$386.31
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.
On this page
CMS RVU26D · Effective 2026-10-01
13120 Complex repair Medicare reimbursement rates in Kentucky
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 Kentucky.
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 Kentucky?
Kentucky has 1 payment locality in this comparison. Use the service location to choose the applicable amount. These are the supported base rates for the payment area shown below, using the same CMS release.
Office / nonfacility
$324.09
1 of 1 localities have a supported rate.
Payment area: Kentucky
One mapped payment locality.
Facility setting
$188.39
1 of 1 localities have a supported rate.
Payment area: Kentucky
One mapped payment locality.
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.
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 Kentucky, from the same CMS release.
$311.67
This is the corresponding complex-repair range for the trunk. Choose by anatomic group, not by wound length alone.
$128.15
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.
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.
1 of 1 payment localities
Kentucky →
Office / nonfacility
$324.09
Facility
$188.39
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How this local rate is calculated
Each RVU component is multiplied by its own geographic practice cost index (GPCI). The three adjusted components are added, then multiplied by the conversion factor. These are the inputs used for 13120 in Kentucky.
PPRRVU2026_Oct_nonQPP.csv
1,436
- Code
- 13120
- Physician work
- 3.15
- Practice expense
- 6.98
- Malpractice
- 0.38
GPCI2026.csv
55
- Locality
- Kentucky
- Physician work
- 1.000
- Practice expense
- 0.889
- Malpractice
- 0.915
| Component | RVU | Locality factor | Adjusted |
|---|---|---|---|
| Physician work | 3.15 | × 1.000 | 3.1500 |
| Practice expense | 6.98 | × 0.889 | 6.2052 |
| Malpractice | 0.38 | × 0.915 | 0.3477 |
| Total RVUs | 9.7029 | ||
| Conversion factor | × 33.4009 | ||
Office / nonfacility rate, Kentucky$324.09
Explore RVUs, geographic factors and the full formula
Office / nonfacility
| Component | RVU | Local GPCI |
|---|---|---|
| Work | 3.15 | 1 |
| Practice expense | 6.98 | 0.889 |
| Malpractice | 0.38 | 0.915 |
(3.15 × 1 + 6.98 × 0.889 + 0.38 × 0.915) × $33.4009 = $324.09
Facility
| Component | RVU | Local GPCI |
|---|---|---|
| Work | 3.15 | 1 |
| Practice expense | 2.41 | 0.889 |
| Malpractice | 0.38 | 0.915 |
(3.15 × 1 + 2.41 × 0.889 + 0.38 × 0.915) × $33.4009 = $188.39
The office and facility calculations use their respective practice-expense RVUs. The facility amount here is the physician fee, not a separate hospital or facility bill.
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.
1,43313100,,Cmplx rpr trunk 1.1-2.5 cm,A,,2.93,6.83,,1.84,,0.36,10.12,5.13,0,010,0.10,0.80,0.10,2,0,1,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
1,43413101,,Cmplx rpr trunk 2.6-7.5 cm,A,,3.41,7.88,,2.48,,0.40,11.69,6.29,0,010,0.10,0.80,0.10,2,0,1,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
1,43513102,,Cmplx rpr trunk addl 5cm/<,A,,1.21,2.19,,0.38,,0.20,3.60,1.79,0,ZZZ,0.00,0.00,0.00,0,0,1,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
1,43613120,,Cmplx rpr s/a/l 1.1-2.5 cm,A,,3.15,6.98,,2.41,,0.38,10.51,5.94,0,010,0.10,0.80,0.10,2,0,1,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
1,43713121,,Cmplx rpr s/a/l 2.6-7.5 cm,A,,3.90,8.17,,2.11,,0.44,12.51,6.45,0,010,0.10,0.80,0.10,2,0,1,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
1,43813122,,Cmplx rpr s/a/l addl 5 cm/>,A,,1.40,2.23,,0.42,,0.21,3.84,2.03,0,ZZZ,0.00,0.00,0.00,0,0,1,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
1,43913131,,Cmplx rpr f/c/c/m/n/ax/g/h/f,A,,3.64,7.44,,2.04,,0.43,11.51,6.11,0,010,0.10,0.80,0.10,2,0,1,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
5208102,IN,00,INDIANA,1.000,0.927,0.486
5305102,IA,00,IOWA,1.000,0.915,0.397
5405202,KS,00,KANSAS,1.000,0.904,0.504
5515102,KY,00,KENTUCKY,1.000,0.889,0.915
5607202,LA,01,NEW ORLEANS,1.000,0.941,1.136
5707202,LA,99,REST OF LOUISIANA,1.000,0.885,0.958
5814112,ME,03,SOUTHERN MAINE,1.000,0.991,0.631