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

Reports simple, superficial wound closure on the face or related sites when the repaired length is 2.5 cm or less.

CMS RVU26DEffective Oct 1, 2026One payment locality80.7K Medicare services in 2024

In Puerto Rico, Medicare pays $140.57 for 12011 in the office and $54.46 when it’s performed in a hospital or facility.

$140.57Office (non-facility)
$54.46Hospital or facility
+0.7%vs the national office rate ($139.62)

Check a contract rate as a % of Medicare · 12011 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 12011 for the payment locality that covers the ZIP.

On this page 11 sections
  1. Rate in Puerto Rico
  2. What 12011 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 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.

How Puerto Rico compares for 12011

Across 109 of 109 payment localities, the office rate for 12011 runs from $122.19 in Arkansas to $182.83 in San Benito County, CA. Puerto Rico pays $140.57. The RVUs are the same everywhere; the geographic indexes change the dollars.

12011 in Puerto Rico vs other payment areas
  1. Puerto Rico · this page$140.57
  2. Los Angeles, CA · California$156.25+$15.68
  3. Washington, DC area · District of Columbia$159.66+$19.09
  4. Miami, FL · Florida$155.35+$14.78
  5. Chicago, IL · Illinois$150.29+$9.72
  6. Manhattan, NY · New York$162.09+$21.52
  7. Alaska · Alaska$159.85+$19.28

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

Every other payment area

12011 in every other Medicare payment locality
Payment localityOfficeFacility
AlabamaAlabama$124.13$49.61
ArkansasArkansas$122.19$49.02
ArizonaArizona$135.50$52.96
Bakersfield, CACalifornia$146.60$53.25
Chico, CACalifornia$145.97$52.62
El Centro, CACalifornia$146.01$52.66
Fresno, CACalifornia$145.97$52.62
Hanford, CACalifornia$145.97$52.62

12011 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.

$122.19

$164.40

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

View every state and territory as a table
12011 office rate range by state
State / territoryOffice rate rangeLocalities
AK$159.851
AL$124.131
AR$122.191
AZ$135.501
CA$145.97–$182.8329
CO$144.571
CT$149.411
DC$159.661
DE$137.851
FL$139.20–$155.353
GA$130.59–$142.822
GU$149.701
HI$149.701
IA$126.721
ID$127.791
IL$135.48–$150.294
IN$128.571
KS$126.471
KY$128.171
LA$128.12–$134.932
MA$143.76–$159.052
MD$140.50–$159.663
ME$128.94–$135.912
MI$132.15–$141.482
MN$137.031
MO$126.00–$134.973
MS$124.101
MT$139.601
NC$130.331
ND$135.051
NE$127.351
NH$142.641
NJ$150.69–$157.882
NM$133.091
NV$138.431
NY$132.47–$166.795
OH$131.221
OK$127.501
OR$136.95–$148.992
PA$131.22–$145.712
PR$140.571
RI$142.651
SC$131.081
SD$134.511
TN$127.211
TX$130.32–$144.458
UT$133.001
VA$135.70–$159.662
VI$140.571
VT$134.851
WA$143.38–$162.012
WI$130.221
WV$130.191
WY$137.621

See 12011 in every payment locality

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.

How the rate is built · 12011

RVUs × geographic indexes × conversion factor

Office or facility?

Work1.04

1.04 RVUs× 1.000 GPCI

Practice expense2.91

2.91 RVUs× 1.000 GPCI

Malpractice0.23

0.23 RVUs× 1.000 GPCI

Adjusted RVUs

4.1800

Conversion factor

$33.4009

Medicare rate

$139.62

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

1,403

Code
12011
Physician work
1.04
Practice expense
2.91
Malpractice
0.23

GPCI2026.csv

91

Locality
Puerto Rico
Physician work
1.000
Practice expense
1.011
Malpractice
0.985
Office calculation for 12011 in Puerto Rico
ComponentRVULocality factorAdjusted
Physician work1.04× 1.0001.0400
Practice expense2.91× 1.0112.9420
Malpractice0.23× 0.9850.2266
Total RVUs4.2086
Conversion factor× 33.4009

Office rate, Puerto Rico$140.57

Office: (1.04 × 1 + 2.91 × 1.011 + 0.23 × 0.985) × $33.4009 = $140.57

Facility: (1.04 × 1 + 0.36 × 1.011 + 0.23 × 0.985) × $33.4009 = $54.46

Open 12011 in the RVU calculator

Payment rules and modifiers for 12011

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

CMS payment indicators · 12011

Wound repair, face, 2.5 cm or less

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

12011 without 51 · national office

$139.62

Wound repair, face, 2.5 cm or less

12011-51 · Second procedure: 50%

$69.81

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 12011

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

Codes related to 12011
CodeHow it relatesOffice range, Puerto Rico
Same family
12013Wound repair, face-area, 2.6–5.0 cmSimple repair in the same anatomic group for a longer wound.$146.56
12014Wound repair, facial sites, 5.1–7.5 cmSimple repair in the same anatomic group at a higher length level.$173.37
Used instead
12001Simple wound repair, 2.5 cm or lessSimple repair for specified scalp, neck, axilla, genital, trunk, or extremity sites.$114.69
12031Wound repair, scalp, trunk, or extremityIntermediate repair for specified sites when closure complexity is greater.$261.80

How 12011 has changed in Puerto Rico

12011 · Office / nonfacility

$140.57

Effective 2026-10-01

The base rate is $31.21 higher than on 2025-10-01, moving from $109.36 to $140.57 (28.5%).

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

    $109.36changed to$140.57

    • Conversion factor 32.3465 changed to 33.4009
    • Work RVU 1.07 changed to 1.04
    • Practice expense RVU 2.09 changed to 2.91
    • Malpractice RVU 0.21 changed to 0.23
    • 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

    $112.88changed to$109.36

    • Conversion factor 33.2875 changed to 32.3465
    • Practice expense RVU 2.10 changed to 2.09

    Held through RVU25B, RVU25C, RVU25D.

  3. March 9, 2024

    RVU24AR

    $111.03changed to$112.88

    • Conversion factor 32.7442 changed to 33.2875

    Held through RVU24B, RVU24C, RVU24D.

  4. January 1, 2024

    RVU24A

    $115.00changed to$111.03

    • Conversion factor 33.8872 changed to 32.7442
    • Practice expense RVU 2.11 changed to 2.10
    • Malpractice RVU 0.20 changed to 0.21
    • Practice expense GPCI 1.008 changed to 1.007
    • Malpractice GPCI 0.984 changed to 0.982

  5. October 1, 2023

    RVU23D

    $114.54changed to$115.00

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

  6. January 1, 2023

    RVU23A

    $116.40changed to$114.54

    • Conversion factor 34.6062 changed to 33.8872
    • Practice expense RVU 2.07 changed to 2.11
    • Malpractice RVU 0.21 changed to 0.20
    • 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

    $117.02changed to$116.40

    • Conversion factor 34.8931 changed to 34.6062
    • Practice expense RVU 2.06 changed to 2.07

    Held through RVU22B, RVU22C, RVU22D.

  8. January 1, 2021

    RVU21A

    $114.13changed to$117.02

    • Conversion factor 36.0896 changed to 34.8931
    • Practice expense RVU 1.87 changed to 2.06
    • Malpractice GPCI 0.988 changed to 0.986

    Held through RVU21B, RVU21C, RVU21D.

  9. January 1, 2020

    RVU20A

    $111.78changed to$114.13

    • Conversion factor 36.0391 changed to 36.0896
    • Practice expense RVU 1.88 changed to 1.87
    • Malpractice RVU 0.14 changed to 0.21
    • 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

    $114.20changed to$111.78

    • Conversion factor 35.9996 changed to 36.0391
    • Practice expense RVU 1.95 changed to 1.88

    Held through RVU19B, RVU19C, RVU19D.

  11. January 1, 2018

    RVU18AR1

    $99.61changed to$114.20

    • Conversion factor 35.8887 changed to 35.9996
    • Practice expense RVU 1.88 changed to 1.95
    • Malpractice RVU 0.15 changed to 0.14
    • 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

    $87.09changed to$99.61

    • Conversion factor 35.8043 changed to 35.8887
    • Practice expense RVU 1.87 changed to 1.88
    • 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

    $87.65changed to$87.09

    • Conversion factor 35.9335 changed to 35.8043
    • Practice expense RVU 1.88 changed to 1.87

    Held through RVU16B, RVU16C, RVU16D.

  14. July 1, 2015

    RVU15C

    $87.22changed to$87.65

    • Conversion factor 35.7547 changed to 35.9335

    Held through RVU15D.

  15. January 1, 2015

    RVU15A

    $85.44changed to$87.22

    • Conversion factor 35.8228 changed to 35.7547
    • Practice expense RVU 1.83 changed to 1.88
    • Malpractice RVU 0.18 changed to 0.15
    • 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

    $85.53changed to$85.44

    • Conversion factor 34.0230 changed to 35.8228
    • Practice expense RVU 2.06 changed to 1.83
    • Malpractice RVU 0.19 changed to 0.18
    • 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: $85.53

    Held through RVU13B, RVU13C, RVU13D.

Rates in every CMS release
Effective fromOfficeFacilityCMS release
2026-10-01$140.57$54.46RVU26D
2026-07-01$140.57$54.46RVU26C
2026-04-01$140.57$54.46RVU26B
2026-01-01$140.57$54.46RVU26A
2025-10-01$109.36$53.98RVU25D
2025-07-01$109.36$53.98RVU25C
2025-04-01$109.36$53.98RVU25B
2025-01-01$109.36$53.98RVU25A
2024-10-01$112.88$55.22RVU24D
2024-07-01$112.88$55.22RVU24C
2024-04-01$112.88$55.22RVU24B
2024-03-09$112.88$55.22RVU24AR
2024-01-01$111.03$54.32RVU24A
2023-10-01$115.00$55.57RVU23D
2023-07-01$114.54$55.58RVU23C
2023-04-01$114.54$55.58RVU23B
2023-01-01$114.54$55.58RVU23A
2022-10-01$116.40$56.40RVU22D
2022-07-01$116.40$56.40RVU22C
2022-04-01$116.40$56.40RVU22B
2022-01-01$116.40$56.40RVU22A
2021-10-01$117.02$56.87RVU21D
2021-07-01$117.02$56.87RVU21C
2021-04-01$117.02$56.87RVU21B
2021-01-01$117.02$56.87RVU21A
2020-10-01$114.13$58.84RVU20D
2020-07-01$114.13$58.84RVU20C
2020-04-01$114.13$58.84RVU20B
2020-01-01$114.13$58.84RVU20A
2019-10-01$111.78$56.62RVU19D
2019-07-01$111.78$56.62RVU19C
2019-04-01$111.78$56.62RVU19B
2019-01-01$111.78$56.62RVU19A
2018-10-01$114.20$56.92RVU18D
2018-07-01$114.20$56.92RVU18C
2018-04-01$114.20$56.92RVU18B
2018-01-01$114.20$56.92RVU18AR1
2017-10-01$99.61$52.92RVU17D
2017-07-01$99.61$52.92RVU17C
2017-04-01$99.61$52.92RVU17B
2017-01-01$99.61$52.92RVU17A
2016-10-01$87.09$48.97RVU16D
2016-07-01$87.09$48.97RVU16C
2016-04-01$87.09$48.97RVU16B
2016-01-01$87.09$48.97RVU16A
2015-10-01$87.65$49.15RVU15D
2015-07-01$87.65$49.15RVU15C
2015-04-01$87.22$48.90RVU15B
2015-01-01$87.22$48.90RVU15A
2014-10-01$85.44$49.00RVU14D
2014-07-01$85.44$49.00RVU14C
2014-04-01$85.44$49.00RVU14B
2014-01-01$85.44$49.00RVU14A
2013-10-01$85.53$47.24RVU13D
2013-07-01$85.53$47.24RVU13C
2013-04-01$85.53$47.24RVU13B
2013-01-01$85.53$47.24RVU13AR

Price 12011 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

12011 billing questions

How is 12011 distinguished from 12013?

Both cover simple repairs in the same anatomic group. Use 12011 when the documented repaired length is 2.5 cm or less; 12013 is for the next length level.

Can lengths of multiple facial wounds be combined?

Combine lengths of simple repairs in the same anatomic grouping when determining the length level. Document each wound’s site and measurement.

When is an intermediate repair code more appropriate?

Use an intermediate repair code when the documented repair involves greater complexity, such as layered closure, rather than a simple superficial closure.

Should modifier 50 be appended for wounds on both sides of the face?

No. Modifier 50 is inappropriate for this code; select the code using the applicable anatomic grouping and repaired length.

Does the code include same-day care around the repair?

Yes. Its 0-day global period includes same-day preoperative and postoperative care.

Can an assistant or co-surgeon be reported for this repair?

Medicare payment for an assistant at surgery is restricted for this code. Co-surgeons and team surgery are not permitted.

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 12011PPRRVU2026_Oct_nonQPP.csv, line 1,403 (RVU26D)
Geographic factors for Puerto RicoGPCI2026.csv, line 91 (RVU26D)

Open CMS sourceHow we calculate rates

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