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CMS RVU26D · Effective 2026-10-01

13120 Complex repair Medicare reimbursement rates in Florida

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. Compare 13120 office and facility rates across CMS payment localities in Florida.

Amounts below use the non-QP conversion factor for participating physicians. These are base physician payments before claim-level adjustments, not patient costs or total hospital charges.

What does Medicare pay for 13120 in Florida?

Florida has 3 payment localities in this comparison. Use the service location to choose the applicable amount. These are the supported base rates for the 3 payment areas shown below, using the same CMS release.

Office / nonfacility

$347.17–$380.01

3 of 3 localities have a supported rate.

Lowest: Rest Of Florida

Highest: Miami

A spread of $32.84 per service.

Facility setting

$201.24–$221.11

3 of 3 localities have a supported rate.

Lowest: Rest Of Florida

Highest: Miami

A spread of $19.87 per service.

These are locality ranges, not averages or address-specific quotes. A facility-setting amount covers the physician service; it does not include a hospital’s separate bill. Choose a locality below to inspect its calculation, compare other payment areas, or price a percentage of Medicare.

Find 13120 in your payment locality →

Where 13120 pays more and less in Florida

3 payment localities

$347.17 to $380.01

$347.17$363.59$380.01
One dot per payment locality, office / nonfacility. Hover a dot to see the locality; select it to open that rate.

Complex wound repair

About 13120: Complex scalp or extremity wound repair

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.

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.

CMS billing rules for 13120

Global period
Minor procedure with a 10-day global period: related postoperative visits for 10 days are included.
Multiple procedures
Standard multiple procedure reduction: the highest-valued procedure is paid in full and others at 50% when performed in the same session.
Bilateral procedures
Bilateral adjustment does not apply; the descriptor or anatomy makes modifier 50 inappropriate.
Assistant at surgery
Statutory restriction: assistant at surgery is not paid.
Co-surgeons
Co-surgeons not permitted.
Team surgery
Team surgery not permitted.

Where the value comes from

  • Work RVU3.15 · 30%
  • Practice expense (office) RVU6.98 · 66%
  • Malpractice RVU0.38 · 4%

12.7K

Medicare services in 2024 · #1348 by national volume

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.

13120 compared with similar codes

Office rates for Florida, from the same CMS release.

13121

Complex repair

Scalp, arm, or leg, 2.6–7.5 cm

$413.23–$451.50

Use 13121 for a complex scalp, arm, or leg repair measuring 2.6–7.5 cm; 13120 is limited to 1.1–2.5 cm.

13100

Complex repair

Trunk, 1.1–2.5 cm

$334.03–$365.76

This is the corresponding complex-repair range for the trunk. Choose by anatomic group, not by wound length alone.

12002

Wound repair

Simple, 2.6–7.5 cm

$139.17–$155.40

This code describes simple repair of a 2.6–7.5 cm scalp or extremity wound. A longer wound does not by itself establish complex repair.

13160

Wound closure

Extensive or complicated

No office rate

13160 addresses secondary closure of a surgical wound or dehiscence; 13120 is for complex repair of a wound in its specified anatomic group and length range.

Compare 13120 by payment locality

Find the payment area for your service address, then open its rate page for calculation inputs, release history and the percentage-of-Medicare tool. A city may cross payment-area boundaries; the ZIP lookup above helps resolve the location.

3 of 3 payment localities

Office and facility base rates · shared scale starting at $0

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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 indices and the applicable conversion factor. Unavailable or separately priced services are labeled rather than assigned a made-up amount.

Source: RVU26D. Effective 2026-10-01 through the day before 2027-01-01.

RVUs for 13120PPRRVU2026_Oct_nonQPP.csv, line 1,436 (RVU26D)