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CPT code 13120: Complex repair, scalp, arm, or leg; 1.1–2.5 cm2026 Medicare rate & RVUs in Puerto Rico

Reports complex repair of a 1.1–2.5 cm wound on the scalp, arm, or leg when closure requires more than routine layered suturing.

CMS RVU26DEffective Oct 1, 2026One payment locality12.7K Medicare services in 2024

In Puerto Rico, Medicare pays $353.42 for 13120 in the office and $199.10 when it’s performed in a hospital or facility.

$353.42Office (non-facility)
$199.10Hospital or facility
+0.7%vs the national office rate ($351.04)

Check a contract rate as a % of Medicare · 13120 nationwide

Medicare allowed amount for participating (non-QP) physicians, before deductible, coinsurance and claim adjustments. Not a patient’s bill or a hospital charge.

We’ll open 13120 for the payment locality that covers the ZIP.

On this page 11 sections
  1. Rate in Puerto Rico
  2. What 13120 covers
  3. Compared with other areas
  4. Rate map
  5. How it’s calculated
  6. Payment rules
  7. Related codes
  8. Rate history
  9. Where it applies
  10. Billing questions
  11. Sources

What 13120 covers

This code covers complex repair of a wound on the scalp, arm, or leg when the repair requires work beyond routine closure, such as extensive undermining, significant debridement, or scar revision. It may be performed by a surgeon, emergency physician, or other clinician managing a traumatic wound or operative defect in an office, emergency department, or facility. The site and the final repaired length must fall within this code’s range.

Choose the complex-repair family based on the documented repair work and anatomic group, not length alone. Record the wound site, repaired length, and the features supporting complexity; lengths may be combined only for wounds in the same classification and anatomic group. The code has a 10-day global period, which includes related postoperative visits during that period. When multiple procedures are performed in the same session, the highest-valued procedure is paid in full and others are subject to a 50% reduction. Modifier 50 is inappropriate for this code. Medicare does not pay for an assistant at surgery, and co-surgeons and team surgery are not permitted.

This summary was written with AI assistance from CMS physician fee schedule data and checked against the CMS billing rules shown here. Rates on this page come directly from CMS files.

How Puerto Rico compares for 13120

Across 109 of 109 payment localities, the office rate for 13120 runs from $312.02 in Arkansas to $459.77 in San Benito County, CA. Puerto Rico pays $353.42. The RVUs are the same everywhere; the geographic indexes change the dollars.

13120 in Puerto Rico vs other payment areas
  1. Puerto Rico · this page$353.42
  2. Los Angeles, CA · California$393.76+$40.34
  3. Washington, DC area · District of Columbia$399.66+$46.24
  4. Miami, FL · Florida$380.01+$26.59
  5. Chicago, IL · Illinois$369.38+$15.96
  6. Manhattan, NY · New York$402.98+$49.56
  7. Alaska · Alaska$413.11+$59.69

Other areas in Puerto Rico first, then benchmark localities. Bars start at $0.

Every other payment area

13120 in every other Medicare payment locality
Payment localityOfficeFacility
AlabamaAlabama$316.39$182.83
ArkansasArkansas$312.02$180.90
ArizonaArizona$341.99$194.08
Bakersfield, CACalifornia$370.46$203.17
Chico, CACalifornia$369.32$202.03
El Centro, CACalifornia$369.39$202.09
Fresno, CACalifornia$369.32$202.03
Hanford, CACalifornia$369.32$202.03

13120 rates by state

Office rate range in each state. Select a state to see its payment localities.

MEWIVTNHMTNDMNMINYMARIWAIDWYSDIAILINOHPANJCTORNVUTCONEMOKYWVVAMDDECAAZNMKSOKARTNNCSCDCTXLAMSALGAFLAKHI

Explore a state

Local rates. Clear comparisons.

Hover or focus a tile to see its rate range. Select it to open the state’s fee schedule.

$312.02

$414.54

Color shows the midpoint of each state’s locality range.

View every state and territory as a table
13120 office rate range by state
State / territoryOffice rate rangeLocalities
AK$413.111
AL$316.391
AR$312.021
AZ$341.991
CA$369.32–$459.7729
CO$364.451
CT$373.761
DC$399.661
DE$347.491
FL$347.17–$380.013
GA$328.30–$357.642
GU$377.641
HI$377.641
IA$323.571
ID$325.701
IL$337.91–$369.384
IN$327.501
KS$322.371
KY$324.091
LA$323.70–$339.012
MA$362.51–$399.192
MD$353.85–$399.663
ME$327.59–$344.262
MI$332.40–$351.592
MN$348.871
MO$318.54–$339.883
MS$315.321
MT$351.021
NC$330.841
ND$343.501
NE$325.201
NH$359.021
NJ$377.93–$395.842
NM$334.241
NV$349.161
NY$335.62–$412.725
OH$330.861
OK$323.271
OR$346.34–$375.362
PA$331.23–$364.952
PR$353.421
RI$359.371
SC$331.421
SD$342.621
TN$323.951
TX$329.16–$363.338
UT$335.761
VA$343.35–$399.662
VI$353.421
VT$342.441
WA$361.73–$406.902
WI$332.471
WV$325.971
WY$347.741

See 13120 in every payment locality

How the 13120 rate is calculated

Each of 13120’s three RVUs is multiplied by a geographic index (GPCI) for the payment locality, added up, and multiplied by the conversion factor. Drag the indexes or enter a ZIP to see what moves the rate.

How the rate is built · 13120

RVUs × geographic indexes × conversion factor

Office or facility?

Work3.15

3.15 RVUs× 1.000 GPCI

Practice expense6.98

6.98 RVUs× 1.000 GPCI

Malpractice0.38

0.38 RVUs× 1.000 GPCI

Adjusted RVUs

10.5100

Conversion factor

$33.4009

Medicare rate

$351.04

Every GPCI starts at 1.000, the national rate. Enter a ZIP or drag a slider.

The exact Puerto Rico inputs and CMS source lines

PPRRVU2026_Oct_nonQPP.csv

1,436

Code
13120
Physician work
3.15
Practice expense
6.98
Malpractice
0.38

GPCI2026.csv

91

Locality
Puerto Rico
Physician work
1.000
Practice expense
1.011
Malpractice
0.985
Office calculation for 13120 in Puerto Rico
ComponentRVULocality factorAdjusted
Physician work3.15× 1.0003.1500
Practice expense6.98× 1.0117.0568
Malpractice0.38× 0.9850.3743
Total RVUs10.5811
Conversion factor× 33.4009

Office rate, Puerto Rico$353.42

Office: (3.15 × 1 + 6.98 × 1.011 + 0.38 × 0.985) × $33.4009 = $353.42

Facility: (3.15 × 1 + 2.41 × 1.011 + 0.38 × 0.985) × $33.4009 = $199.10

Open 13120 in the RVU calculator

Payment rules and modifiers for 13120

13120 has a 10-day global period: related visits in that window are included in the surgery payment.

CMS payment indicators · 13120

Complex repair, scalp, arm, or leg; 1.1–2.5 cm

RuleCMS valueWhat it means
Global period010Minor procedure: the day of the procedure plus 10 days after are included.
Multiple procedures2Standard reduction: highest-valued procedure at 100%, others at 50%.
Bilateral (modifier 50)0The 150% bilateral adjustment doesn’t apply.
Assistant at surgery (80/81/82/AS)1Not paid (statutory restriction).
Co-surgeons (62)0Not permitted.
Team surgery (66)0Not permitted.
Professional/technical0Physician service: no professional/technical split.
Split (54/55/56)0.10/0.80/0.10Share of the payment for pre-op, the procedure itself, and post-op care.

Global surgery period · 13120

Complex repair, scalp, arm, or leg; 1.1–2.5 cm

10-day global period ends

Oct 11, 2026

Covers Oct 1, 2026 through Oct 11, 2026 (11 days).

Visit on Oct 31, 2026

After the global period ends: visits and procedures are billed normally.

SurgeryVisit
Sep 28, 2026Oct 14, 2026

What modifiers do to the payment

Modifier 51 · payment effect

With and without the modifier

13120 without 51 · national office

$351.04

Complex repair, scalp, arm, or leg; 1.1–2.5 cm

13120-51 · Second procedure: 50%

$175.52

When this isn’t the highest-valued procedure in the session, Medicare pays 50% of its fee schedule amount (the highest is paid at 100%).

When to use modifier 51

Codes related to 13120

Related codes aren’t interchangeable: bill the code that matches the service performed.

Codes related to 13120
CodeHow it relatesOffice range, Puerto Rico
Same family
13121Complex repair, scalp, arm, or leg, 2.6–7.5 cmComplex repair of the same anatomic group for a repaired length of 2.6–7.5 cm.$420.63
13100Complex repair, trunk, 1.1–2.5 cmComplex repair in the trunk group for a 1.1–2.5 cm repaired length.$340.35
13131Complex repair, face and related sites, 1.1–2.5 cmComplex repair for a different anatomic group, including areas such as the face, neck, hands, and feet.$386.96
Add-on codes
13122Complex repair, additional scalp or limb lengthAdd-on code for each additional 5 cm or less of complex repair in this anatomic group.$128.97
Used instead
12002Wound repair, simple, 2.6–7.5 cmSimple repair of a 2.6–7.5 cm wound on the scalp, arms, or legs when complex repair criteria are not met.$140.20

How 13120 has changed in Puerto Rico

13120 · Office / nonfacility

$353.42

Effective 2026-10-01

The base rate is $10.18 higher than on 2025-10-01, moving from $343.24 to $353.42 (3.0%).

It is unchanged from the immediately preceding available release, effective 2026-07-01.

Base rate by release · bars start at $0 · select a bar to compare

One bar per available release, ordered by effective date. Missing rates remain gaps. These comparisons hold the code, setting and locality identifiers constant; they do not isolate which policy or input caused a change.

What changed, release by release

  1. January 1, 2026

    RVU26A

    $343.24changed to$353.42

    • Conversion factor 32.3465 changed to 33.4009
    • Work RVU 3.23 changed to 3.15
    • Practice expense RVU 6.94 changed to 6.98
    • Malpractice RVU 0.40 changed to 0.38
    • Practice expense GPCI 1.007 changed to 1.011
    • Malpractice GPCI 0.982 changed to 0.985

    Held through RVU26B, RVU26C, RVU26D.

  2. January 1, 2025

    RVU25A

    $356.24changed to$343.24

    • Conversion factor 33.2875 changed to 32.3465
    • Practice expense RVU 7.03 changed to 6.94

    Held through RVU25B, RVU25C, RVU25D.

  3. March 9, 2024

    RVU24AR

    $350.43changed to$356.24

    • Conversion factor 32.7442 changed to 33.2875

    Held through RVU24B, RVU24C, RVU24D.

  4. January 1, 2024

    RVU24A

    $364.29changed to$350.43

    • Conversion factor 33.8872 changed to 32.7442
    • Practice expense RVU 7.07 changed to 7.03
    • Practice expense GPCI 1.008 changed to 1.007
    • Malpractice GPCI 0.984 changed to 0.982

  5. October 1, 2023

    RVU23D

    $362.59changed to$364.29

    • Practice expense GPCI 1.000 changed to 1.008
    • Malpractice GPCI 1.000 changed to 0.984

  6. January 1, 2023

    RVU23A

    $369.96changed to$362.59

    • Conversion factor 34.6062 changed to 33.8872
    • Practice expense RVU 7.02 changed to 7.07
    • Malpractice RVU 0.39 changed to 0.40
    • Practice expense GPCI 1.008 changed to 1.000
    • Malpractice GPCI 0.986 changed to 1.000

    Held through RVU23B, RVU23C.

  7. January 1, 2022

    RVU22A

    $373.05changed to$369.96

    • Conversion factor 34.8931 changed to 34.6062
    • Practice expense RVU 7.04 changed to 7.02
    • Malpractice RVU 0.37 changed to 0.39

    Held through RVU22B, RVU22C, RVU22D.

  8. January 1, 2021

    RVU21A

    $367.67changed to$373.05

    • Conversion factor 36.0896 changed to 34.8931
    • Practice expense RVU 6.53 changed to 7.04
    • Malpractice RVU 0.38 changed to 0.37
    • Malpractice GPCI 0.988 changed to 0.986

    Held through RVU21B, RVU21C, RVU21D.

  9. January 1, 2020

    RVU20A

    $365.07changed to$367.67

    • Conversion factor 36.0391 changed to 36.0896
    • Practice expense RVU 6.38 changed to 6.53
    • Malpractice RVU 0.48 changed to 0.38
    • Practice expense GPCI 1.007 changed to 1.008
    • Malpractice GPCI 0.990 changed to 0.988

    Held through RVU20B, RVU20C, RVU20D.

  10. January 1, 2019

    RVU19A

    $360.68changed to$365.07

    • Conversion factor 35.9996 changed to 36.0391
    • Practice expense RVU 6.26 changed to 6.38
    • Malpractice RVU 0.49 changed to 0.48

    Held through RVU19B, RVU19C, RVU19D.

  11. January 1, 2018

    RVU18AR1

    $318.29changed to$360.68

    • Conversion factor 35.8887 changed to 35.9996
    • Practice expense RVU 6.22 changed to 6.26
    • Practice expense GPCI 0.856 changed to 1.007
    • Malpractice GPCI 0.642 changed to 0.990

    Held through RVU18B, RVU18C, RVU18D.

  12. January 1, 2017

    RVU17A

    $276.89changed to$318.29

    • Conversion factor 35.8043 changed to 35.8887
    • Practice expense RVU 6.18 changed to 6.22
    • Malpractice RVU 0.50 changed to 0.49
    • Practice expense GPCI 0.705 changed to 0.856
    • Malpractice GPCI 0.293 changed to 0.642

    Held through RVU17B, RVU17C, RVU17D.

  13. January 1, 2016

    RVU16A

    $277.47changed to$276.89

    • Conversion factor 35.9335 changed to 35.8043
    • Malpractice RVU 0.46 changed to 0.50

    Held through RVU16B, RVU16C, RVU16D.

  14. July 1, 2015

    RVU15C

    $276.09changed to$277.47

    • Conversion factor 35.7547 changed to 35.9335

    Held through RVU15D.

  15. January 1, 2015

    RVU15A

    $270.10changed to$276.09

    • Conversion factor 35.8228 changed to 35.7547
    • Practice expense RVU 6.04 changed to 6.18
    • Malpractice RVU 0.48 changed to 0.46
    • Practice expense GPCI 0.692 changed to 0.705
    • Malpractice GPCI 0.271 changed to 0.293

    Held through RVU15B.

  16. January 1, 2014

    RVU14A

    $270.99changed to$270.10

    • Conversion factor 34.0230 changed to 35.8228
    • Practice expense RVU 6.80 changed to 6.04
    • Malpractice RVU 0.50 changed to 0.48
    • Practice expense GPCI 0.678 changed to 0.692
    • Malpractice GPCI 0.249 changed to 0.271

    Held through RVU14B, RVU14C, RVU14D.

  17. January 1, 2013

    RVU13AR

    Earliest loaded release: $270.99

    Held through RVU13B, RVU13C, RVU13D.

Rates in every CMS release
Effective fromOfficeFacilityCMS release
2026-10-01$353.42$199.10RVU26D
2026-07-01$353.42$199.10RVU26C
2026-04-01$353.42$199.10RVU26B
2026-01-01$353.42$199.10RVU26A
2025-10-01$343.24$224.68RVU25D
2025-07-01$343.24$224.68RVU25C
2025-04-01$343.24$224.68RVU25B
2025-01-01$343.24$224.68RVU25A
2024-10-01$356.24$230.54RVU24D
2024-07-01$356.24$230.54RVU24C
2024-04-01$356.24$230.54RVU24B
2024-03-09$356.24$230.54RVU24AR
2024-01-01$350.43$226.78RVU24A
2023-10-01$364.29$234.15RVU23D
2023-07-01$362.59$233.48RVU23C
2023-04-01$362.59$233.48RVU23B
2023-01-01$362.59$233.48RVU23A
2022-10-01$369.96$236.71RVU22D
2022-07-01$369.96$236.71RVU22C
2022-04-01$369.96$236.71RVU22B
2022-01-01$369.96$236.71RVU22A
2021-10-01$373.05$238.69RVU21D
2021-07-01$373.05$238.69RVU21C
2021-04-01$373.05$238.69RVU21B
2021-01-01$373.05$238.69RVU21A
2020-10-01$367.67$241.80RVU20D
2020-07-01$367.67$241.80RVU20C
2020-04-01$367.67$241.80RVU20B
2020-01-01$367.67$241.80RVU20A
2019-10-01$365.07$244.95RVU19D
2019-07-01$365.07$244.95RVU19C
2019-04-01$365.07$244.95RVU19B
2019-01-01$365.07$244.95RVU19A
2018-10-01$360.68$246.12RVU18D
2018-07-01$360.68$246.12RVU18C
2018-04-01$360.68$246.12RVU18B
2018-01-01$360.68$246.12RVU18AR1
2017-10-01$318.29$222.44RVU17D
2017-07-01$318.29$222.44RVU17C
2017-04-01$318.29$222.44RVU17B
2017-01-01$318.29$222.44RVU17A
2016-10-01$276.89$198.39RVU16D
2016-07-01$276.89$198.39RVU16C
2016-04-01$276.89$198.39RVU16B
2016-01-01$276.89$198.39RVU16A
2015-10-01$277.47$198.93RVU15D
2015-07-01$277.47$198.93RVU15C
2015-04-01$276.09$197.94RVU15B
2015-01-01$276.09$197.94RVU15A
2014-10-01$270.10$194.98RVU14D
2014-07-01$270.10$194.98RVU14C
2014-04-01$270.10$194.98RVU14B
2014-01-01$270.10$194.98RVU14A
2013-10-01$270.99$191.18RVU13D
2013-07-01$270.99$191.18RVU13C
2013-04-01$270.99$191.18RVU13B
2013-01-01$270.99$191.18RVU13AR

Price 13120 for an earlier date of service

Where the Puerto Rico rate applies

Puerto Rico is a Medicare payment area, not a city. Our Census mapping connects it to 292 cities and communities in Puerto Rico. Some span more than one payment area; confirm with the service ZIP.

  • Aceitunas
  • Adjuntas
  • Aguada
  • Aguadilla
  • Aguas Buenas
  • Aguas Claras
  • Aguilita
  • Aibonito

Browse all communities in Puerto Rico

13120 billing questions

How is 13120 distinguished from 13121?

Both cover complex repair on the scalp, arms, or legs. Use 13120 for a repaired length of 1.1–2.5 cm and 13121 for 2.6–7.5 cm.

Can wound lengths be added together?

Lengths may be combined when multiple wounds share the same repair classification and anatomic group. Document each wound’s site and length so the reported total is supported.

When is 13122 reported with 13120?

13122 is an add-on for each additional 5 cm or less of complex repair on the scalp, arms, or legs beyond the length covered by the primary code.

Are related postoperative visits separately reported during the global period?

Related postoperative visits during the 10-day global period are included in the repair.

Should modifier 50 be used for repairs on both sides?

No. The descriptor and anatomy make bilateral adjustment inappropriate for 13120.

What documentation supports reporting complex repair?

Document the anatomic site, repaired length, and specific work that makes the closure complex, such as extensive undermining, significant debridement, or scar revision.

Where these rates come from

FeeBase calculates base physician payments from CMS work, practice-expense and malpractice RVUs, adjusted by each locality’s geographic indexes and the conversion factor. Services without a published rate are labeled, never given a made-up amount. Amounts are Medicare allowed amounts before claim adjustments: not a patient’s bill or a commercial rate.

CMS RVU26D · effective Oct 1, 2026 through the day before Jan 1, 2027

Show the CMS file lines behind this rate
RVUs for 13120PPRRVU2026_Oct_nonQPP.csv, line 1,436 (RVU26D)
Geographic factors for Puerto RicoGPCI2026.csv, line 91 (RVU26D)

Open CMS sourceHow we calculate rates

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