY SURGERY CENTER, LLC, SURGERY CENTER OF BOERNE352599588 - (TX) HILL COUNTRY SURGERY CENTER LLCTXAmbulatory Surgical Clinic/Center (261QA1903X)
United
99202$100.0012345678901234567890CACardiologist
United
99202$100.0012345678901234567890CACardiologist
United
99202$100.0012345678901234567890CACardiologist
United
99202$100.0012345678901234567890CACardiologist
United
99202$100.0012345678901234567890CACardiologist
United
99202$100.0012345678901234567890CACardiologist
United
99202$100.0012345678901234567890CACardiologist
United
99202$100.0012345678901234567890CACardiologist
United
99202$100.0012345678901234567890CACardiologist
United
99202$100.0012345678901234567890CACardiologist

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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.

CodeComplexityDescription
12020-CPTModerateClosure Superfic Wound Dehiscence
13100-CPTModerateComplx Rpr Trnk 1.1-2.5 Cm
13101-CPTModerateRep Complex Trunk 2.5-7.5cm
13102-CPTLowRepair, Complex, Trunk; Each Additional 5 Cm Or Less

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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