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CPT 13120 Fee Schedule

Last Verified: January 2026

Healthcare providers use this code to document and receive reimbursement for visits that address moderate-level medical decision-making, often including multiple diagnoses or prescription management.

Complx Rpr Sclp Arm Leg 1.1-2.5 Cm
Key FactDetail
Service Type

Surgery

Surgical Procedures on the Integumentary System

Common Place of Service

11 - Office

24 - Ambulatory Surgical Center

Common Modifiers

None

59 - Distinct Procedural Service

79 - Unrelated procedure - postop period

Complexity LevelModerate

National average reimbursement for CPT 13120 by major payers:

bcbs

$410.36

uhc

$435.33

aetna

$451.46

cigna

$578.95

Preview provider-level rates for...
For billing codeCPT 13120
PayerCodeRateNPITax IDStateSpecialty

Select a payer to view fee schedule data

Choose a payer from the options above to see rates for CPT 13120

United
13120$544.001326494188 - SOUTH AUSTIN SURGICENTER, LLC300924492TXAmbulatory Surgical Clinic/Center (261QA1903X)
United
13120$935.001699863258 - ROBERT E WAILES MD A PROFESSIONAL, PACIFIC SURGERY CENTER330113109CAAmbulatory Surgical Clinic/Center (261QA1903X)
United
13120$627.001124324181 - MANHATTAN ENDOSCOPY CENTER LLC, MANHATTAN ENDO271510596 - (NY) MANHATTAN ENDOSCOPY CENTERNYAmbulatory Surgical Clinic/Center (261QA1903X)
United
13120$566.001841395894 - FRANKLIN ENDOSCOPY CENTER, LLC, FRANKLIN ENDOSCOPY CENTER383730672 - (TN) FRANKLIN ENDOSCOPY CENTER LLCTNAmbulatory Surgical Clinic/Center (261QA1903X)
United
13120$555.001487620043 - NEW HORIZONS SURGERY CENTER LLC731572167 - (OH) NEW HORIZONS SURGERY CENTER LLCOHAmbulatory Surgical Clinic/Center (261QA1903X)
United
13120$935.001336231059 - CENTINELA VALLEY ENDOSCOPY CENTER INC.200244220 - (CA) CENTINELA VALLEY ENDOSCOPY CENTER INCCAAmbulatory Surgical Clinic/Center (261QA1903X)
United
13120$115.001487043386 - DENTAL SURGICENTER OF LOUISVILLE INC464672803 - (KY) DENTAL SURGICENTERKYAmbulatory Surgical Clinic/Center (261QA1903X)
United
13120$544.001962671487 - HYDE PARK SURGERY CENTER, LLC, HYDE PARK SURGERY CENTER, LP421731685TXAmbulatory Surgical Clinic/Center (261QA1903X)
United
13120$351.001326549676 - CHATHAM ORTHOPAEDIC ASC, LLC, CHATHAM ORTHOPAEDIC SURGERY CENTER824075002GAAmbulatory Surgical Clinic/Center (261QA1903X)
United
13120$563.001366864514 - GREAT SOUTH BAY ENDOSCOPY CENTER, LLC463055867 - (NY) GREAT SOUTH BAY ENDOSCOPY CENTER LLCNYAmbulatory Surgical Clinic/Center (261QA1903X)
United
13120$116.001437623626 - PRIME SURGICAL SUITES, LLC, SCSV, LLC463556921 - (NC) PRIME SURGICAL SUITES LLCNCAmbulatory Surgical Clinic/Center (261QA1903X)
United
13120$618.401124466040 - NATHAN OAKLEY350593390 - DEACONESS HOSPITAL INCINFamily Medicine Physician (207Q00000X)
United
13120$325.001730124561 - SURGERY CENTER OF WESTON LLC650933685 - (FL) SURGERY CENTER OF WESTON LLCFLAmbulatory Surgical Clinic/Center (261QA1903X)
United
13120$242.001629142666 - ENDOSCOPY CENTER OF BUCKS COUNTY, LP841693856 - (PA) ENDOSCOPY CENTER OF BUCKS COUNTY LPPAAmbulatory Surgical Clinic/Center (261QA1903X)
United
13120$922.001164056974 - ORTHOPEDIC SURGERY CENTER OF THE FOX VALLEY LLC842016212 - (WI) ORTHOPEDIC SURGERY CENTER OF THE FOX VALLEYWIAmbulatory Surgical Clinic/Center (261QA1903X)
United
99202$100.0012345678901234567890CACardiologist
United
99202$100.0012345678901234567890CACardiologist
United
99202$100.0012345678901234567890CACardiologist
United
99202$100.0012345678901234567890CACardiologist
United
99202$100.0012345678901234567890CACardiologist
United
99202$100.0012345678901234567890CACardiologist
United
99202$100.0012345678901234567890CACardiologist
United
99202$100.0012345678901234567890CACardiologist
United
99202$100.0012345678901234567890CACardiologist
United
99202$100.0012345678901234567890CACardiologist

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CPT 13120 vs. Other Surgical Procedures on the Integumentary System Codes

The CPT 13120 code is part of the Surgery services used for Surgical Procedures on the Integumentary System. It represents a moderate-complexity encounter and is one of several codes that vary based on time spent, level of medical decision-making, and documentation requirements.

The CPT 13120 code involves more provider time and moderate medical decision-making, unlike lower-level codes that require less time and simpler assessments. It typically includes multiple diagnoses, medication management, or test interpretation, leading to higher reimbursement and more detailed documentation requirements.

CodeComplexityDescription
12020-CPTModerateClosure Superfic Wound Dehiscence
13120-CPTModerateComplx Rpr Sclp Arm Leg 1.1-2.5 Cm
13121-CPTModerateRep Complex Scalp/Limb 2.5-7.5 Cm
13122-CPTLowRepair, Complex, Scalp, Arms, And/Or Legs; Each Additional 5 Cm Or Less (List Separately In Addition To Code For Primary Procedure)

What is a fee schedule?

A fee schedule is a list of fixed prices that healthcare providers charge for specific services, including CPT 13120. These prices vary depending on payer type (Medicare, Medicaid, private insurance), geographic location, and provider contracts.

Understanding the 13120 fee schedule helps patients estimate costs and providers optimize billing for accurate reimbursements.

Factors that affect fee schedules


Medicare & Medicaid Rates

Government-set reimbursement amounts


Private Insurance Rates

Negotiated rates between providers and insurance companies


Geographic Location

Costs may be higher in urban areas.


Provider Type

Hospital providers may have different rates than private practice.

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