Find policies, billing codes, payers, states, and providers
CPT 13100: Complex Repair of Wound, Trunk (1.1–2.5 cm)
CPT code 13100 denotes a complex repair of a wound to the trunk for defects measuring 1.1 to 2.5 cm. This code captures procedures involving more advanced closure techniques than simple or intermediate repairs and is commonly billed for wounds requiring layered closure, significant undermining, or scar revision. The code is relevant nationally for surgical specialties and primary care clinicians who perform procedural wound management and has implications for procedure classification, billing accuracy, and claims adjudication.
Key payers discussed in this analysis include Aetna, Blue Cross Blue Shield, Cigna Health, UnitedHealthcare, and Medicare. Readers will find a concise review of the clinical context for 13100, common service settings, and the relationship of this code to adjacent closure codes in the repair series. The report summarizes typical billing considerations, common ICD-10 diagnoses that pair with this service, and how 13100 fits into the spectrum of wound repair codes used across surgical and primary care practices.
This publication provides practical reference material on code definition and clinical scope, highlights payer coverage considerations at a national level, and clarifies where 13100 is positioned relative to intermediate and other complex repair codes. Data not available in the input will be noted where applicable.
Customize your policy alerts
Sign up for cpt 13100 policy alerts
Get alerted when payer policies referencing 13100 are released or updated.
Monitor payer policy activity
Billing Code Overview
CPT code 13100 describes a complex repair of a wound to the trunk for wounds measuring 1.1 to 2.5 cm. This procedure is a surgical closure that involves more extensive techniques than simple or intermediate repairs, such as layered closure, extensive undermining, or scar revision methods.
Service Type: Complex wound repair (suturing/closure with advanced techniques)
Typical Site of Service: Ambulatory surgical center, hospital outpatient department, or physician office procedure suite where minor to intermediate surgical procedures are performed
National Reimbursement Benchmarks
Across national payers the Medicare mean sits at $350, while BUCA’s average commercial rate is notably higher at $582.30, a gap of $232.30 that reflects a sizable premium in BUCA’s commercial positioning relative to the government benchmark. Blue Cross Blue Shield’s mean of $741.70 and UnitedHealth Group’s mean of $477.90 further illustrate the spread in commercial pricing above Medicare, with Cigna ($442.40) and Aetna ($189.10) filling additional mid- to lower-tier positions.
Dispersion measured by the interquartile range (P75 minus P25) is narrowest for Aetna at $220.00 and tight for UnitedHealth Group at $321.70, indicating more clustered commercial contracting around their medians. The widest dispersion appears with Blue Cross Blue Shield at $418.60 and BUCA at $351.20, signaling greater variability in contract rates for those payers. Cigna’s IQR is $320.60, placing it near UnitedHealth Group in spread.