{
    "code": "13101",
    "coding_system": "CPT",
    "canonical_url": "https://localishealth.com/cpt/13101/2019/A",
    "release_specific_url": "https://localishealth.com/cpt/13101/2019/B",
    "description": "The most involved tier of wound closure on the torso, going beyond layered stitching to include work such as extensive undermining of the surrounding skin, trimming ragged or scarred wound edges, or placing stress-relieving sutures so the closure holds. This code covers a mid-length wound on the trunk; a shorter wound has its own code, and extra length beyond this band is reported with an additional code. Complexity here refers to the reconstructive effort, not simply the size of the defect.",
    "answer": {
        "question": "How much did Medicare pay for CPT 13101 in Q2 2019?",
        "text": "Medicare paid $410.49 for CPT 13101 in the office (non-facility) setting and $262.00 in a facility under the Q2 2019 Physician Fee Schedule, effective April 2019. These are the national allowed amounts before the ~2% sequestration cut and before locality (GPCI) adjustment. This price has been unchanged since Q1 2019, when it increased 1.2%."
    },
    "release": {
        "schedule": "pfs",
        "year": 2019,
        "quarter": "B",
        "label": "Q2 2019",
        "effective": "April 1 – June 30, 2019",
        "revision": 1
    },
    "status": {
        "code": "A",
        "non_facility_payable": true,
        "facility_payable": true
    },
    "national_rates_usd": {
        "office_non_facility": 410.49,
        "facility": 262,
        "sequestration_applied": false,
        "gpci": 1
    },
    "rvus": {
        "work": 3.5,
        "practice_expense_non_facility": 7.37,
        "practice_expense_facility": 3.25,
        "malpractice": 0.52
    },
    "formula": "(work_rvu × work_gpci + pe_rvu × pe_gpci + mp_rvu × mp_gpci) × conversion_factor",
    "conversion_factor": 36.0391,
    "source": {
        "label": "Physician relative value file (Q2 2019)",
        "cms_url": "https://www.cms.gov/medicare/medicare-fee-for-service-payment/physicianfeesched/downloads/rvu19b.zip",
        "local_source_url": "https://localishealth.com/sources/physician-fee-schedule/2019/B",
        "file": "PPRRVU19_APR.csv",
        "row": 5642,
        "sha256": "b427bbfdcb61b355ba034840681873d1bd6cdcf51752bdae1bab7c5449efc971"
    },
    "modified_at": "2026-08-04T03:08:53+00:00"
}