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CPT 13101 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.

Rep Complex Trunk 2.5-7.5cm
Key FactDetail
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 LevelModerate

National average reimbursement for CPT 13101 by major payers:

bcbs

$447.84

uhc

$497.79

aetna

$520.71

cigna

$656.16

Preview provider-level rates for...
For billing codeCPT 13101
PayerCodeRateNPITax IDStateSpecialty

Select a payer to view fee schedule data

Choose a payer from the options above to see rates for CPT 13101

United
13101$396.001770731853 - SHAWNEE MISSION PRAIRIE STAR SURGERY CENTER LLC, ADVENTHEALTH SURGERY CENTER LENEXA364634843 - (KS) SHAWNEE MISSION PRAIRIE STAR SURGERY CENTER LLCKSAmbulatory Surgical Clinic/Center (261QA1903X)
United
13101$199.001841256302 - NEW ENGLAND PAIN CARE760718172MAAmbulatory Surgical Clinic/Center (261QA1903X)
United
13101$100.001740944487 - ADVANCED AMBULATORY SURGERY CENTER LLC822160115 - (KS) ADVANCED AMBULATORY SURGERY CENTER LLCKSAmbulatory Surgical Clinic/Center (261QA1903X)
United
13101$935.001538316278 - PHYSICIANS' SURGERY CENTER OF DOWNEY, LLC205170962 - (CA) PHYSICIANS SURGERY CENTER OFCAAmbulatory Surgical Clinic/Center (261QA1903X)
United
13101$688.001013964063 - BRISTOL SURGERY CENTER, LLC834345983TNAmbulatory Surgical Clinic/Center (261QA1903X)
United
13101$220.001649494170 - SOUTHWEST ENDOSCOPY AND SURGERY CENTER203136303TXAmbulatory Surgical Clinic/Center (261QA1903X)
United
13101$658.001346244845 - LAKELAND SURGICAL & DIAGNOSTIC CENTER LLP593346125 - (FL) LAKELAND SURGICAL AND DIAGNOSTIC CENTER LLPFLAmbulatory Surgical Clinic/Center (261QA1903X)
United
13101$158.001891754271 - WESTERN WASHINGTON ENDOSCOPY CENTERS LLC, DIGESTIVE HEALTH NETWORK ENDOSCOPY CENTER200289310 - (WA) WESTERN WASHINGTON ENDOSCOPY CENTERS LLCWAAmbulatory Surgical Clinic/Center (261QA1903X)
United
13101$935.001962556076 - AK SURGERY CENTER, LLC203332833 - (CA) AK SURGERY CENTER LLCCAAmbulatory Surgical Clinic/Center (261QA1903X)
United
13101$176.001366449910 - OREGON ENDOSCOPY CENTER, LLC931311609 - (OR) OREGON ENDOSCOPY CENTER LLCORAmbulatory Surgical Clinic/Center (261QA1903X)
United
13101$85.001861660151 - HOWERTON SURGICAL CENTER, LLC450581270 - (TX) HOWERTON SURGICAL CENTER LLCTXAmbulatory Surgical Clinic/Center (261QA1903X)
United
13101$50.001578567954 - E. RONALD SALVITTI, M.D., INC., SOUTHWESTERN PA EYE SURGERY CENTER251787703 - (PA) E. RONALD SALVITTI, M.D., INC.PAAmbulatory Surgical Clinic/Center (261QA1903X)
United
13101$100.001033560420 - ABINGDON SURGICAL CENTER PC813054896 - (MD) ABINGDON SURGICAL CENTER PCMDAmbulatory Surgical Clinic/Center (261QA1903X)
United
13101$79.001881125870 - RENAL ASSOCIATES, P.A.742083988 - (TX) RENAL ASSOCIATES, PATXAmbulatory Surgical Clinic/Center (261QA1903X)
United
13101$633.001558487009 - MIDWEST DIGESTIVE HEALTH CENTER LLC431918703 - (MO) MIDWEST DIGESTIVE HEALTH CENTER LLCMOAmbulatory 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 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.

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 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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