CPT 13131

Repair Complex F/C/C/M/N/Ax/G/H/F 1.1-2.5 Cm

CPT 13131 pays $384.44 in a non-facility setting and $204.08 in a facility setting under the 2026 Medicare Physician Fee Schedule, before geographic adjustment. After geographic adjustment, state amounts run from $342.44 in Arkansas to $454.94 in Alaska, a 33% spread.

National non-facility rate

$384.44

Office and other outpatient settings

Facility rate
$204.08

Hospital and ASC settings

Highest state
$454.94

Alaska

Lowest state
$342.44

Arkansas · 33% spread

Medicare rate by state

53 Medicare jurisdictions, highest to lowest. State values average every locality in the jurisdiction at a 33.4009 conversion factor.

Non-facilityFacilityNational $384.44
CPT 13131 Medicare reimbursement rate by state, 33.4009 conversion factor, 2026 Physician Fee Schedule. National non-facility $384.44, national facility $204.08.
StateRate compared visuallyNon-facilityFacility
Alaska
$454.94$262.85
District of Columbia
$436.87$224.40
California
$427.77$214.35
New York
$424.10$222.88
New Jersey
$423.20$220.11
Washington
$420.03$214.42
Massachusetts
$416.35$213.71
Hawaii
$412.44$207.37
Connecticut
$409.03$214.77
Florida
$398.87$217.90
Colorado
$398.66$206.75
Maryland
$397.70$209.67
Oregon
$394.74$204.73
Rhode Island
$393.40$207.09
New Hampshire
$392.84$205.08
Illinois
$389.57$215.29
Puerto Rico
$386.96$204.61
Virgin Islands
$386.96$204.61
Montana
$384.42$204.05
Nevada
$382.29$201.75
Minnesota
$381.54$195.94
Pennsylvania
$381.44$204.77
Wyoming
$380.71$200.35
Delaware
$380.62$202.42
Texas
$380.24$202.67
Georgia
$376.02$203.95
Virginia
$376.00$198.70
North Dakota
$375.91$195.55
Michigan
$375.14$205.78
South Dakota
$374.91$194.54
Vermont
$374.86$196.30
Arizona
$374.67$199.90
Utah
$368.07$198.53
Maine
$368.02$195.68
New Mexico
$366.71$201.31
Wisconsin
$364.07$191.28
Missouri
$363.76$198.24
Louisiana
$363.50$198.83
South Carolina
$363.40$196.75
Ohio
$362.94$198.27
North Carolina
$362.61$194.33
Indiana
$358.92$191.72
West Virginia
$358.08$201.34
Idaho
$357.00$191.06
Nebraska
$356.38$189.90
Kentucky
$355.64$195.30
Tennessee
$355.18$191.23
Iowa
$354.66$189.63
Oklahoma
$354.65$193.59
Kansas
$353.46$190.41
Alabama
$347.15$189.33
Mississippi
$346.15$190.86
Arkansas
$342.44$187.51

Billed by 1 specialties

Commercial rates for 13131

Medicare is the floor, not the market. See what UHC, Aetna, Cigna and BCBS actually pay — down to the TIN.

See negotiated rates