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CPT code 12001: Simple wound repair, 2.5 cm or less2026 Medicare rate & RVUs in Queens, NY

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 Queens, NY, Medicare pays $132.96 for 12001 in the office and $50.44 when it’s performed in a hospital or facility.

$132.96Office (non-facility)
$50.44Hospital or facility
+16.7%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 Queens, NY
  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 Queens, NY 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. Queens, NY pays $132.96. The RVUs are the same everywhere; the geographic indexes change the dollars.

12001 in Queens, NY vs other payment areas
  1. Queens, NY · this page$132.96
  2. Manhattan, NY · New York$132.21−$0.75
  3. NYC suburbs and Long Island, NY · New York$136.02+$3.06
  4. Poughkeepsie and northern NYC suburbs, NY · New York$124.04−$8.92
  5. Rest of New York · New York$108.09−$24.87
  6. Los Angeles, CA · California$127.73−$5.23
  7. Washington, DC area · District of Columbia$130.38−$2.58

Other areas in New York first, then benchmark localities. Bars start at $0.

Every other payment area

12001 in every other Medicare payment locality
Payment localityOfficeFacility
Miami, FLFlorida$126.39$53.72
Chicago, ILIllinois$122.28$52.12
AlaskaAlaska$130.12$55.78
AlabamaAlabama$101.23$40.14
ArkansasArkansas$99.63$39.67
ArizonaArizona$110.54$42.89
Bakersfield, CACalifornia$119.79$43.28
Chico, 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 Queens, NY 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

81

Locality
Queens, NY
Physician work
1.064
Practice expense
1.182
Malpractice
1.442
Office calculation for 12001 in Queens, NY
ComponentRVULocality factorAdjusted
Physician work0.82× 1.0640.8725
Practice expense2.41× 1.1822.8486
Malpractice0.18× 1.4420.2596
Total RVUs3.9807
Conversion factor× 33.4009

Office rate, Queens, NY$132.96

Office: (0.82 × 1.064 + 2.41 × 1.182 + 0.18 × 1.442) × $33.4009 = $132.96

Facility: (0.82 × 1.064 + 0.32 × 1.182 + 0.18 × 1.442) × $33.4009 = $50.44

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, Queens, NY
Same family
12002Wound repair, simple, 2.6–7.5 cmSimple repair in the same anatomic group for a longer total wound length.$162.34
Used instead
12011Wound repair, face, 2.5 cm or lessSimple repair for the separate face, ears, eyelids, nose, lips, or mucous membrane group.$162.92
12031Wound repair, scalp, trunk, or extremityIntermediate repair in a related anatomic group when the closure requires greater complexity.$301.47
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.$304.80

How 12001 has changed in Queens, NY

12001 · Office / nonfacility

$132.96

Effective 2026-10-01

The base rate is $26.11 higher than on 2025-10-01, moving from $106.85 to $132.96 (24.4%).

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

    $106.85changed to$132.96

    • 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 1.065 changed to 1.064
    • Practice expense GPCI 1.195 changed to 1.182
    • Malpractice GPCI 1.462 changed to 1.442

    Held through RVU26B, RVU26C, RVU26D.

  2. January 1, 2025

    RVU25A

    $110.76changed to$106.85

    • 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

    $108.95changed to$110.76

    • Conversion factor 32.7442 changed to 33.2875

    Held through RVU24B, RVU24C, RVU24D.

  4. January 1, 2024

    RVU24A

    $116.82changed to$108.95

    • 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 1.061 changed to 1.065
    • Practice expense GPCI 1.212 changed to 1.195
    • Malpractice GPCI 2.061 changed to 1.462

  5. January 1, 2023

    RVU23A

    $122.42changed to$116.82

    • Conversion factor 34.6062 changed to 33.8872
    • Practice expense RVU 1.79 changed to 1.82
    • Work GPCI 1.056 changed to 1.061
    • Practice expense GPCI 1.228 changed to 1.212
    • Malpractice GPCI 2.661 changed to 2.061

    Held through RVU23B, RVU23C, RVU23D.

  6. January 1, 2022

    RVU22A

    $120.72changed to$122.42

    • 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

    $114.56changed to$120.72

    • Conversion factor 36.0896 changed to 34.8931
    • Practice expense RVU 1.59 changed to 1.77
    • Work GPCI 1.054 changed to 1.056
    • Practice expense GPCI 1.214 changed to 1.228
    • Malpractice GPCI 2.391 changed to 2.661

    Held through RVU21B, RVU21C, RVU21D.

  8. January 1, 2020

    RVU20A

    $108.59changed to$114.56

    • 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 1.052 changed to 1.054
    • Practice expense GPCI 1.200 changed to 1.214
    • Malpractice GPCI 2.121 changed to 2.391

    Held through RVU20B, RVU20C, RVU20D.

  9. January 1, 2019

    RVU19A

    $111.06changed to$108.59

    • 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

    $108.68changed to$111.06

    • Conversion factor 35.8887 changed to 35.9996
    • Practice expense RVU 1.59 changed to 1.64
    • Malpractice GPCI 2.151 changed to 2.121

    Held through RVU18B, RVU18C, RVU18D.

  11. January 1, 2017

    RVU17A

    $107.63changed to$108.68

    • Conversion factor 35.8043 changed to 35.8887
    • Practice expense RVU 1.57 changed to 1.59
    • Practice expense GPCI 1.199 changed to 1.200
    • Malpractice GPCI 2.181 changed to 2.151

    Held through RVU17B, RVU17C, RVU17D.

  12. January 1, 2016

    RVU16A

    $108.45changed to$107.63

    • 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

    $107.91changed to$108.45

    • Conversion factor 35.7547 changed to 35.9335

    Held through RVU15D.

  14. January 1, 2015

    RVU15A

    $106.82changed to$107.91

    • 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 1.057 changed to 1.052
    • Practice expense GPCI 1.197 changed to 1.199
    • Malpractice GPCI 1.836 changed to 2.181

    Held through RVU15B.

  15. January 1, 2014

    RVU14A

    $108.20changed to$106.82

    • 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 1.062 changed to 1.057
    • Practice expense GPCI 1.195 changed to 1.197
    • Malpractice GPCI 1.491 changed to 1.836

    Held through RVU14B, RVU14C, RVU14D.

  16. January 1, 2013

    RVU13AR

    Earliest loaded release: $108.20

    Held through RVU13B, RVU13C, RVU13D.

Rates in every CMS release
Effective fromOfficeFacilityCMS release
2026-10-01$132.96$50.44RVU26D
2026-07-01$132.96$50.44RVU26C
2026-04-01$132.96$50.44RVU26B
2026-01-01$132.96$50.44RVU26A
2025-10-01$106.85$49.65RVU25D
2025-07-01$106.85$49.65RVU25C
2025-04-01$106.85$49.65RVU25B
2025-01-01$106.85$49.65RVU25A
2024-10-01$110.76$51.09RVU24D
2024-07-01$110.76$51.09RVU24C
2024-04-01$110.76$51.09RVU24B
2024-03-09$110.76$51.09RVU24AR
2024-01-01$108.95$50.26RVU24A
2023-10-01$116.82$55.63RVU23D
2023-07-01$116.82$55.63RVU23C
2023-04-01$116.82$55.63RVU23B
2023-01-01$116.82$55.63RVU23A
2022-10-01$122.42$59.95RVU22D
2022-07-01$122.42$59.95RVU22C
2022-04-01$122.42$59.95RVU22B
2022-01-01$122.42$59.95RVU22A
2021-10-01$120.72$58.16RVU21D
2021-07-01$120.72$58.16RVU21C
2021-04-01$120.72$58.16RVU21B
2021-01-01$120.72$58.16RVU21A
2020-10-01$114.56$58.48RVU20D
2020-07-01$114.56$58.48RVU20C
2020-04-01$114.56$58.48RVU20B
2020-01-01$114.56$58.48RVU20A
2019-10-01$108.59$54.09RVU19D
2019-07-01$108.59$54.09RVU19C
2019-04-01$108.59$54.09RVU19B
2019-01-01$108.59$54.09RVU19A
2018-10-01$111.06$54.04RVU18D
2018-07-01$111.06$54.04RVU18C
2018-04-01$111.06$54.04RVU18B
2018-01-01$111.06$54.04RVU18AR1
2017-10-01$108.68$53.99RVU17D
2017-07-01$108.68$53.99RVU17C
2017-04-01$108.68$53.99RVU17B
2017-01-01$108.68$53.99RVU17A
2016-10-01$107.63$53.97RVU16D
2016-07-01$107.63$53.97RVU16C
2016-04-01$107.63$53.97RVU16B
2016-01-01$107.63$53.97RVU16A
2015-10-01$108.45$54.16RVU15D
2015-07-01$108.45$54.16RVU15C
2015-04-01$107.91$53.89RVU15B
2015-01-01$107.91$53.89RVU15A
2014-10-01$106.82$54.08RVU14D
2014-07-01$106.82$54.08RVU14C
2014-04-01$106.82$54.08RVU14B
2014-01-01$106.82$54.08RVU14A
2013-10-01$108.20$51.28RVU13D
2013-07-01$108.20$51.28RVU13C
2013-04-01$108.20$51.28RVU13B
2013-01-01$108.20$51.28RVU13AR

Price 12001 for an earlier date of service

Where the Queens, NY rate applies

Queens, NY is a Medicare payment area, not a city. Our Census mapping connects it to 1 cities and communities in New York. Some span more than one payment area; confirm with the service ZIP.

Browse all communities in New York

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 Queens, NYGPCI2026.csv, line 81 (RVU26D)

Open CMS sourceHow we calculate rates

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