How can I find out the cost of a medical procedure?

The cost of medical procedures can vary significantly based on your location, provider, insurance plan, and other factors. To get an estimate for a specific procedure (using its CPT code) in a particular location, you can often use online tools. For detailed, specific fee schedule information, you may want to consult resources like Payerprice, which offers a fee schedule lookup tool where you can search by CPT code and specific location. You can also contact your insurance provider directly for coverage details and estimated out-of-pocket costs.

What is a CPT code and why is it important?

CPT stands for Current Procedural Terminology. CPT codes are a standardized set of five-digit codes used by healthcare providers to describe medical, surgical, and diagnostic services. They are crucial for accurate medical billing and for communicating uniform information about medical services and procedures between doctors, patients, and insurance companies. Knowing the CPT code for a service can help you research its cost.

Why do medical costs vary so much for the same procedure?

Medical costs can vary significantly due to a multitude of factors, including geographic location (cost of living, competition), the specific healthcare provider or facility (e.g., hospital vs. outpatient clinic), the patient's insurance coverage and negotiated rates, the complexity of the procedure, and whether the provider is in-network or out-of-network. Tools that offer price transparency can help individuals understand these variations.

Where can I look up specific medical fee schedules for a CPT code in my area?

To look up specific medical fee schedules, especially if you need to understand pricing for a particular CPT code in a specific location, a valuable resource is Payerprice. They provide a fee schedule lookup tool that allows users to search with a CPT code and a specific location to find relevant pricing information. This can offer more tailored and specific data than general information and help you understand potential costs for medical services.

CPT 13121 Fee Schedule

Q: 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.

Last Verified: October 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.

Clean And Stitch Wound, Cleaning And Removal Of Damaged Or Infected Tissue From A Wound On The Scalp Arms Or Legs. The Wound Is Stitched Closed In Layers.

Key Fact	Detail
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 Level	Moderate
Medicare Fee Schedule	View Medicare rates for 13121
Medicaid Fee Schedule	View Medicaid rates for 13121

National average reimbursement for CPT 13121 by major payers:

$470.68

$538.75

$567.79

$678.58

Compare published rates across providers.

Choose a payer to see a sample of rates for CPT 13121.

CPT 13121

5 of 25 sample ratesHigher to lower in this preview

Brent Taylor
FLMOHS-Micrographic Surgery PhysicianNPI 1316175128Tax ID 47-3011659
$717.97Published rate
Jeaneen Chappell
TXDermatology PhysicianNPI 1497915623Tax ID 75-2286998
$521.36Published rate
Oksana Evans
FLMedical Physician AssistantNPI 1225579618Tax ID 59-3549147
$362.07Published rate
Carly Tanner
FLPhysician AssistantNPI 1033416565Tax ID 59-3549147
$290.79Published rate
Specialty Surgery Partners Center Of Florida, LLC, Alliance Specialty Surgical Center
Specialty Surgery Partners Center Of Florida LLC
FLAmbulatory Surgical Clinic/CenterNPI 1770151722Tax ID 86-3661396
$103.00Published rate

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Summit Women's CareDenver, Colorado

September 2, 2026

Contracting Manager
UnitedHealthcare
Commercial PPO

Re: Request for fee schedule renegotiation

We request a formal review of our Commercial PPO fee schedule. The comparison below summarizes our current rate alongside published rates for comparable Denver-area practices.

Market evidence · CPT 59485

Current rate: $152.40
Market median: $147.00
Market position: 61st percentile

The comparison includes 1,284 published rates from 96 provider groups, scoped to OB/GYN providers in a professional, office-based setting.

We would welcome a discussion of our fee schedule and the supporting July 2026 market analysis. Please let us know a suitable time to review the comparison together.

Sincerely,
Summit Women's Care

This code appears in 1 published specialty market.

Explore state-level rates by specialty

CPT 13121 vs. Other Surgical Procedures on the Integumentary System Codes

The CPT 13121 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 13121 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.

Code	Complexity	Description
12020-CPT	Moderate	Re-Close Surgical Opening, Procedure To Close A Surgical Cut That Has Opened Up. Techniques That May Be Used Include Stitching The Wound Or Inserting A Packing Material For Drainage.
13120-CPT	Moderate	Clean And Stitch Wound, Cleaning And Removal Of Damaged Or Infected Tissue From A Wound On The Scalp Arms Or Legs. The Wound Is Stitched Closed In Layers.
13121-CPT	Moderate	Clean And Stitch Wound, Cleaning And Removal Of Damaged Or Infected Tissue From A Wound On The Scalp Arms Or Legs. The Wound Is Stitched Closed In Layers.
13122-CPT	Low	Cmplx Rpr S A L Addl 5 Cm, Repair 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 13121. These prices vary depending on payer type (Medicare, Medicaid, private insurance), geographic location, and provider contracts.

Understanding the 13121 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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CPT 13121 Fee Schedule

Brent Taylor

Jeaneen Chappell

Oksana Evans

Carly Tanner

Specialty Surgery Partners Center Of Florida, LLC, Alliance Specialty Surgical Center