CPT Code 13101Complete Billing & Coding Guide (2026)Cmplx rpr trunk 2.6-7.5 cm
About CPT 13101
CPT 13101 is a Current Procedural Terminology code in the Anesthesia category maintained by the American Medical Association. The CMS short descriptor reads "Cmplx rpr trunk 2.6-7.5 cm". For the full AMA long descriptor and clinical guidance, refer to the current CPT code manual.
Minor surgical codes carry a 10-day global period. Most post-op E/M visits in those 10 days are bundled into the procedure payment unless the visit is for an unrelated reason (modifier 24). Documentation tying the encounter to the procedure determines the bundling decision.
CPT 13101 has a 10-day global period. Office visits for post-op care during those 10 days are not separately billable unless unrelated to the procedure.
Code Properties
RVU Breakdown
Every CPT code’s Medicare payment is calculated from three Relative Value Unit components: physician work, practice expense, and malpractice. Together they multiply by the conversion factor to produce the payment amount.
Payment = Total RVU × Conversion Factor ($33.4009) × Geographic Adjustment (GPCI). National averages shown. Actual payment varies by locality.
Medicare Payment by State
Medicare adjusts payment by locality based on GPCI (Geographic Practice Cost Index). Higher cost-of-living areas like California and New York pay more. Rural states pay less. Top 12 states shown.
Showing top 12 of 53 states. Full locality data available in CMS PFS Locality file.
NCCI Bundling Edits
10 pairsThese codes trigger National Correct Coding Initiative edits when billed with 13101. An indicator of 0 means the pair cannot be unbundled. Indicator 1 means modifier 59 or X-modifiers may allow separate billing with supporting documentation.
Billing 13101 alongside a bundled code without the correct modifier generates CARC 97 denials. Payers often flag these as audit risks. Document medical necessity for the separate service and apply modifier 59 or the appropriate X-modifier (XE, XS, XP, XU) only when clinically justified.
Misuse of Column Two code with Column One code
Misuse of Column Two code with Column One code
Misuse of Column Two code with Column One code
Misuse of Column Two code with Column One code
Misuse of Column Two code with Column One code
Misuse of Column Two code with Column One code
Misuse of Column Two code with Column One code
Misuse of Column Two code with Column One code
Misuse of Column Two code with Column One code
Misuse of Column Two code with Column One code
Bundling denials on 13101 are recoverable when the edit indicator is 1 and the chart documents a distinct, separately identifiable service. Our coders verify the indicator and pick the precise X-modifier (XE, XS, XP, XU) instead of defaulting to modifier 59.
Applicable Modifiers
Modifiers commonly paired with 13101 based on its category. Apply only when the clinical circumstance warrants. Incorrect modifier use is a top audit target.
Modifier audits catch what scrubbers miss. Our AAPC-certified team reviews every modifier choice on 13101 against the chart documentation before submission, surfacing missed and misapplied modifiers across the practice.
Find the revenue leakage in your 13101 claims.
Wrong modifier, missing documentation, bundling without justification, stale ICD-10 linkage: these are the silent revenue killers on Anesthesia claims. Our AAPC-certified team audits your last 90 days of 13101 claims, surfaces the recoverable dollars, and appeals them. Free, no obligation.
Losing revenue on CPT 13101? We’ll find it.
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Related CPT Codes
Codes in the same family as 13101
Specialty billing guides
CPT 13101 is among the top codes profiled in these specialty billing guides.
Everything about CPT 13101
What does CPT code 13101 cover?
CPT 13101 is a Current Procedural Terminology code in the Anesthesia category maintained by the American Medical Association. The CMS short descriptor reads "Cmplx rpr trunk 2.6-7.5 cm". For the full AMA long descriptor and clinical guidance, refer to the current CPT code manual.
What is the Medicare payment for CPT 13101?
The national average Medicare payment for CPT 13101 is approximately $390.46 in a non-facility setting and $210.09 in a facility setting. Actual payment varies by locality based on GPCI adjustments. Total RVU is 11.69 with a conversion factor of $33.4009.
What is the global period for CPT 13101?
CPT 13101 has a 10-day global period (indicator 010). Routine post-op care for the next 10 days is bundled into the procedure payment. Bill modifier 24 for unrelated E/M, modifier 79 for unrelated procedures, or modifier 78 for related returns to the OR during this window.
What codes bundle with CPT 13101?
CPT 13101 has NCCI Procedure-to-Procedure edits with 10+ codes including 0213T, 0216T, 0543T. Modifier indicator 0 means the edit cannot be bypassed. Indicator 1 means modifier 59 or X-modifiers may allow separate billing with documentation.
CPT codes and descriptions are copyright of the American Medical Association. RVU values reflect current CMS publications. Actual payment varies by locality. Commercial payer rates vary by contract.
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We audit your last 90 days of claims and surface the revenue leakage: wrong modifiers, missed bundling appeals, ICD-10 specificity gaps. AAPC-certified coders. 2.49% of collections. No setup fees.