CPT code 13121: Complex repair, scalp, arm, or leg, 2.6–7.5 cm2026 Medicare rate & RVUs in Texas
Reports complex closure of a 2.6–7.5 cm wound on the scalp, arm, or leg when the repair requires work beyond routine layered closure.
Medicare pays $392.24–$432.26 for 13121 in the office in Texas, from Beaumont, TX to Austin, TX. Which amount applies depends on the service address.
Medicare allowed amount for participating (non-QP) physicians, before deductible, coinsurance and claim adjustments. Not a patient’s bill or a hospital charge.
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On this page 9 sections
What 13121 covers
This code covers a complex repair of a wound on the scalp, arm, or leg, with a repaired length from 2.6 through 7.5 cm. The repair involves more than routine layered closure, such as extensive undermining or other substantial measures needed to close a complicated wound. Surgeons, dermatologists, plastic surgeons, and emergency physicians may perform these repairs in office, outpatient, or hospital settings, including after trauma or removal of a lesion.
Choose the code by the wound’s anatomic group, repair complexity, and length; documentation should identify the site, final repaired length, and work supporting complex rather than intermediate closure. Related postoperative visits are included in the 10-day global period. When multiple procedures occur in one session, the highest-valued procedure is paid in full and other procedures are subject to the standard 50% reduction. Modifier 50 is inappropriate; assistant-at-surgery services are not paid, and co-surgeon and team-surgery billing 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.
Where 13121 pays more and less in Texas
The same RVUs, adjusted for each area’s costs. Open a locality for its calculation, history and nearby areas.
8 payment localities
$392.24 to $432.26
8 of 8 payment localities
| Payment locality | Office | Facility |
|---|---|---|
| Austin, TX | $432.26 | $218.11 |
| Beaumont, TX | $392.24 | $208.05 |
| Brazoria, TX | $413.20 | $212.61 |
| Dallas, TX | $415.84 | $214.24 |
| Fort Worth, TX | $413.30 | $213.73 |
| Galveston, TX | $414.45 | $213.46 |
| Houston, TX | $422.50 | $221.51 |
| Rest of Texas | $402.50 | $210.42 |
How the 13121 rate is calculated
Each of 13121’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 · 13121
RVUs × geographic indexes × conversion factor
Work3.90
3.90 RVUs× 1.000 GPCI
Practice expense8.17
8.17 RVUs× 1.000 GPCI
Malpractice0.44
0.44 RVUs× 1.000 GPCI
Adjusted RVUs
12.5100
Conversion factor
$33.4009
Medicare rate
$417.85
Every GPCI starts at 1.000, the national rate. Enter a ZIP or drag a slider.
Payment rules and modifiers for 13121
13121 has a 10-day global period: related visits in that window are included in the surgery payment.
CMS payment indicators · 13121
Complex repair, scalp, arm, or leg, 2.6–7.5 cm
| Rule | CMS value | What it means |
|---|---|---|
| Global period | 010 | Minor procedure: the day of the procedure plus 10 days after are included. |
| Multiple procedures | 2 | Standard reduction: highest-valued procedure at 100%, others at 50%. |
| Bilateral (modifier 50) | 0 | The 150% bilateral adjustment doesn’t apply. |
| Assistant at surgery (80/81/82/AS) | 1 | Not paid (statutory restriction). |
| Co-surgeons (62) | 0 | Not permitted. |
| Team surgery (66) | 0 | Not permitted. |
| Professional/technical | 0 | Physician service: no professional/technical split. |
| Split (54/55/56) | 0.10/0.80/0.10 | Share of the payment for pre-op, the procedure itself, and post-op care. |
Global surgery period · 13121
Complex repair, scalp, arm, or leg, 2.6–7.5 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.
What modifiers do to the payment
Modifier 51 · payment effect
With and without the modifier
13121 without 51 · national office
$417.85
Complex repair, scalp, arm, or leg, 2.6–7.5 cm
13121-51 · Second procedure: 50%
$208.93
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%).
13121 compared with similar codes
Compare codes · National
5 codes, side by side
How to choose
- 13120Complex repairScalp, arm, or leg; 1.1–2.5 cm
- Both apply to complex repairs on the scalp, arms, or legs. Select 13121 for a repaired length of 2.6–7.5 cm and 13120 for the shorter range.
- 13122Complex repairAdditional scalp or limb length
- 13121 is the primary code for a repair in its length range; 13122 reports qualifying additional length beyond that primary range.
- 13101Complex repairTrunk, 2.6–7.5 cm
- Both describe complex repair, but 13101 is for the trunk. Use 13121 for the scalp, arm, or leg.
- 13131Complex repairFace and related sites, 1.1–2.5 cm
- 13131 applies to a different anatomic group, including the hands and feet; 13121 covers the scalp, arms, and legs.
13121 billing questions
How is this code distinguished from 13120?
Both cover complex repair of the scalp, arms, or legs. Use 13121 for a repaired length of 2.6–7.5 cm; 13120 is for the shorter length range.
When is complex repair supported rather than intermediate repair?
The record should show work beyond routine layered closure, such as extensive undermining or other substantial measures required by a complicated wound. Layered closure alone does not establish complex repair.
Can 13122 be reported with this code?
Yes, when the repair extends beyond the primary length range and the additional length meets the add-on code’s criteria. Document the total repaired length and report the primary repair code with the applicable add-on code.
Should modifier 50 be used for wounds on both sides?
No. The CMS bilateral adjustment does not apply to this code, and modifier 50 is inappropriate.
Are related postoperative visits separately payable during the global period?
Related postoperative visits during the 10-day global period are included in the repair. Unrelated services are evaluated separately under the applicable reporting rules.
How does Medicare handle multiple procedures in the same session?
The highest-valued procedure is paid in full, and other procedures are subject to the standard 50% multiple-procedure reduction. Assistant-at-surgery payment is restricted, and co-surgeon and team-surgery billing are not permitted.
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
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