How much does Medicare pay for CPT 13122?

Medicare allowed an average of $115.92 per service and paid $92.64 of that, the balance being the patient's coinsurance and deductible (2024 data). Providers submitted an average of $355.32, which is what they billed rather than what they received — Medicare pays its fee schedule regardless of the charge.

What is CPT code 13122?

Complicated repair of wound of scalp, arms, or legs, each additional 5.0 cm or less. It was billed 10,617 times to 8,893 Medicare beneficiaries by 389 providers in 2024.

Does 13122 pay differently in an office than a hospital?

Yes. The allowed amount averaged $124.18 in an office setting and $81.84 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 13122 most?

Dermatology, with 6,597 services from 249 clinicians. Next are Micrographic Dermatologic Surgery, Plastic and Reconstructive Surgery, Orthopedic Surgery.

CPT 13122

Complicated repair of wound of scalp, arms, or legs, each additional 5.0 cm or less

$115.92Medicare-allowed amount per service, averaged across 10,617 services

Providers submitted

$355.32

Asking price, not received

Medicare allowed

$115.92

The fee schedule figure

Medicare paid

$92.64

Balance is patient coinsurance

Providers submitted an average of $355.32 for this code and Medicare allowed $115.92 — 3.1× 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 $92.64 (80%); the rest is the patient’s coinsurance and deductible.

Office pays differently to hospital

Office / non-facility: $124.18
Hospital / facility: $81.84

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. 8,546 services were billed in an office setting and 2,071 in a facility.

Services: 10,617
Beneficiaries: 8,893
Providers billing it: 389
Total allowed: $1,230,723

What Medicare pays for CPT 13122

Across 10,617 services billed by 389 providers to 8,893 beneficiaries, Medicare allowed an average of $115.92 per service. That is 1.2 services per beneficiary, so this is a code patients typically receive more than once. 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 13122

Specialty	Services	Beneficiaries	Avg allowed	Providers
Dermatology	6,597	5,756	$122.49	249
Micrographic Dermatologic Surgery	1,413	1,242	$121.13	48
Plastic and Reconstructive Surgery	801	586	$103.02	31
Orthopedic Surgery	478	281	$79.63	11
General Surgery	317	207	$85.14	13
Physician Assistant	304	272	$104.06	14
Surgical Oncology	276	223	$97.12	10
General Practice	142	66	$92.44	1
Otolaryngology	104	93	$122.29	3
Undefined Physician type	68	62	$116.58	3
Nurse Practitioner	45	37	$105.66	3
Pathology	42	39	$74.69	1
Ophthalmology	19	18	$133.76	1
Osteopathic Manipulative Medicine	11	11	$121.27	1

13122 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
California	1,610	$116.46	$87.58	53
Florida	1,300	$121.71	$93.56	44
Texas	1,226	$119.89	$94.95	38
Arizona	589	$105.54	$85.06	16
New York	555	$121.61	$84.37	17
Georgia	551	$114.20	$94.40	15
New Jersey	438	$124.21	$94.34	11
Illinois	360	$124.11	$93.28	16
North Carolina	276	$114.88	$96.43	12
Pennsylvania	253	$110.26	$82.54	13
Massachusetts	225	$130.03	$99.06	9
Maryland	224	$114.40	$84.45	9
Indiana	206	$101.99	$85.41	11
Ohio	200	$109.10	$91.30	10
Virginia	189	$121.12	$97.47	7
Alabama	177	$111.18	$95.09	8
Nevada	172	$124.55	$99.09	5
Missouri	163	$105.68	$87.90	9
South Carolina	149	$118.16	$98.78	5
Wisconsin	143	$117.92	$98.96	4
Arkansas	141	$99.36	$87.23	5
Kansas	125	$88.12	$73.61	6
Michigan	121	$124.71	$99.70	4
Washington	119	$121.63	$96.21	8
Delaware	117	$103.53	$83.38	5
Oklahoma	115	$108.76	$92.56	6
Kentucky	114	$116.08	$99.25	6
Tennessee	113	$106.77	$91.76	5
Connecticut	104	$121.77	$94.07	4
Rhode Island	76	$108.35	$83.26	3
Utah	73	$94.56	$77.29	2
Wyoming	66	$96.64	$78.75	3
Mississippi	65	$87.63	$75.07	3
Colorado	57	$127.70	$99.27	4
New Hampshire	41	$79.39	$63.84	1
South Dakota	35	$116.07	$99.64	2
Minnesota	27	$120.71	$98.87	2
Louisiana	14	$121.91	$99.06	1
North Dakota	14	$76.50	$63.49	1
Maine	14	$77.54	$63.49	1
Hawaii	13	$131.35	$98.92	1
West Virginia	13	$100.27	$84.29	1
Idaho	12	$121.64	$99.17	1
District of Columbia	11	$140.77	$98.43	1
Iowa	11	$114.12	$98.89	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
13120Complicated repair of wound of scalp$264.15
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.