CPT code 12005: Simple wound repair, 12.6–20.0 cm2026 Medicare rate & RVUs in Metropolitan Boston, MA

In Metropolitan Boston, MA, Medicare pays $237.87 for 12005 in the office and $93.10 when it’s performed in a hospital or facility.

Check a contract rate as a % of Medicare · 12005 nationwide

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

What 12005 covers

This code covers straightforward, one-layer closure of superficial wounds involving the epidermis, dermis, or superficial subcutaneous tissue, without deeper structural repair. The covered sites are the scalp, neck, axillae, external genitalia, and trunk. Emergency clinicians, surgeons, and other qualified practitioners may perform these repairs in an emergency department, office, or outpatient setting. A typical case is a long, uncomplicated laceration of the trunk closed in a single layer.

Select the code using the documented repair length and covered body site. When multiple wounds belong to the same repair category and anatomic grouping, combine their lengths for code selection; document each wound’s location, length, and closure technique. CMS assigns a 0-day global period, so same-day preoperative and postoperative care is included. When other procedures are performed in the same session, the highest-valued procedure is paid in full and other procedures are subject to the standard multiple-procedure reduction. Assistant-at-surgery services are not paid, and co-surgeons and team surgery are not permitted.

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 Metropolitan Boston, MA compares for 12005

Across 109 of 109 payment localities, the office rate for 12005 runs from $185.43 in Arkansas to $270.09 in San Benito County, CA. Metropolitan Boston, MA pays $237.87. The RVUs are the same everywhere; the geographic indexes change the dollars.

Every other payment area

12005 rates by state

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

See 12005 in every payment locality

How the 12005 rate is calculated

Each of 12005’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.

Payment rules and modifiers for 12005

The CMS indicators that decide how 12005 is paid alongside other services.

What modifiers do to the payment

When to use modifier 51

Codes related to 12005

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

How 12005 has changed in Metropolitan Boston, MA

Price 12005 for an earlier date of service

Where the Metropolitan Boston, MA rate applies

Metropolitan Boston, MA is a Medicare payment area, not a city. Our Census mapping connects it to 60 cities and communities in Massachusetts. Some span more than one payment area; confirm with the service ZIP.

• Boston
• Arlington
• Ayer
• Bellingham
• Belmont
• Braintree Town
• Brookline
• Burlington

Browse all communities in Massachusetts

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

Open CMS sourceHow we calculate rates