CPT 13101 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 • 22 - On Campus Outpatient Hospital |
| Common Modifiers | • None • 59 - Distinct Procedural Service • 79 - Unrelated procedure - postop period |
| Complexity Level | Moderate |
| Medicare Fee Schedule | View Medicare rates for 13101 |
National average reimbursement for CPT 13101 by major payers:
$447.84
$497.79
$520.71
$656.16
| 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 13101 | ||||||
United | 13101 | $375.83 | 1760452353 - JOSEPHINE NGUYEN | 811345719 | MD | Dermatology Physician (207N00000X) |
United | 13101 | $269.45 | 1558879767 - DEMI SOULET | 593549147 | FL | Medical Physician Assistant (363AM0700X) |
United | 13101 | $680.09 | 1043207293 - SHERRIE BULLARD | 650003177 | FL | Dermatology Physician (207N00000X) |
United | 13101 | $100.00 | 1033560420 - ABINGDON SURGICAL CENTER PC | 813054896 - (MD) ABINGDON SURGICAL CENTER PC | MD | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 13101 | $221.00 | 1639254980 - ALICIA BROWN | 593549147 | FL | Medical Physician Assistant (363AM0700X) |
United | 13101 | $399.35 | 1306417647 - JUSTINE IPAC | 880394939 | NV | Physician Assistant (363A00000X) |
United | 13101 | $1099.51 | 1598398018 - RUBY TRUJILLO | 473291857 | FL | Physician Assistant (363A00000X) |
United | 13101 | $220.00 | 1649494170 - SOUTHWEST ENDOSCOPY AND SURGERY CENTER | 203136303 | TX | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 13101 | $510.42 | 1447036173 - KIRSTEN DEKOSTER | 471404474 | CO | Physician Assistant (363A00000X) |
United | 13101 | $269.45 | 1255713111 - DEVONNE COLLINS | 593549147 | FL | Family Nurse Practitioner (363LF0000X) |
United | 13101 | $378.67 | 1811267909 - ANGEL WENGER | 223951517 | NV | Surgical Physician Assistant (363AS0400X) |
United | 13101 | $510.42 | 1982983946 - JEFFREY KAMENSKI | 471404474 | CO | Physician Assistant (363A00000X) |
United | 13101 | $658.00 | 1346244845 - LAKELAND SURGICAL & DIAGNOSTIC CENTER LLP | 593346125 - (FL) LAKELAND SURGICAL AND DIAGNOSTIC CENTER LLP | FL | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 13101 | $375.83 | 1760452353 - JOSEPHINE NGUYEN | 811345719 | VA | Dermatology Physician (207N00000X) |
United | 13101 | $257.10 | 1679779565 - MADELIENE GAINERS | 391351587 | MO | Dermatology Physician (207N00000X) |
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 13101 vs. Other Surgical Procedures on the Integumentary System Codes
The CPT 13101 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 13101 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 13101. These prices vary depending on payer type (Medicare, Medicaid, private insurance), geographic location, and provider contracts.
Understanding the 13101 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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