CPT code 12011: Wound repair, face, 2.5 cm or less2026 Medicare rate & RVUs

Medicare pays $139.62 for 12011 nationally in the office and $54.44 in a hospital or facility. Local office rates run $122.19–$182.83.

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

What 12011 covers

This code describes simple closure of a superficial wound involving the face, ears, eyelids, nose, lips, or mucous membranes. The repair is generally a single-layer closure of skin or mucosal edges, such as a small facial laceration closed with sutures or tissue adhesive. Emergency clinicians, primary care practitioners, and surgeons commonly perform these repairs in emergency departments, offices, and urgent care settings.

Choose the code based on the wound’s location, repair complexity, and documented length. Record the site, length, depth, and closure method; combine lengths of simple repairs in the same anatomic grouping when selecting the length level. A layered closure or repair requiring more than simple closure may call for an intermediate repair code. The 0-day global period includes same-day preoperative and postoperative care. When multiple procedures occur in one session, the highest-valued procedure is paid in full and others at 50%. Modifier 50 is inappropriate; assistant-at-surgery payment is restricted, and co-surgery 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.

Where 12011 pays more and less

The same RVUs, adjusted for each area’s costs. Open a locality for its calculation, history and nearby areas.

109 of 109 payment localities

12011 rates by state

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

How the 12011 rate is calculated

Each of 12011’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 12011

The CMS indicators that decide how 12011 is paid alongside other services.

What modifiers do to the payment

When to use modifier 51

12011 compared with similar codes

How to choose

12013Wound repairFace-area, 2.6–5.0 cm

Both describe simple repair in the same anatomic group. Choose 12011 for a repaired length of 2.5 cm or less and 12013 for the next length level.

12001Simple wound repair2.5 cm or less

This code is for simple repairs of the face and related sites. Code 12001 covers specified scalp, neck, axilla, genital, trunk, and extremity sites instead.

12031Wound repairScalp, trunk, or extremity

12011 describes simple superficial closure. Consider 12031 when the documented repair is intermediate in complexity and its anatomic site and length fit that code.

Codes related to 12011

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

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