How much does Medicare pay for CPT 13101?

Medicare allowed an average of $328.17 per service and paid $254.92 of that, the balance being the patient's coinsurance and deductible (2024 data). Providers submitted an average of $897.42, which is what they billed rather than what they received — Medicare pays its fee schedule regardless of the charge.

What is CPT code 13101?

Complicated repair of wound of trunk, 2.6-7.5 cm. It was billed 74,032 times to 67,699 Medicare beneficiaries by 2,179 providers in 2024.

Does 13101 pay differently in an office than a hospital?

Yes. The allowed amount averaged $339.60 in an office setting and $209.00 in a facility. The office rate is generally higher because the practice supplies the room, staff and equipment out of that single payment; in a hospital those are billed separately by the facility.

Which specialty bills 13101 most?

Dermatology, with 50,061 services from 1,398 clinicians. Next are Physician Assistant, Plastic and Reconstructive Surgery, Micrographic Dermatologic Surgery.

CPT 13101

Complicated repair of wound of trunk, 2.6-7.5 cm

$328.17Medicare-allowed amount per service, averaged across 74,032 services

Providers submitted

$897.42

Asking price, not received

Medicare allowed

$328.17

The fee schedule figure

Medicare paid

$254.92

Balance is patient coinsurance

Providers submitted an average of $897.42 for this code and Medicare allowed $328.17 — 2.7× less. That gap is normal and means nothing on its own: Medicare pays its fee schedule regardless of what is billed, so the submitted figure describes a hospital chargemaster, not a price anyone paid. Of the allowed amount Medicare paid $254.92 (78%); the rest is the patient’s coinsurance and deductible.

Office pays differently to hospital

Office / non-facility: $339.60
Hospital / facility: $209.00

The office rate is higher because the practice supplies the room, staff and equipment out of that payment. In a hospital the facility bills those separately, so the clinician's share is smaller — the total cost to Medicare is usually higher, not lower. 67,552 services were billed in an office setting and 6,480 in a facility.

Services: 74,032
Beneficiaries: 67,699
Providers billing it: 2,179
Total allowed: $24,295,081

What Medicare pays for CPT 13101

Across 74,032 services billed by 2,179 providers to 67,699 beneficiaries, Medicare allowed an average of $328.17 per service. The allowed amount is the figure that matters: it is what Medicare and the patient together owe, set by the fee schedule and adjusted for local practice costs. What a provider chose to submit has no bearing on it.

Who bills 13101

Specialty	Services	Beneficiaries	Avg allowed	Providers
Dermatology	50,061	45,602	$337.97	1,398
Physician Assistant	8,000	7,307	$323.19	281
Plastic and Reconstructive Surgery	4,618	4,295	$318.44	153
Micrographic Dermatologic Surgery	4,485	4,142	$301.27	123
Ambulatory Surgical Center	2,375	2,169	$263.83	58
Nurse Practitioner	1,922	1,767	$316.01	70
General Surgery	661	635	$228.70	29
Otolaryngology	420	380	$354.83	11
Surgical Oncology	356	348	$186.30	17
Family Practice	352	330	$370.54	13
Internal Medicine	206	185	$334.75	8
Undefined Physician type	132	122	$224.36	4
Pathology	124	114	$290.64	2
General Practice	84	81	$253.00	4
Ophthalmology	68	66	$359.82	2

13101 reimbursement by state

Two different numbers. Allowed is what Medicare actually allowed in that state, which includes the local practice-cost adjustment. Standardized strips that geographic adjustment out of the payment, so it is the column to use when comparing states — a difference there reflects how the code was billed, not what it costs to run a practice locally.

State	Services	Allowed	Standardized pmt	Providers
Florida	16,339	$342.01	$261.99	392
California	9,963	$363.00	$251.92	316
New York	4,439	$344.23	$236.23	128
Texas	3,919	$314.24	$243.41	128
Arizona	2,995	$322.78	$249.93	100
New Jersey	2,782	$345.62	$243.65	87
Illinois	2,541	$322.84	$247.95	69
Georgia	2,507	$287.82	$225.13	76
Pennsylvania	2,266	$324.08	$247.87	72
North Carolina	1,833	$332.54	$267.67	41
Indiana	1,783	$275.52	$226.67	37
South Carolina	1,779	$306.86	$251.06	49
Virginia	1,510	$335.58	$255.63	48
Massachusetts	1,456	$332.10	$242.85	38
Tennessee	1,348	$296.08	$248.67	48
Ohio	1,328	$303.91	$246.88	46
Missouri	1,318	$288.99	$239.12	36
Washington	1,305	$338.03	$246.27	43
Alabama	1,202	$273.69	$235.96	34
Colorado	1,089	$362.53	$268.47	36
Maryland	925	$331.14	$231.44	33
Michigan	897	$320.24	$248.10	37
Nevada	818	$322.29	$249.27	33
Kentucky	811	$323.18	$275.67	19
Arkansas	727	$224.46	$196.86	13
Delaware	712	$299.86	$227.31	13
Wisconsin	471	$310.38	$249.07	21
Connecticut	451	$317.94	$229.56	15
Oregon	438	$335.24	$253.51	17
Kansas	433	$265.56	$220.11	19
Minnesota	386	$370.79	$269.54	13
Louisiana	351	$248.58	$206.51	13
Oklahoma	305	$250.21	$208.19	10
New Hampshire	294	$323.46	$242.15	9
Wyoming	290	$224.86	$182.86	4
West Virginia	290	$308.93	$236.17	12
South Dakota	225	$249.34	$202.54	8
Iowa	214	$336.87	$279.34	11
Mississippi	214	$270.11	$231.67	10
Utah	151	$324.66	$254.16	9
District of Columbia	141	$342.69	$244.38	3
New Mexico	138	$338.42	$259.19	4
Rhode Island	122	$309.99	$237.06	6
Hawaii	114	$358.10	$271.10	4
North Dakota	113	$285.14	$233.81	5
Nebraska	108	$310.42	$242.61	5
Montana	82	$381.68	$282.88	4
Maine	46	$308.12	$238.51	2
Idaho	39	$304.84	$239.75	2
Vermont	24	$218.53	$166.47	1

Related codes

13132Complicated repair of wound of forehead$269.67
13121Complicated repair of wound of scalp$297.90
13152Complicated repair of wound of eyelids$268.00
13131Complicated repair of wound of forehead$229.32
13151Complicated repair of wound of eyelids$235.39
13122Complicated repair of wound of scalp$115.92
13120Complicated repair of wound of scalp$264.15
13102Complicated repair of wound of trunk$96.99
13133Complicated repair of wound of forehead$157.28
13160Extensive or complicated repair of surface wound reopening$650.97
13100Complicated repair of wound of trunk$317.65

Billing this code is not the same as earning it

An allowed amount is revenue to a practice, not income to a clinician. It funds staff, premises, equipment and supplies before anyone is paid. What clinicians actually earn is published separately by the Department of Labor, and what industry pays them is published separately again by CMS — this site carries both.

What doctors are paid →·Look up a clinician →·All procedure codes →

Where this comes from. CMS Medicare Physician & Other Practitioners, by Provider and Service, 2024. It covers fee-for-service Original Medicare Part B only — not Medicare Advantage, not Medicaid, and not commercial insurance, which typically pays more for the same code.

How it is averaged. CMS publishes one average per provider per code. Every figure here is re-weighted by the number of services, so a clinician who billed the code 4,000 times counts 4,000 times more than one who billed it twice. CMS also suppresses any provider-code pair with fewer than 11 beneficiaries, so low-volume practice is missing from these totals by design.