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CPT 13100 Fee Schedule

Last Verified: December 2025

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

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$395.001841782539 - MILE HIGH SURGICENTER, LLC830543458COAmbulatory Surgical Clinic/Center (261QA1903X)
United
13100$312.001467629147 - PACIFIC CATARACT AND LASER INSTITUTE, INC., P.C.911394965 - PACIFIC CATARACT AND LASER INSTITUTE, INC., PCWAAmbulatory Surgical Clinic/Center (261QA1903X)
United
13100$110.001578917035 - HABANA AMBULATORY SURGERY CENTER LLC475162374 - (FL) HABANA AMBULATORY SURGERY CENTER LLCFLAmbulatory Surgical Clinic/Center (261QA1903X)
United
13100$935.001760518609 - NORTH POINT SURGERY CENTER, INC770557917 - (CA) NORTH POINT SURGERY CENTERCAAmbulatory Surgical Clinic/Center (261QA1903X)
United
13100$430.001639553779 - UNIVERSITY OF MINNESOTA HEALTH CLINICS AND SURGERY CENTER, INC., M HEALTH CLINICS AND SURGERY CENTER465444821 - (MN) UNIVERSITY OF MINNESOTA HEALTH CLINICS AND SURGERY CENTER INCMNAmbulatory Surgical Clinic/Center (261QA1903X)
United
13100$935.001225275688 - MAIN STREET SPECIALTY SURGERY CENTER, LLC954813223 - (CA) MAIN STREET SPECIALTY SURGERY CENTERCAAmbulatory Surgical Clinic/Center (261QA1903X)
United
13100$531.001821453796 - MASON RIDGE AMBULATORY SURGERY CENTER LP, GATEWAY ENDOSCOPY CENTER205953364MOAmbulatory Surgical Clinic/Center (261QA1903X)
United
13100$1306.001144291261 - OCEAN SURGICAL PAVILION, PC, OCEAN SURGICAL PAVILION223182653NJAmbulatory Surgical Clinic/Center (261QA1903X)
United
13100$349.001386858595 - ALDERWOOD SURGERY CENTER LLC204979154 - (WA) ALDERWOOD SURGICAL CENTERWAAmbulatory Surgical Clinic/Center (261QA1903X)
United
13100$306.001083659866 - ORTHOPAEDIC SURGERY CENTER OF SAN ANTONIO LP, FOUNDATION SURGERY AFFILIATE OF SAN ANTONIO LP742976746 - (TX) ORTHOPAEDIC SURGERY CENTER OF SAN ANTONIO LPTXAmbulatory Surgical Clinic/Center (261QA1903X)
United
13100$1469.001649482449 - METHODIST HEALTHCARE SYSTEM OF SAN ANTONIO, LTD., L.L.P., METHODIST HOSPITAL742730328TXAmbulatory Surgical Clinic/Center (261QA1903X)
United
13100$182.001174850176 - SOUTHWEST OHIO PAIN MANAGEMENT LLC300571536 - (OH) SOUTHWEST OHIO PAIN MANAGEMENTOHAmbulatory Surgical Clinic/Center (261QA1903X)
United
13100$248.001720125156 - SCOTTSDALE EYE INSTITUTE, PLC, SCOTTSDALE EYE INSTITUTE, PLC61692976 - (AZ) SCOTTSDALE EYE INSTITUTE PLCAZAmbulatory Surgical Clinic/Center (261QA1903X)
United
13100$673.001205845740 - THE UROLOGY CENTER LLC311579733 - (OH) THE UROLOGY CENTER LLCOHAmbulatory Surgical Clinic/Center (261QA1903X)
United
13100$1473.001831274208 - MT KISCO SURGERY CENTER LLC, THE AMBULATORY SURGERY CENTER OF WESTCHESTER134158313 - (NY) MOUNT KISCO SURGERY CENTER, L.L.C.NYAmbulatory 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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