How much does Medicare pay for CPT 13120?

Medicare allowed an average of $264.15 per service and paid $208.70 of that, the balance being the patient's coinsurance and deductible (2024 data). Providers submitted an average of $711.61, which is what they billed rather than what they received — Medicare pays its fee schedule regardless of the charge.

What is CPT code 13120?

Complicated repair of wound of scalp, arms, or legs, 1.1-2.5 cm. It was billed 6,236 times to 5,638 Medicare beneficiaries by 191 providers in 2024.

Does 13120 pay differently in an office than a hospital?

Yes. The allowed amount averaged $268.83 in an office setting and $214.19 in a facility. The office rate is generally higher because the practice supplies the room, staff and equipment out of that single payment; in a hospital those are billed separately by the facility.

Which specialty bills 13120 most?

Dermatology, with 4,710 services from 133 clinicians. Next are Plastic and Reconstructive Surgery, Physician Assistant, Micrographic Dermatologic Surgery.

CPT 13120

Complicated repair of wound of scalp, arms, or legs, 1.1-2.5 cm

$264.15Medicare-allowed amount per service, averaged across 6,236 services

Providers submitted

$711.61

Asking price, not received

Medicare allowed

$264.15

The fee schedule figure

Medicare paid

$208.70

Balance is patient coinsurance

Providers submitted an average of $711.61 for this code and Medicare allowed $264.15 — 2.7× less. That gap is normal and means nothing on its own: Medicare pays its fee schedule regardless of what is billed, so the submitted figure describes a hospital chargemaster, not a price anyone paid. Of the allowed amount Medicare paid $208.70 (79%); the rest is the patient’s coinsurance and deductible.

Office pays differently to hospital

Office / non-facility: $268.83
Hospital / facility: $214.19

The office rate is higher because the practice supplies the room, staff and equipment out of that payment. In a hospital the facility bills those separately, so the clinician's share is smaller — the total cost to Medicare is usually higher, not lower. 5,702 services were billed in an office setting and 534 in a facility.

Services: 6,236
Beneficiaries: 5,638
Providers billing it: 191
Total allowed: $1,647,239

What Medicare pays for CPT 13120

Across 6,236 services billed by 191 providers to 5,638 beneficiaries, Medicare allowed an average of $264.15 per service. The allowed amount is the figure that matters: it is what Medicare and the patient together owe, set by the fee schedule and adjusted for local practice costs. What a provider chose to submit has no bearing on it.

Who bills 13120

Specialty	Services	Beneficiaries	Avg allowed	Providers
Dermatology	4,710	4,197	$255.99	133
Plastic and Reconstructive Surgery	481	454	$335.80	17
Physician Assistant	304	292	$286.88	16
Micrographic Dermatologic Surgery	278	270	$213.20	11
Ambulatory Surgical Center	269	236	$291.67	7
Family Practice	64	64	$166.39	1
Internal Medicine	59	56	$365.96	2
Otolaryngology	45	44	$336.15	2
Nurse Practitioner	26	25	$296.57	2

13120 reimbursement by state

Two different numbers. Allowed is what Medicare actually allowed in that state, which includes the local practice-cost adjustment. Standardized strips that geographic adjustment out of the payment, so it is the column to use when comparing states — a difference there reflects how the code was billed, not what it costs to run a practice locally.

State	Services	Allowed	Standardized pmt	Providers
Florida	1,959	$280.30	$205.67	44
California	1,549	$290.36	$204.60	41
South Carolina	314	$197.65	$168.97	4
Georgia	222	$224.95	$167.53	10
Arizona	210	$285.14	$207.24	12
New York	199	$293.00	$201.20	10
New Jersey	163	$266.60	$195.14	7
Tennessee	160	$201.66	$171.93	6
Texas	158	$223.02	$172.67	6
Arkansas	131	$205.32	$174.85	4
District of Columbia	116	$376.07	$251.49	1
Ohio	100	$203.15	$163.73	5
Illinois	100	$216.56	$171.24	6
Louisiana	97	$210.52	$173.11	1
Pennsylvania	93	$316.55	$249.07	3
Oklahoma	88	$195.42	$169.07	1
West Virginia	64	$166.39	$142.77	1
Colorado	59	$209.74	$161.86	3
Nevada	48	$284.52	$224.67	2
Kentucky	44	$181.68	$154.54	3
Missouri	43	$248.16	$200.72	2
Washington	39	$213.04	$161.47	3
Mississippi	38	$194.03	$167.55	2
Oregon	36	$279.60	$143.92	3
Massachusetts	32	$206.10	$142.94	1
North Carolina	30	$174.07	$141.36	2
Michigan	24	$316.70	$173.69	1
Rhode Island	23	$201.33	$156.25	1
Maryland	23	$261.15	$216.54	1
Iowa	19	$188.64	$152.90	1
Utah	16	$207.00	$173.02	1
New Mexico	13	$175.11	$138.40	1
Indiana	13	$237.24	$202.95	1
Virginia	13	$328.57	$250.26	1

Related codes

13132Complicated repair of wound of forehead$269.67
13121Complicated repair of wound of scalp$297.90
13101Complicated repair of wound of trunk$328.17
13152Complicated repair of wound of eyelids$268.00
13131Complicated repair of wound of forehead$229.32
13151Complicated repair of wound of eyelids$235.39
13122Complicated repair of wound of scalp$115.92
13102Complicated repair of wound of trunk$96.99
13133Complicated repair of wound of forehead$157.28
13160Extensive or complicated repair of surface wound reopening$650.97
13100Complicated repair of wound of trunk$317.65

Billing this code is not the same as earning it

An allowed amount is revenue to a practice, not income to a clinician. It funds staff, premises, equipment and supplies before anyone is paid. What clinicians actually earn is published separately by the Department of Labor, and what industry pays them is published separately again by CMS — this site carries both.

What doctors are paid →·Look up a clinician →·All procedure codes →

Where this comes from. CMS Medicare Physician & Other Practitioners, by Provider and Service, 2024. It covers fee-for-service Original Medicare Part B only — not Medicare Advantage, not Medicaid, and not commercial insurance, which typically pays more for the same code.

How it is averaged. CMS publishes one average per provider per code. Every figure here is re-weighted by the number of services, so a clinician who billed the code 4,000 times counts 4,000 times more than one who billed it twice. CMS also suppresses any provider-code pair with fewer than 11 beneficiaries, so low-volume practice is missing from these totals by design.