Billing code 13122: Complex repairMedicare rate & RVUs in Texas
Reports each additional length segment of a complex repair on the scalp, arm, or leg when the wound exceeds the primary code’s length span.
Medicare pays $121.06–$131.87 for 13122 in the office in Texas, from Beaumont to Austin. 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.
On this page 9 sections
What 13122 covers
13122 captures the additional length of a complex wound closure on the scalp, an arm, or a leg after the initial length has been reported. A surgeon, plastic surgeon, or dermatologist may perform it after traumatic laceration repair or closure following lesion excision, in an office procedure room or operating room. The repair must meet complex-repair criteria, such as extensive undermining, scar revision, or work beyond routine layered closure; layered closure alone supports an intermediate repair, not this code.
Report 13122 with the primary complex repair code for the same site grouping when total repaired length extends beyond the primary code’s span; it represents each additional 5 cm or less. For wounds in the same classification and anatomic grouping, follow billing code length-aggregation instructions before assigning the base and additional units. Documentation should identify the site, final repaired length, tissue layers, and the work supporting complex repair. CMS treats 13122 as an add-on: submit it with a primary procedure, and its payment falls within that procedure’s global period.
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 13122 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
$121.06 to $131.87
8 of 8 payment localities
| Payment locality | Office | Facility |
|---|---|---|
| Austin | $131.87 | $67.91 |
| Beaumont | $121.06 | $66.04 |
| Brazoria | $126.42 | $66.51 |
| Dallas | $127.39 | $67.17 |
| Fort Worth | $126.73 | $67.12 |
| Galveston | $126.91 | $66.87 |
| Houston | $130.75 | $70.72 |
| Rest Of Texas | $123.78 | $66.41 |
How the 13122 rate is calculated
Each of 13122’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 · 13122
RVUs × geographic indexes × conversion factor
Work1.40
1.40 RVUs× 1.000 GPCI
Practice expense2.23
2.23 RVUs× 1.000 GPCI
Malpractice0.21
0.21 RVUs× 1.000 GPCI
Adjusted RVUs
3.8400
Conversion factor
$33.4009
Medicare rate
$128.26
Every GPCI starts at 1.000, the national rate. Enter a ZIP or drag a slider.
Payment rules and modifiers for 13122
The CMS indicators that decide how 13122 is paid alongside other services.
CMS payment indicators · 13122
Complex repair
| Rule | CMS value | What it means |
|---|---|---|
| Global period | ZZZ | Add-on code: falls within the primary procedure’s global period. |
| Multiple procedures | 0 | No multiple-procedure reduction. |
| 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. |
13122 compared with similar codes
Compare codes · National
4 codes, side by side
How to choose
- 13121Complex repair
- 13121 reports the primary length of a complex repair on the scalp, arms, or legs; 13122 reports each additional 5 cm or less beyond that primary span.
- 13102Complex repair
- 13102 reports additional complex-repair length on the trunk. Use 13122 for the scalp, arms, or legs.
- 13133Complex repair
- 13133 covers additional complex-repair length at the forehead, cheeks, chin, mouth, neck, axillae, genitalia, hands, or feet, rather than the scalp, arms, or legs.
13122 billing questions
Can 13122 be billed by itself?
No. It is an add-on for additional length and must be submitted with the primary complex repair procedure.
Which primary repair code is paired with 13122?
For a complex repair on the scalp, arm, or leg that exceeds 7.5 cm, report 13121 for the primary length and 13122 for each additional 5 cm or less.
How are multiple wounds counted?
Apply billing code instructions for combining lengths of wounds in the same repair classification and anatomic grouping before selecting the primary code and additional units.
Does layered closure alone support 13122?
No. The repair must meet complex-repair criteria, with documentation of work beyond routine layered closure, such as extensive undermining or scar revision.
What documentation supports the additional-length code?
Record the scalp, arm, or leg site, the final repaired length, the repair layers, and the details establishing complex repair.
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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