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CPT code 12001: Simple wound repair, 2.5 cm or less2026 Medicare rate & RVUs in Washington, DC area

Reports simple closure of a superficial wound 2.5 cm or shorter on the scalp, neck, axilla, external genitalia, trunk, or extremities.

CMS RVU26DEffective Oct 1, 2026One payment locality146.3K Medicare services in 2024

In Washington, DC area, Medicare pays $130.38 for 12001 in the office and $48.15 when it’s performed in a hospital or facility.

$130.38Office (non-facility)
$48.15Hospital or facility
+14.5%vs the national office rate ($113.90)

Check a contract rate as a % of Medicare · 12001 nationwide

Medicare allowed amount for participating (non-QP) physicians, before deductible, coinsurance and claim adjustments. Not a patient’s bill or a hospital charge.

We’ll open 12001 for the payment locality that covers the ZIP.

On this page 11 sections
  1. Rate in Washington, DC area
  2. What 12001 covers
  3. Compared with other areas
  4. Rate map
  5. How it’s calculated
  6. Payment rules
  7. Related codes
  8. Rate history
  9. Where it applies
  10. Billing questions
  11. Sources

What 12001 covers

This service covers straightforward closure of a superficial wound involving the skin and subcutaneous tissue, without significant deeper-structure involvement. A physician or other qualified practitioner may close it in an office, emergency department, or hospital using a single-layer technique such as sutures, staples, or adhesive. The covered locations include the scalp, neck, axillae, external genitalia, trunk, and extremities, including hands and feet.

Select the code by anatomic group and the total length of the qualifying wound or wounds; add lengths of wounds in the same classification. The documented site, measured length, superficial nature, and closure method support the choice. This minor procedure has a 0-day global period, so same-day preoperative and postoperative care is included. In a session with multiple procedures subject to the standard reduction, the highest-valued procedure is paid in full and others at 50%. Modifier 50 is inappropriate. Medicare does not pay an assistant at surgery for this service and does not permit co-surgeon or team-surgery billing.

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.

How Washington, DC area compares for 12001

Across 109 of 109 payment localities, the office rate for 12001 runs from $99.63 in Arkansas to $149.70 in San Benito County, CA. Washington, DC area pays $130.38. The RVUs are the same everywhere; the geographic indexes change the dollars.

12001 in Washington, DC area vs other payment areas
  1. Washington, DC area · this page$130.38
  2. Los Angeles, CA · California$127.73−$2.65
  3. Miami, FL · Florida$126.39−$3.99
  4. Chicago, IL · Illinois$122.28−$8.10
  5. Manhattan, NY · New York$132.21+$1.83
  6. Alaska · Alaska$130.12−$0.26
  7. Alabama · Alabama$101.23−$29.15

Other areas in District of Columbia first, then benchmark localities. Bars start at $0.

Every other payment area

12001 in every other Medicare payment locality
Payment localityOfficeFacility
ArkansasArkansas$99.63$39.67
ArizonaArizona$110.54$42.89
Bakersfield, CACalifornia$119.79$43.28
Chico, CACalifornia$119.30$42.79
El Centro, CACalifornia$119.33$42.82
Fresno, CACalifornia$119.30$42.79
Hanford, CACalifornia$119.30$42.79
Madera, CACalifornia$119.30$42.79

12001 rates by state

Office rate range in each state. Select a state to see its payment localities.

MEWIVTNHMTNDMNMINYMARIWAIDWYSDIAILINOHPANJCTORNVUTCONEMOKYWVVAMDDECAAZNMKSOKARTNNCSCDCTXLAMSALGAFLAKHI

Explore a state

Local rates. Clear comparisons.

Hover or focus a tile to see its rate range. Select it to open the state’s fee schedule.

$99.63

$134.50

Color shows the midpoint of each state’s locality range.

View every state and territory as a table
12001 office rate range by state
State / territoryOffice rate rangeLocalities
AK$130.121
AL$101.231
AR$99.631
AZ$110.541
CA$119.30–$149.7029
CO$118.061
CT$121.911
DC$130.381
DE$112.461
FL$113.38–$126.393
GA$106.36–$116.482
GU$122.391
HI$122.391
IA$103.431
ID$104.291
IL$110.28–$122.284
IN$104.931
KS$103.191
KY$104.451
LA$104.39–$109.972
MA$117.38–$129.972
MD$114.64–$130.383
ME$105.18–$110.952
MI$107.67–$115.202
MN$112.001
MO$102.63–$110.053
MS$101.141
MT$113.891
NC$106.331
ND$110.331
NE$103.961
NH$116.451
NJ$122.98–$128.912
NM$108.421
NV$112.971
NY$108.09–$136.025
OH$106.941
OK$103.941
OR$111.79–$121.732
PA$106.97–$118.852
PR$114.691
RI$116.421
SC$106.881
SD$109.901
TN$103.791
TX$106.23–$117.948
UT$108.451
VA$110.76–$130.382
VI$114.691
VT$110.121
WA$117.08–$132.442
WI$106.361
WV$105.941
WY$112.331

See 12001 in every payment locality

How the 12001 rate is calculated

Each of 12001’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 · 12001

RVUs × geographic indexes × conversion factor

Office or facility?

Work0.82

0.82 RVUs× 1.000 GPCI

Practice expense2.41

2.41 RVUs× 1.000 GPCI

Malpractice0.18

0.18 RVUs× 1.000 GPCI

Adjusted RVUs

3.4100

Conversion factor

$33.4009

Medicare rate

$113.90

Every GPCI starts at 1.000, the national rate. Enter a ZIP or drag a slider.

The exact Washington, DC area inputs and CMS source lines

PPRRVU2026_Oct_nonQPP.csv

1,396

Code
12001
Physician work
0.82
Practice expense
2.41
Malpractice
0.18

GPCI2026.csv

39

Locality
Washington, DC area
Physician work
1.054
Practice expense
1.178
Malpractice
1.113
Office calculation for 12001 in Washington, DC area
ComponentRVULocality factorAdjusted
Physician work0.82× 1.0540.8643
Practice expense2.41× 1.1782.8390
Malpractice0.18× 1.1130.2003
Total RVUs3.9036
Conversion factor× 33.4009

Office rate, Washington, DC area$130.38

Office: (0.82 × 1.054 + 2.41 × 1.178 + 0.18 × 1.113) × $33.4009 = $130.38

Facility: (0.82 × 1.054 + 0.32 × 1.178 + 0.18 × 1.113) × $33.4009 = $48.15

Open 12001 in the RVU calculator

Payment rules and modifiers for 12001

The CMS indicators that decide how 12001 is paid alongside other services.

CMS payment indicators · 12001

Simple wound repair, 2.5 cm or less

RuleCMS valueWhat it means
Global period000Same-day global: pre- and post-op care on the day of the procedure is included.
Multiple procedures2Standard reduction: highest-valued procedure at 100%, others at 50%.
Bilateral (modifier 50)0The 150% bilateral adjustment doesn’t apply.
Assistant at surgery (80/81/82/AS)1Not paid (statutory restriction).
Co-surgeons (62)0Not permitted.
Team surgery (66)0Not permitted.
Professional/technical0Physician service: no professional/technical split.

What modifiers do to the payment

Modifier 51 · payment effect

With and without the modifier

12001 without 51 · national office

$113.90

Simple wound repair, 2.5 cm or less

12001-51 · Second procedure: 50%

$56.95

When this isn’t the highest-valued procedure in the session, Medicare pays 50% of its fee schedule amount (the highest is paid at 100%).

When to use modifier 51

Codes related to 12001

Related codes aren’t interchangeable: bill the code that matches the service performed.

Codes related to 12001
CodeHow it relatesOffice range, Washington, DC area
Same family
12002Wound repair, simple, 2.6–7.5 cmSimple repair in the same anatomic group for a longer total wound length.$158.96
Used instead
12011Wound repair, face, 2.5 cm or lessSimple repair for the separate face, ears, eyelids, nose, lips, or mucous membrane group.$159.66
12031Wound repair, scalp, trunk, or extremityIntermediate repair in a related anatomic group when the closure requires greater complexity.$297.54
12041Intermediate repair, neck, hands, feet, genitalia, 2.5 cm or lessIntermediate repair for neck, hands, feet, or external genitalia when greater repair complexity is required.$300.62

How 12001 has changed in Washington, DC area

12001 · Office / nonfacility

$130.38

Effective 2026-10-01

The base rate is $25.44 higher than on 2025-10-01, moving from $104.94 to $130.38 (24.2%).

It is unchanged from the immediately preceding available release, effective 2026-07-01.

Base rate by release · bars start at $0 · select a bar to compare

One bar per available release, ordered by effective date. Missing rates remain gaps. These comparisons hold the code, setting and locality identifiers constant; they do not isolate which policy or input caused a change.

What changed, release by release

  1. January 1, 2026

    RVU26A

    $104.94changed to$130.38

    • Conversion factor 32.3465 changed to 33.4009
    • Work RVU 0.84 changed to 0.82
    • Practice expense RVU 1.82 changed to 2.41
    • Malpractice RVU 0.16 changed to 0.18
    • Work GPCI 1.057 changed to 1.054
    • Practice expense GPCI 1.192 changed to 1.178
    • Malpractice GPCI 1.168 changed to 1.113

    Held through RVU26B, RVU26C, RVU26D.

  2. January 1, 2025

    RVU25A

    $108.78changed to$104.94

    • Conversion factor 33.2875 changed to 32.3465
    • Practice expense RVU 1.84 changed to 1.82

    Held through RVU25B, RVU25C, RVU25D.

  3. March 9, 2024

    RVU24AR

    $107.01changed to$108.78

    • Conversion factor 32.7442 changed to 33.2875

    Held through RVU24B, RVU24C, RVU24D.

  4. January 1, 2024

    RVU24A

    $112.02changed to$107.01

    • Conversion factor 33.8872 changed to 32.7442
    • Practice expense RVU 1.82 changed to 1.84
    • Malpractice RVU 0.17 changed to 0.16
    • Work GPCI 1.056 changed to 1.057
    • Practice expense GPCI 1.214 changed to 1.192
    • Malpractice GPCI 1.231 changed to 1.168

  5. January 1, 2023

    RVU23A

    $114.82changed to$112.02

    • Conversion factor 34.6062 changed to 33.8872
    • Practice expense RVU 1.79 changed to 1.82
    • Work GPCI 1.054 changed to 1.056
    • Practice expense GPCI 1.236 changed to 1.214
    • Malpractice GPCI 1.294 changed to 1.231

    Held through RVU23B, RVU23C, RVU23D.

  6. January 1, 2022

    RVU22A

    $114.00changed to$114.82

    • Conversion factor 34.8931 changed to 34.6062
    • Practice expense RVU 1.77 changed to 1.79
    • Malpractice RVU 0.15 changed to 0.17

    Held through RVU22B, RVU22C, RVU22D.

  7. January 1, 2021

    RVU21A

    $108.78changed to$114.00

    • Conversion factor 36.0896 changed to 34.8931
    • Practice expense RVU 1.59 changed to 1.77
    • Work GPCI 1.049 changed to 1.054
    • Practice expense GPCI 1.221 changed to 1.236
    • Malpractice GPCI 1.277 changed to 1.294

    Held through RVU21B, RVU21C, RVU21D.

  8. January 1, 2020

    RVU20A

    $105.25changed to$108.78

    • Conversion factor 36.0391 changed to 36.0896
    • Practice expense RVU 1.58 changed to 1.59
    • Malpractice RVU 0.11 changed to 0.15
    • Work GPCI 1.045 changed to 1.049
    • Practice expense GPCI 1.205 changed to 1.221
    • Malpractice GPCI 1.261 changed to 1.277

    Held through RVU20B, RVU20C, RVU20D.

  9. January 1, 2019

    RVU19A

    $107.74changed to$105.25

    • Conversion factor 35.9996 changed to 36.0391
    • Practice expense RVU 1.64 changed to 1.58

    Held through RVU19B, RVU19C, RVU19D.

  10. January 1, 2018

    RVU18AR1

    $105.37changed to$107.74

    • Conversion factor 35.8887 changed to 35.9996
    • Practice expense RVU 1.59 changed to 1.64
    • Work GPCI 1.048 changed to 1.045
    • Malpractice GPCI 1.271 changed to 1.261

    Held through RVU18B, RVU18C, RVU18D.

  11. January 1, 2017

    RVU17A

    $104.39changed to$105.37

    • Conversion factor 35.8043 changed to 35.8887
    • Practice expense RVU 1.57 changed to 1.59
    • Work GPCI 1.051 changed to 1.048
    • Malpractice GPCI 1.280 changed to 1.271

    Held through RVU17B, RVU17C, RVU17D.

  12. January 1, 2016

    RVU16A

    $105.20changed to$104.39

    • Conversion factor 35.9335 changed to 35.8043
    • Practice expense RVU 1.58 changed to 1.57

    Held through RVU16B, RVU16C, RVU16D.

  13. July 1, 2015

    RVU15C

    $104.67changed to$105.20

    • Conversion factor 35.7547 changed to 35.9335

    Held through RVU15D.

  14. January 1, 2015

    RVU15A

    $103.95changed to$104.67

    • Conversion factor 35.8228 changed to 35.7547
    • Practice expense RVU 1.55 changed to 1.58
    • Malpractice RVU 0.13 changed to 0.11
    • Work GPCI 1.050 changed to 1.051
    • Practice expense GPCI 1.202 changed to 1.205
    • Malpractice GPCI 1.205 changed to 1.280

    Held through RVU15B.

  15. January 1, 2014

    RVU14A

    $106.28changed to$103.95

    • Conversion factor 34.0230 changed to 35.8228
    • Practice expense RVU 1.74 changed to 1.55
    • Malpractice RVU 0.14 changed to 0.13
    • Work GPCI 1.049 changed to 1.050
    • Practice expense GPCI 1.198 changed to 1.202
    • Malpractice GPCI 1.130 changed to 1.205

    Held through RVU14B, RVU14C, RVU14D.

  16. January 1, 2013

    RVU13AR

    Earliest loaded release: $106.28

    Held through RVU13B, RVU13C, RVU13D.

Rates in every CMS release
Effective fromOfficeFacilityCMS release
2026-10-01$130.38$48.15RVU26D
2026-07-01$130.38$48.15RVU26C
2026-04-01$130.38$48.15RVU26B
2026-01-01$130.38$48.15RVU26A
2025-10-01$104.94$47.87RVU25D
2025-07-01$104.94$47.87RVU25C
2025-04-01$104.94$47.87RVU25B
2025-01-01$104.94$47.87RVU25A
2024-10-01$108.78$49.27RVU24D
2024-07-01$108.78$49.27RVU24C
2024-04-01$108.78$49.27RVU24B
2024-03-09$108.78$49.27RVU24AR
2024-01-01$107.01$48.46RVU24A
2023-10-01$112.02$50.73RVU23D
2023-07-01$112.02$50.73RVU23C
2023-04-01$112.02$50.73RVU23B
2023-01-01$112.02$50.73RVU23A
2022-10-01$114.82$51.94RVU22D
2022-07-01$114.82$51.94RVU22C
2022-04-01$114.82$51.94RVU22B
2022-01-01$114.82$51.94RVU22A
2021-10-01$114.00$51.04RVU21D
2021-07-01$114.00$51.04RVU21C
2021-04-01$114.00$51.04RVU21B
2021-01-01$114.00$51.04RVU21A
2020-10-01$108.78$52.37RVU20D
2020-07-01$108.78$52.37RVU20C
2020-04-01$108.78$52.37RVU20B
2020-01-01$108.78$52.37RVU20A
2019-10-01$105.25$50.53RVU19D
2019-07-01$105.25$50.53RVU19C
2019-04-01$105.25$50.53RVU19B
2019-01-01$105.25$50.53RVU19A
2018-10-01$107.74$50.48RVU18D
2018-07-01$107.74$50.48RVU18C
2018-04-01$107.74$50.48RVU18B
2018-01-01$107.74$50.48RVU18AR1
2017-10-01$105.37$50.45RVU17D
2017-07-01$105.37$50.45RVU17C
2017-04-01$105.37$50.45RVU17B
2017-01-01$105.37$50.45RVU17A
2016-10-01$104.39$50.46RVU16D
2016-07-01$104.39$50.46RVU16C
2016-04-01$104.39$50.46RVU16B
2016-01-01$104.39$50.46RVU16A
2015-10-01$105.20$50.64RVU15D
2015-07-01$105.20$50.64RVU15C
2015-04-01$104.67$50.39RVU15B
2015-01-01$104.67$50.39RVU15A
2014-10-01$103.95$50.99RVU14D
2014-07-01$103.95$50.99RVU14C
2014-04-01$103.95$50.99RVU14B
2014-01-01$103.95$50.99RVU14A
2013-10-01$106.28$49.22RVU13D
2013-07-01$106.28$49.22RVU13C
2013-04-01$106.28$49.22RVU13B
2013-01-01$106.28$49.22RVU13AR

Price 12001 for an earlier date of service

Where the Washington, DC area rate applies

Washington, DC area is a Medicare payment area, not a city. Our Census mapping connects it to 1 cities and communities in District of Columbia. Some span more than one payment area; confirm with the service ZIP.

  • Washington

Browse all communities in District of Columbia

12001 billing questions

How is 12001 distinguished from 12002?

Both cover simple repair in the same anatomic group. Choose 12001 when the applicable total wound length is 2.5 cm or less; 12002 is for the next length range.

Can lengths of multiple wounds be combined?

Yes. Add the lengths of wounds in the same classification and select the code for their total length. Document each wound's site and measured length.

When is 12001 preferable to 12011?

Use 12001 for the scalp, neck, axillae, external genitalia, trunk, or extremities. The 12011 family is for repairs in its separate face, ears, eyelids, nose, lips, or mucous membrane group.

What supports reporting a simple repair rather than an intermediate repair?

Document a superficial wound and straightforward single-layer closure. A repair requiring layered closure or involving deeper structures may fit an intermediate-repair code instead.

Should modifier 50 be added for wounds on both sides?

No. CMS identifies bilateral adjustment as inappropriate for this code; report the qualifying repairs based on their anatomic classification and total length.

How does the multiple-procedure reduction affect 12001?

When multiple procedures subject to the standard reduction are performed in the same session, the highest-valued procedure is paid in full and the others at 50%. Same-day preoperative and postoperative care is included in this code's 0-day global period.

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
RVUs for 12001PPRRVU2026_Oct_nonQPP.csv, line 1,396 (RVU26D)
Geographic factors for Washington, DC areaGPCI2026.csv, line 39 (RVU26D)

Open CMS sourceHow we calculate rates

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