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CPT code 12005: Simple wound repair, 12.6–20.0 cm2026 Medicare rate & RVUs in Puerto Rico

Reports simple, one-layer closure of superficial wounds on specified body sites when the combined repair length falls between 12.6 and 20.0 cm.

CMS RVU26DEffective Oct 1, 2026One payment locality5.3K Medicare services in 2024

In Puerto Rico, Medicare pays $212.34 for 12005 in the office and $89.76 when it’s performed in a hospital or facility.

$212.34Office (non-facility)
$89.76Hospital or facility
+0.6%vs the national office rate ($211.09)

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.

We’ll open 12005 for the payment locality that covers the ZIP.

On this page 11 sections
  1. Rate in Puerto Rico
  2. What 12005 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 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 Puerto Rico 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. Puerto Rico pays $212.34. The RVUs are the same everywhere; the geographic indexes change the dollars.

12005 in Puerto Rico vs other payment areas
  1. Puerto Rico · this page$212.34
  2. Los Angeles, CA · California$233.16+$20.82
  3. Washington, DC area · District of Columbia$239.78+$27.44
  4. Miami, FL · Florida$238.49+$26.15
  5. Chicago, IL · Illinois$230.80+$18.46
  6. Manhattan, NY · New York$245.10+$32.76
  7. Alaska · Alaska$245.33+$32.99

Other areas in Puerto Rico first, then benchmark localities. Bars start at $0.

Every other payment area

12005 in every other Medicare payment locality
Payment localityOfficeFacility
AlabamaAlabama$188.29$82.20
ArkansasArkansas$185.43$81.28
ArizonaArizona$204.91$87.43
Bakersfield, CACalifornia$219.43$86.54
Chico, CACalifornia$218.25$85.36
El Centro, CACalifornia$218.32$85.44
Fresno, CACalifornia$218.25$85.36
Hanford, CACalifornia$218.25$85.36

12005 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.

$185.43

$245.33

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

View every state and territory as a table
12005 office rate range by state
State / territoryOffice rate rangeLocalities
AK$245.331
AL$188.291
AR$185.431
AZ$204.911
CA$218.25–$270.0929
CO$217.201
CT$225.601
DC$239.781
DE$208.371
FL$212.48–$238.493
GA$199.53–$216.292
GU$223.211
HI$223.211
IA$191.161
ID$192.921
IL$207.64–$230.804
IN$194.031
KS$191.241
KY$195.151
LA$195.24–$205.222
MA$216.23–$237.872
MD$212.15–$239.783
ME$195.06–$204.602
MI$201.41–$216.312
MN$204.831
MO$192.42–$204.763
MS$188.911
MT$211.061
NC$197.021
ND$202.561
NE$191.951
NH$214.741
NJ$227.25–$237.332
NM$202.971
NV$208.831
NY$200.20–$252.575
OH$199.671
OK$193.701
OR$206.30–$223.162
PA$199.43–$220.462
PR$212.341
RI$215.141
SC$198.861
SD$201.561
TN$192.381
TX$198.14–$217.288
UT$201.671
VA$204.62–$239.782
VI$212.341
VT$202.671
WA$215.52–$241.772
WI$195.591
WV$199.911
WY$207.361

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.

How the rate is built · 12005

RVUs × geographic indexes × conversion factor

Office or facility?

Work1.92

1.92 RVUs× 1.000 GPCI

Practice expense3.97

3.97 RVUs× 1.000 GPCI

Malpractice0.43

0.43 RVUs× 1.000 GPCI

Adjusted RVUs

6.3200

Conversion factor

$33.4009

Medicare rate

$211.09

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

The exact Puerto Rico inputs and CMS source lines

PPRRVU2026_Oct_nonQPP.csv

1,399

Code
12005
Physician work
1.92
Practice expense
3.97
Malpractice
0.43

GPCI2026.csv

91

Locality
Puerto Rico
Physician work
1.000
Practice expense
1.011
Malpractice
0.985
Office calculation for 12005 in Puerto Rico
ComponentRVULocality factorAdjusted
Physician work1.92× 1.0001.9200
Practice expense3.97× 1.0114.0137
Malpractice0.43× 0.9850.4235
Total RVUs6.3572
Conversion factor× 33.4009

Office rate, Puerto Rico$212.34

Office: (1.92 × 1 + 3.97 × 1.011 + 0.43 × 0.985) × $33.4009 = $212.34

Facility: (1.92 × 1 + 0.34 × 1.011 + 0.43 × 0.985) × $33.4009 = $89.76

Open 12005 in the RVU calculator

Payment rules and modifiers for 12005

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

CMS payment indicators · 12005

Simple wound repair, 12.6–20.0 cm

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

12005 without 51 · national office

$211.09

Simple wound repair, 12.6–20.0 cm

12005-51 · Second procedure: 50%

$105.55

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 12005

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

Codes related to 12005
CodeHow it relatesOffice range, Puerto Rico
Same family
12004Simple wound repair, nonfacial sites, 7.6–12.5 cmSimple repair at the same general sites for a total length of 7.6–12.5 cm.$162.98
12006Simple wound repair, 20.1–30 cm, specified sitesSimple repair at the same general sites for a total length of 20.1–30.0 cm.$241.50
12002Wound repair, simple, 2.6–7.5 cmSimple repair at the same general sites for a total length of 2.6–7.5 cm.$140.20
Used instead
12035Wound repair, intermediate, 12.6–20 cmIntermediate repair for a similar length when layered closure is required at covered sites.$416.94
12016Simple wound repair, face group, 12.6–20 cmSimple repair for a similar length on the face, ears, eyelids, nose, lips, or mucous membranes.$269.00

How 12005 has changed in Puerto Rico

12005 · Office / nonfacility

$212.34

Effective 2026-10-01

The base rate is $40.14 higher than on 2025-10-01, moving from $172.20 to $212.34 (23.3%).

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

    $172.20changed to$212.34

    • Conversion factor 32.3465 changed to 33.4009
    • Work RVU 1.97 changed to 1.92
    • Practice expense RVU 2.95 changed to 3.97
    • Malpractice RVU 0.39 changed to 0.43
    • Practice expense GPCI 1.007 changed to 1.011
    • Malpractice GPCI 0.982 changed to 0.985

    Held through RVU26B, RVU26C, RVU26D.

  2. January 1, 2025

    RVU25A

    $178.21changed to$172.20

    • Conversion factor 33.2875 changed to 32.3465
    • Practice expense RVU 2.97 changed to 2.95
    • Malpractice RVU 0.40 changed to 0.39

    Held through RVU25B, RVU25C, RVU25D.

  3. March 9, 2024

    RVU24AR

    $175.30changed to$178.21

    • Conversion factor 32.7442 changed to 33.2875

    Held through RVU24B, RVU24C, RVU24D.

  4. January 1, 2024

    RVU24A

    $180.55changed to$175.30

    • Conversion factor 33.8872 changed to 32.7442
    • Malpractice RVU 0.37 changed to 0.40
    • Practice expense GPCI 1.008 changed to 1.007
    • Malpractice GPCI 0.984 changed to 0.982

  5. October 1, 2023

    RVU23D

    $179.94changed to$180.55

    • Practice expense GPCI 1.000 changed to 1.008
    • Malpractice GPCI 1.000 changed to 0.984

  6. January 1, 2023

    RVU23A

    $183.34changed to$179.94

    • Conversion factor 34.6062 changed to 33.8872
    • Practice expense RVU 2.92 changed to 2.97
    • Malpractice RVU 0.39 changed to 0.37
    • Practice expense GPCI 1.008 changed to 1.000
    • Malpractice GPCI 0.986 changed to 1.000

    Held through RVU23B, RVU23C.

  7. January 1, 2022

    RVU22A

    $181.70changed to$183.34

    • Conversion factor 34.8931 changed to 34.6062
    • Practice expense RVU 2.84 changed to 2.92
    • Malpractice RVU 0.38 changed to 0.39

    Held through RVU22B, RVU22C, RVU22D.

  8. January 1, 2021

    RVU21A

    $176.68changed to$181.70

    • Conversion factor 36.0896 changed to 34.8931
    • Practice expense RVU 2.53 changed to 2.84
    • Malpractice GPCI 0.988 changed to 0.986

    Held through RVU21B, RVU21C, RVU21D.

  9. January 1, 2020

    RVU20A

    $169.54changed to$176.68

    • Conversion factor 36.0391 changed to 36.0896
    • Practice expense RVU 2.45 changed to 2.53
    • Malpractice RVU 0.27 changed to 0.38
    • Practice expense GPCI 1.007 changed to 1.008
    • Malpractice GPCI 0.990 changed to 0.988

    Held through RVU20B, RVU20C, RVU20D.

  10. January 1, 2019

    RVU19A

    $167.18changed to$169.54

    • Conversion factor 35.9996 changed to 36.0391
    • Practice expense RVU 2.39 changed to 2.45

    Held through RVU19B, RVU19C, RVU19D.

  11. January 1, 2018

    RVU18AR1

    $148.42changed to$167.18

    • Conversion factor 35.8887 changed to 35.9996
    • Practice expense RVU 2.32 changed to 2.39
    • Malpractice RVU 0.28 changed to 0.27
    • Practice expense GPCI 0.856 changed to 1.007
    • Malpractice GPCI 0.642 changed to 0.990

    Held through RVU18B, RVU18C, RVU18D.

  12. January 1, 2017

    RVU17A

    $132.03changed to$148.42

    • Conversion factor 35.8043 changed to 35.8887
    • Practice expense GPCI 0.705 changed to 0.856
    • Malpractice GPCI 0.293 changed to 0.642

    Held through RVU17B, RVU17C, RVU17D.

  13. January 1, 2016

    RVU16A

    $136.16changed to$132.03

    • Conversion factor 35.9335 changed to 35.8043
    • Practice expense RVU 2.46 changed to 2.32
    • Malpractice RVU 0.29 changed to 0.28

    Held through RVU16B, RVU16C, RVU16D.

  14. July 1, 2015

    RVU15C

    $135.48changed to$136.16

    • Conversion factor 35.7547 changed to 35.9335

    Held through RVU15D.

  15. January 1, 2015

    RVU15A

    $133.42changed to$135.48

    • Conversion factor 35.8228 changed to 35.7547
    • Practice expense RVU 2.41 changed to 2.46
    • Malpractice RVU 0.32 changed to 0.29
    • Practice expense GPCI 0.692 changed to 0.705
    • Malpractice GPCI 0.271 changed to 0.293

    Held through RVU15B.

  16. January 1, 2014

    RVU14A

    $131.87changed to$133.42

    • Conversion factor 34.0230 changed to 35.8228
    • Practice expense RVU 2.69 changed to 2.41
    • Malpractice RVU 0.33 changed to 0.32
    • Practice expense GPCI 0.678 changed to 0.692
    • Malpractice GPCI 0.249 changed to 0.271

    Held through RVU14B, RVU14C, RVU14D.

  17. January 1, 2013

    RVU13AR

    Earliest loaded release: $131.87

    Held through RVU13B, RVU13C, RVU13D.

Rates in every CMS release
Effective fromOfficeFacilityCMS release
2026-10-01$212.34$89.76RVU26D
2026-07-01$212.34$89.76RVU26C
2026-04-01$212.34$89.76RVU26B
2026-01-01$212.34$89.76RVU26A
2025-10-01$172.20$91.09RVU25D
2025-07-01$172.20$91.09RVU25C
2025-04-01$172.20$91.09RVU25B
2025-01-01$172.20$91.09RVU25A
2024-10-01$178.21$94.07RVU24D
2024-07-01$178.21$94.07RVU24C
2024-04-01$178.21$94.07RVU24B
2024-03-09$178.21$94.07RVU24AR
2024-01-01$175.30$92.54RVU24A
2023-10-01$180.55$95.15RVU23D
2023-07-01$179.94$95.22RVU23C
2023-04-01$179.94$95.22RVU23B
2023-01-01$179.94$95.22RVU23A
2022-10-01$183.34$97.18RVU22D
2022-07-01$183.34$97.18RVU22C
2022-04-01$183.34$97.18RVU22B
2022-01-01$183.34$97.18RVU22A
2021-10-01$181.70$97.99RVU21D
2021-07-01$181.70$97.99RVU21C
2021-04-01$181.70$97.99RVU21B
2021-01-01$181.70$97.99RVU21A
2020-10-01$176.68$101.02RVU20D
2020-07-01$176.68$101.02RVU20C
2020-04-01$176.68$101.02RVU20B
2020-01-01$176.68$101.02RVU20A
2019-10-01$169.54$97.69RVU19D
2019-07-01$169.54$97.69RVU19C
2019-04-01$169.54$97.69RVU19B
2019-01-01$169.54$97.69RVU19A
2018-10-01$167.18$97.94RVU18D
2018-07-01$167.18$97.94RVU18C
2018-04-01$167.18$97.94RVU18B
2018-01-01$167.18$97.94RVU18AR1
2017-10-01$148.42$91.90RVU17D
2017-07-01$148.42$91.90RVU17C
2017-04-01$148.42$91.90RVU17B
2017-01-01$148.42$91.90RVU17A
2016-10-01$132.03$85.34RVU16D
2016-07-01$132.03$85.34RVU16C
2016-04-01$132.03$85.34RVU16B
2016-01-01$132.03$85.34RVU16A
2015-10-01$136.16$88.54RVU15D
2015-07-01$136.16$88.54RVU15C
2015-04-01$135.48$88.09RVU15B
2015-01-01$135.48$88.09RVU15A
2014-10-01$133.42$88.06RVU14D
2014-07-01$133.42$88.06RVU14C
2014-04-01$133.42$88.06RVU14B
2014-01-01$133.42$88.06RVU14A
2013-10-01$131.87$84.58RVU13D
2013-07-01$131.87$84.58RVU13C
2013-04-01$131.87$84.58RVU13B
2013-01-01$131.87$84.58RVU13AR

Price 12005 for an earlier date of service

Where the Puerto Rico rate applies

Puerto Rico is a Medicare payment area, not a city. Our Census mapping connects it to 292 cities and communities in Puerto Rico. Some span more than one payment area; confirm with the service ZIP.

  • Aceitunas
  • Adjuntas
  • Aguada
  • Aguadilla
  • Aguas Buenas
  • Aguas Claras
  • Aguilita
  • Aibonito

Browse all communities in Puerto Rico

12005 billing questions

How is this code distinguished from 12004 or 12006?

All three cover simple repairs at the same general body sites. Choose by the documented total repair length: 12004 covers 7.6–12.5 cm, this code covers 12.6–20.0 cm, and 12006 covers 20.1–30.0 cm.

Can the lengths of multiple wounds be combined?

Combine lengths when the wounds are in the same repair category and anatomic grouping. Record the location and length of each wound so the reported total can be supported.

When would 12035 be considered instead?

Consider 12035 for an intermediate repair in its covered sites, such as the scalp, axilla, or trunk, when the wound requires layered closure rather than a simple one-layer repair. The repair method and documented complexity, not length alone, distinguish the codes.

Is modifier 50 appropriate for repairs on both sides?

No. CMS identifies bilateral adjustment as inappropriate for this code; report the repair based on the applicable wound lengths and sites rather than applying modifier 50.

What same-day care is included, and how are other procedures handled?

The 0-day global period includes same-day preoperative and postoperative care. If other procedures are performed in the same session, the highest-valued procedure is paid in full and the others are subject to the standard multiple-procedure reduction.

Can an assistant or additional surgeon be reported for this repair?

Assistant-at-surgery services are not paid for this code. CMS also does not permit co-surgeons or team surgery.

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 12005PPRRVU2026_Oct_nonQPP.csv, line 1,399 (RVU26D)
Geographic factors for Puerto RicoGPCI2026.csv, line 91 (RVU26D)

Open CMS sourceHow we calculate rates

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