CPT code 12001: Simple wound repair, 2.5 cm or less2026 Medicare rate & RVUs in Texas
Reports simple closure of a superficial wound 2.5 cm or shorter on the scalp, neck, axilla, external genitalia, trunk, or extremities.
Medicare pays $106.23–$117.94 for 12001 in the office in Texas, from Beaumont, TX to Austin, TX. Which amount applies depends on the service address.
Medicare allowed amount for participating (non-QP) physicians, before deductible, coinsurance and claim adjustments. Not a patient’s bill or a hospital charge.
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On this page 9 sections
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.
Where 12001 pays more and less in Texas
The same RVUs, adjusted for each area’s costs. Open a locality for its calculation, history and nearby areas.
8 payment localities
$106.23 to $117.94
8 of 8 payment localities
| Payment locality | Office | Facility |
|---|---|---|
| Austin, TX | $117.94 | $44.08 |
| Beaumont, TX | $106.23 | $42.70 |
| Brazoria, TX | $112.07 | $42.89 |
| Dallas, TX | $112.97 | $43.44 |
| Fort Worth, TX | $112.24 | $43.41 |
| Galveston, TX | $112.52 | $43.20 |
| Houston, TX | $115.81 | $46.49 |
| Rest of Texas | $109.21 | $42.96 |
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
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.
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
| Rule | CMS value | What it means |
|---|---|---|
| Global period | 000 | Same-day global: pre- and post-op care on the day of the procedure is included. |
| Multiple procedures | 2 | Standard reduction: highest-valued procedure at 100%, others at 50%. |
| Bilateral (modifier 50) | 0 | The 150% bilateral adjustment doesn’t apply. |
| Assistant at surgery (80/81/82/AS) | 1 | Not paid (statutory restriction). |
| Co-surgeons (62) | 0 | Not permitted. |
| Team surgery (66) | 0 | Not permitted. |
| Professional/technical | 0 | Physician 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%).
12001 compared with similar codes
Compare codes · National
4 codes, side by side
How to choose
- 12002Wound repairSimple, 2.6–7.5 cm
- Both describe simple repair in the same anatomic group, but 12002 applies when the total wound length falls in the next length range above 12001.
- 12011Wound repairFace, 2.5 cm or less
- Choose 12011 for the face, ears, eyelids, nose, lips, or mucous membranes; 12001 covers the scalp, neck, axillae, external genitalia, trunk, and extremities.
- 12031Wound repairScalp, trunk, or extremity
- 12031 is for intermediate repair in its anatomic group. Use 12001 for a superficial wound closed with a straightforward single-layer technique.
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
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