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

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 Houston, TX, Medicare pays $216.08 for 12005 in the office and $95.68 when it’s performed in a hospital or facility.

$216.08Office (non-facility)
$95.68Hospital or facility
+2.4%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 Houston, TX
  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 Houston, TX 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. Houston, TX pays $216.08. The RVUs are the same everywhere; the geographic indexes change the dollars.

12005 in Houston, TX vs other payment areas
  1. Houston, TX · this page$216.08
  2. Austin, TX · Texas$217.28+$1.20
  3. Beaumont, TX · Texas$198.14−$17.94
  4. Brazoria, TX · Texas$207.25−$8.83
  5. Dallas, TX · Texas$209.10−$6.98
  6. Fort Worth, TX · Texas$207.96−$8.12
  7. Galveston, TX · Texas$208.21−$7.87

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

Every other payment area

12005 in every other Medicare payment locality
Payment localityOfficeFacility
Rest of TexasTexas$202.94$87.88
Los Angeles, CACalifornia$233.16$89.73
Washington, DC areaDistrict of Columbia$239.78$96.96
Miami, FLFlorida$238.49$112.27
Chicago, ILIllinois$230.80$108.95
Manhattan, NYNew York$245.10$104.21
AlaskaAlaska$245.33$116.20
AlabamaAlabama$188.29$82.20

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 Houston, TX 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

102

Locality
Houston, TX
Physician work
1.008
Practice expense
0.993
Malpractice
1.376
Office calculation for 12005 in Houston, TX
ComponentRVULocality factorAdjusted
Physician work1.92× 1.0081.9354
Practice expense3.97× 0.9933.9422
Malpractice0.43× 1.3760.5917
Total RVUs6.4693
Conversion factor× 33.4009

Office rate, Houston, TX$216.08

Office: (1.92 × 1.008 + 3.97 × 0.993 + 0.43 × 1.376) × $33.4009 = $216.08

Facility: (1.92 × 1.008 + 0.34 × 0.993 + 0.43 × 1.376) × $33.4009 = $95.68

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, Houston, TX
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.$165.78
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.$246.16
12002Wound repair, simple, 2.6–7.5 cmSimple repair at the same general sites for a total length of 2.6–7.5 cm.$141.93
Used instead
12035Wound repair, intermediate, 12.6–20 cmIntermediate repair for a similar length when layered closure is required at covered sites.$420.91
12016Simple wound repair, face group, 12.6–20 cmSimple repair for a similar length on the face, ears, eyelids, nose, lips, or mucous membranes.$274.78

How 12005 has changed in Houston, TX

12005 · Office / nonfacility

$216.08

Effective 2026-10-01

The base rate is $37.98 higher than on 2025-10-01, moving from $178.10 to $216.08 (21.3%).

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

    $178.10changed to$216.08

    • 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
    • Work GPCI 1.014 changed to 1.008
    • Practice expense GPCI 1.003 changed to 0.993
    • Malpractice GPCI 1.409 changed to 1.376

    Held through RVU26B, RVU26C, RVU26D.

  2. January 1, 2025

    RVU25A

    $184.42changed to$178.10

    • 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

    $181.41changed to$184.42

    • Conversion factor 32.7442 changed to 33.2875

    Held through RVU24B, RVU24C, RVU24D.

  4. January 1, 2024

    RVU24A

    $185.02changed to$181.41

    • Conversion factor 33.8872 changed to 32.7442
    • Malpractice RVU 0.37 changed to 0.40
    • Work GPCI 1.023 changed to 1.014
    • Practice expense GPCI 1.016 changed to 1.003
    • Malpractice GPCI 1.154 changed to 1.409

  5. January 1, 2023

    RVU23A

    $186.48changed to$185.02

    • 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
    • Work GPCI 1.032 changed to 1.023
    • Practice expense GPCI 1.029 changed to 1.016
    • Malpractice GPCI 0.900 changed to 1.154

    Held through RVU23B, RVU23C, RVU23D.

  6. January 1, 2022

    RVU22A

    $184.84changed to$186.48

    • 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.

  7. January 1, 2021

    RVU21A

    $178.67changed to$184.84

    • Conversion factor 36.0896 changed to 34.8931
    • Practice expense RVU 2.53 changed to 2.84
    • Work GPCI 1.026 changed to 1.032
    • Practice expense GPCI 1.020 changed to 1.029
    • Malpractice GPCI 0.918 changed to 0.900

    Held through RVU21B, RVU21C, RVU21D.

  8. January 1, 2020

    RVU20A

    $170.88changed to$178.67

    • 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
    • Work GPCI 1.020 changed to 1.026
    • Practice expense GPCI 1.012 changed to 1.020
    • Malpractice GPCI 0.936 changed to 0.918

    Held through RVU20B, RVU20C, RVU20D.

  9. January 1, 2019

    RVU19A

    $168.51changed to$170.88

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

    Held through RVU19B, RVU19C, RVU19D.

  10. January 1, 2018

    RVU18AR1

    $165.63changed to$168.51

    • 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 1.009 changed to 1.012
    • Malpractice GPCI 0.946 changed to 0.936

    Held through RVU18B, RVU18C, RVU18D.

  11. January 1, 2017

    RVU17A

    $165.01changed to$165.63

    • Conversion factor 35.8043 changed to 35.8887
    • Work GPCI 1.019 changed to 1.020
    • Practice expense GPCI 1.006 changed to 1.009
    • Malpractice GPCI 0.955 changed to 0.946

    Held through RVU17B, RVU17C, RVU17D.

  12. January 1, 2016

    RVU16A

    $171.01changed to$165.01

    • 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.

  13. July 1, 2015

    RVU15C

    $170.16changed to$171.01

    • Conversion factor 35.7547 changed to 35.9335

    Held through RVU15D.

  14. January 1, 2015

    RVU15A

    $169.00changed to$170.16

    • 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
    • Work GPCI 1.014 changed to 1.019
    • Practice expense GPCI 1.004 changed to 1.006
    • Malpractice GPCI 0.939 changed to 0.955

    Held through RVU15B.

  15. January 1, 2014

    RVU14A

    $169.70changed to$169.00

    • 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
    • Work GPCI 1.009 changed to 1.014
    • Practice expense GPCI 1.002 changed to 1.004
    • Malpractice GPCI 0.923 changed to 0.939

    Held through RVU14B, RVU14C, RVU14D.

  16. January 1, 2013

    RVU13AR

    Earliest loaded release: $169.70

    Held through RVU13B, RVU13C, RVU13D.

Rates in every CMS release
Effective fromOfficeFacilityCMS release
2026-10-01$216.08$95.68RVU26D
2026-07-01$216.08$95.68RVU26C
2026-04-01$216.08$95.68RVU26B
2026-01-01$216.08$95.68RVU26A
2025-10-01$178.10$97.31RVU25D
2025-07-01$178.10$97.31RVU25C
2025-04-01$178.10$97.31RVU25B
2025-01-01$178.10$97.31RVU25A
2024-10-01$184.42$100.61RVU24D
2024-07-01$184.42$100.61RVU24C
2024-04-01$184.42$100.61RVU24B
2024-03-09$184.42$100.61RVU24AR
2024-01-01$181.41$98.97RVU24A
2023-10-01$185.02$98.94RVU23D
2023-07-01$185.02$98.94RVU23C
2023-04-01$185.02$98.94RVU23B
2023-01-01$185.02$98.94RVU23A
2022-10-01$186.48$98.53RVU22D
2022-07-01$186.48$98.53RVU22C
2022-04-01$186.48$98.53RVU22B
2022-01-01$186.48$98.53RVU22A
2021-10-01$184.84$99.39RVU21D
2021-07-01$184.84$99.39RVU21C
2021-04-01$184.84$99.39RVU21B
2021-01-01$184.84$99.39RVU21A
2020-10-01$178.67$102.10RVU20D
2020-07-01$178.67$102.10RVU20C
2020-04-01$178.67$102.10RVU20B
2020-01-01$178.67$102.10RVU20A
2019-10-01$170.88$98.67RVU19D
2019-07-01$170.88$98.67RVU19C
2019-04-01$170.88$98.67RVU19B
2019-01-01$170.88$98.67RVU19A
2018-10-01$168.51$98.92RVU18D
2018-07-01$168.51$98.92RVU18C
2018-04-01$168.51$98.92RVU18B
2018-01-01$168.51$98.92RVU18AR1
2017-10-01$165.63$99.00RVU17D
2017-07-01$165.63$99.00RVU17C
2017-04-01$165.63$99.00RVU17B
2017-01-01$165.63$99.00RVU17A
2016-10-01$165.01$98.38RVU16D
2016-07-01$165.01$98.38RVU16C
2016-04-01$165.01$98.38RVU16B
2016-01-01$165.01$98.38RVU16A
2015-10-01$171.01$103.05RVU15D
2015-07-01$171.01$103.05RVU15C
2015-04-01$170.16$102.54RVU15B
2015-01-01$170.16$102.54RVU15A
2014-10-01$169.00$103.18RVU14D
2014-07-01$169.00$103.18RVU14C
2014-04-01$169.00$103.18RVU14B
2014-01-01$169.00$103.18RVU14A
2013-10-01$169.70$99.81RVU13D
2013-07-01$169.70$99.81RVU13C
2013-04-01$169.70$99.81RVU13B
2013-01-01$169.70$99.81RVU13AR

Price 12005 for an earlier date of service

Where the Houston, TX rate applies

Houston, TX is a Medicare payment area, not a city. Our Census mapping connects it to 46 cities and communities in Texas. Some span more than one payment area; confirm with the service ZIP.

Browse all communities in Texas

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 Houston, TXGPCI2026.csv, line 102 (RVU26D)

Open CMS sourceHow we calculate rates

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