CPT code 12013: Wound repair, face-area, 2.6–5.0 cm2026 Medicare rate & RVUs in Colorado

Reports simple closure of a 2.6–5.0 cm superficial wound on the face, ears, eyelids, nose, lips, or mucous membranes.

CMS RVU26DEffective Oct 1, 2026One payment locality48.3K Medicare services in 2024

In Colorado, Medicare pays $150.33 for 12013 in the office and $54.73 when it’s performed in a hospital or facility.

$150.33Office (non-facility)
$54.73Hospital or facility
+3.2%vs the national office rate ($145.63)

Check a contract rate as a % of Medicare · 12013 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 12013 for the payment locality that covers the ZIP.

On this page 11 sections
  1. Rate in Colorado
  2. What 12013 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 12013 covers

This code covers simple repair of a superficial wound in the face, ears, eyelids, nose, lips, or mucous membranes when the repaired length is 2.6–5.0 cm. The closure is limited to the superficial tissue layers; it does not involve the layered closure of deeper tissue characteristic of an intermediate repair. Emergency clinicians, surgeons, and other qualified practitioners commonly perform these repairs in emergency departments, outpatient clinics, and offices.

Select the code by the wound’s anatomic group, repair complexity, and final repaired length. For multiple simple wounds in the same classification and anatomic group, combine lengths when determining the level; document the wound sites, lengths, and closure technique. This minor procedure has a 0-day global period, so same-day preoperative and postoperative care is included. When multiple procedures are performed in one session, the highest-valued procedure is paid in full and other procedures are subject to the standard 50% reduction. Modifier 50 is inappropriate; assistant-at-surgery payment is statutorily restricted, and co-surgeon and team-surgery billing 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 Colorado compares for 12013

Across 109 of 109 payment localities, the office rate for 12013 runs from $127.60 in Arkansas to $188.63 in San Benito County, CA. Colorado pays $150.33. The RVUs are the same everywhere; the geographic indexes change the dollars.

12013 in Colorado vs other payment areas
  1. Colorado · this page$150.33
  2. Los Angeles, CA · California$161.95+$11.62
  3. Washington, DC area · District of Columbia$166.03+$15.70
  4. Miami, FL · Florida$163.39+$13.06
  5. Chicago, IL · Illinois$158.07+$7.74
  6. Manhattan, NY · New York$169.15+$18.82
  7. Alaska · Alaska$167.75+$17.42

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

Every other payment area

12013 in every other Medicare payment locality
Payment localityOfficeFacility
AlabamaAlabama$129.61$50.99
ArkansasArkansas$127.60$50.42
ArizonaArizona$141.33$54.26
Bakersfield, CACalifornia$152.16$53.68
Chico, CACalifornia$151.42$52.94
El Centro, CACalifornia$151.46$52.99
Fresno, CACalifornia$151.42$52.94
Hanford, CACalifornia$151.42$52.94

12013 rates by state

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

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.

$127.60

$170.02

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

View every state and territory as a table
12013 office rate range by state
State / territoryOffice rate rangeLocalities
AK$167.751
AL$129.611
AR$127.601
AZ$141.331
CA$151.42–$188.6329
CO$150.331
CT$155.781
DC$166.031
DE$143.751
FL$145.90–$163.393
GA$136.90–$149.112
GU$155.101
HI$155.101
IA$131.961
ID$133.131
IL$142.28–$158.074
IN$133.921
KS$131.861
KY$134.111
LA$134.11–$141.142
MA$149.57–$165.062
MD$146.45–$166.033
ME$134.47–$141.432
MI$138.36–$148.422
MN$142.091
MO$132.03–$141.003
MS$129.811
MT$145.611
NC$135.881
ND$140.271
NE$132.561
NH$148.471
NJ$157.00–$164.242
NM$139.401
NV$144.221
NY$138.11–$174.215
OH$137.271
OK$133.251
OR$142.56–$154.712
PA$137.19–$152.062
PR$146.561
RI$148.611
SC$136.911
SD$139.641
TN$132.641
TX$136.27–$150.308
UT$138.901
VA$141.33–$166.032
VI$146.561
VT$140.201
WA$149.12–$167.952
WI$135.321
WV$136.831
WY$143.281

See 12013 in every payment locality

How the 12013 rate is calculated

Each of 12013’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 · 12013

RVUs × geographic indexes × conversion factor

Office or facility?

Work1.19

1.19 RVUs× 1.000 GPCI

Practice expense2.90

2.90 RVUs× 1.000 GPCI

Malpractice0.27

0.27 RVUs× 1.000 GPCI

Adjusted RVUs

4.3600

Conversion factor

$33.4009

Medicare rate

$145.63

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

The exact Colorado inputs and CMS source lines

PPRRVU2026_Oct_nonQPP.csv

1,404

Code
12013
Physician work
1.19
Practice expense
2.90
Malpractice
0.27

GPCI2026.csv

37

Locality
Colorado
Physician work
1.012
Practice expense
1.064
Malpractice
0.781
Office calculation for 12013 in Colorado
ComponentRVULocality factorAdjusted
Physician work1.19× 1.0121.2043
Practice expense2.90× 1.0643.0856
Malpractice0.27× 0.7810.2109
Total RVUs4.5008
Conversion factor× 33.4009

Office rate, Colorado$150.33

Office: (1.19 × 1.012 + 2.9 × 1.064 + 0.27 × 0.781) × $33.4009 = $150.33

Facility: (1.19 × 1.012 + 0.21 × 1.064 + 0.27 × 0.781) × $33.4009 = $54.73

Open 12013 in the RVU calculator

Payment rules and modifiers for 12013

The CMS indicators that decide how 12013 is paid alongside other services.

CMS payment indicators · 12013

Wound repair, face-area, 2.6–5.0 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

12013 without 51 · national office

$145.63

Wound repair, face-area, 2.6–5.0 cm

12013-51 · Second procedure: 50%

$72.82

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

How 12013 has changed in Colorado

12013 · Office / nonfacility

$150.33

Effective 2026-10-01

The base rate is $34.31 higher than on 2025-10-01, moving from $116.02 to $150.33 (29.6%).

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

    $116.02changed to$150.33

    • Conversion factor 32.3465 changed to 33.4009
    • Work RVU 1.22 changed to 1.19
    • Practice expense RVU 2.05 changed to 2.90
    • Malpractice RVU 0.24 changed to 0.27
    • Work GPCI 1.008 changed to 1.012
    • Practice expense GPCI 1.053 changed to 1.064
    • Malpractice GPCI 0.827 changed to 0.781

    Held through RVU26B, RVU26C, RVU26D.

  2. January 1, 2025

    RVU25A

    $119.75changed to$116.02

    • Conversion factor 33.2875 changed to 32.3465
    • Practice expense RVU 2.06 changed to 2.05

    Held through RVU25B, RVU25C, RVU25D.

  3. March 9, 2024

    RVU24AR

    $117.79changed to$119.75

    • Conversion factor 32.7442 changed to 33.2875

    Held through RVU24B, RVU24C, RVU24D.

  4. January 1, 2024

    RVU24A

    $121.95changed to$117.79

    • Conversion factor 33.8872 changed to 32.7442
    • Practice expense RVU 2.07 changed to 2.06
    • Malpractice RVU 0.25 changed to 0.24
    • Work GPCI 1.005 changed to 1.008
    • Practice expense GPCI 1.050 changed to 1.053
    • Malpractice GPCI 0.797 changed to 0.827
  5. January 1, 2023

    RVU23A

    $122.18changed to$121.95

    • Conversion factor 34.6062 changed to 33.8872
    • Practice expense RVU 2.03 changed to 2.07
    • Malpractice RVU 0.24 changed to 0.25
    • Work GPCI 1.001 changed to 1.005
    • Practice expense GPCI 1.047 changed to 1.050
    • Malpractice GPCI 0.767 changed to 0.797

    Held through RVU23B, RVU23C, RVU23D.

  6. January 1, 2022

    RVU22A

    $122.56changed to$122.18

    • Conversion factor 34.8931 changed to 34.6062
    • Practice expense RVU 2.02 changed to 2.03
    • Malpractice RVU 0.23 changed to 0.24

    Held through RVU22B, RVU22C, RVU22D.

  7. January 1, 2021

    RVU21A

    $120.09changed to$122.56

    • Conversion factor 36.0896 changed to 34.8931
    • Practice expense RVU 1.83 changed to 2.02
    • Malpractice RVU 0.24 changed to 0.23
    • Work GPCI 1.000 changed to 1.001
    • Practice expense GPCI 1.033 changed to 1.047
    • Malpractice GPCI 0.905 changed to 0.767

    Held through RVU21B, RVU21C, RVU21D.

  8. January 1, 2020

    RVU20A

    $117.86changed to$120.09

    • Conversion factor 36.0391 changed to 36.0896
    • Practice expense RVU 1.84 changed to 1.83
    • Malpractice RVU 0.17 changed to 0.24
    • Practice expense GPCI 1.018 changed to 1.033
    • Malpractice GPCI 1.042 changed to 0.905

    Held through RVU20B, RVU20C, RVU20D.

  9. January 1, 2019

    RVU19A

    $120.66changed to$117.86

    • Conversion factor 35.9996 changed to 36.0391
    • Practice expense RVU 1.92 changed to 1.84

    Held through RVU19B, RVU19C, RVU19D.

  10. January 1, 2018

    RVU18AR1

    $117.31changed to$120.66

    • Conversion factor 35.8887 changed to 35.9996
    • Practice expense RVU 1.84 changed to 1.92
    • Practice expense GPCI 1.015 changed to 1.018
    • Malpractice GPCI 1.066 changed to 1.042

    Held through RVU18B, RVU18C, RVU18D.

  11. January 1, 2017

    RVU17A

    $116.92changed to$117.31

    • Conversion factor 35.8043 changed to 35.8887
    • Practice expense GPCI 1.011 changed to 1.015
    • Malpractice GPCI 1.090 changed to 1.066

    Held through RVU17B, RVU17C, RVU17D.

  12. January 1, 2016

    RVU16A

    $123.52changed to$116.92

    • Conversion factor 35.9335 changed to 35.8043
    • Practice expense RVU 2.01 changed to 1.84

    Held through RVU16B, RVU16C, RVU16D.

  13. July 1, 2015

    RVU15C

    $122.90changed to$123.52

    • Conversion factor 35.7547 changed to 35.9335

    Held through RVU15D.

  14. January 1, 2015

    RVU15A

    $121.16changed to$122.90

    • Conversion factor 35.8228 changed to 35.7547
    • Practice expense RVU 1.96 changed to 2.01
    • Malpractice RVU 0.19 changed to 0.17
    • Practice expense GPCI 1.008 changed to 1.011
    • Malpractice GPCI 0.981 changed to 1.090

    Held through RVU15B.

  15. January 1, 2014

    RVU14A

    $122.93changed to$121.16

    • Conversion factor 34.0230 changed to 35.8228
    • Practice expense RVU 2.21 changed to 1.96
    • Malpractice RVU 0.20 changed to 0.19
    • Practice expense GPCI 1.004 changed to 1.008
    • Malpractice GPCI 0.872 changed to 0.981

    Held through RVU14B, RVU14C, RVU14D.

  16. January 1, 2013

    RVU13AR

    Earliest loaded release: $122.93

    Held through RVU13B, RVU13C, RVU13D.

Rates in every CMS release
Effective fromOfficeFacilityCMS release
2026-10-01$150.33$54.73RVU26D
2026-07-01$150.33$54.73RVU26C
2026-04-01$150.33$54.73RVU26B
2026-01-01$150.33$54.73RVU26A
2025-10-01$116.02$55.39RVU25D
2025-07-01$116.02$55.39RVU25C
2025-04-01$116.02$55.39RVU25B
2025-01-01$116.02$55.39RVU25A
2024-10-01$119.75$57.01RVU24D
2024-07-01$119.75$57.01RVU24C
2024-04-01$119.75$57.01RVU24B
2024-03-09$119.75$57.01RVU24AR
2024-01-01$117.79$56.08RVU24A
2023-10-01$121.95$57.91RVU23D
2023-07-01$121.95$57.91RVU23C
2023-04-01$121.95$57.91RVU23B
2023-01-01$121.95$57.91RVU23A
2022-10-01$122.18$58.05RVU22D
2022-07-01$122.18$58.05RVU22C
2022-04-01$122.18$58.05RVU22B
2022-01-01$122.18$58.05RVU22A
2021-10-01$122.56$58.27RVU21D
2021-07-01$122.56$58.27RVU21C
2021-04-01$122.56$58.27RVU21B
2021-01-01$122.56$58.27RVU21A
2020-10-01$120.09$61.56RVU20D
2020-07-01$120.09$61.56RVU20C
2020-04-01$120.09$61.56RVU20B
2020-01-01$120.09$61.56RVU20A
2019-10-01$117.86$60.26RVU19D
2019-07-01$117.86$60.26RVU19C
2019-04-01$117.86$60.26RVU19B
2019-01-01$117.86$60.26RVU19A
2018-10-01$120.66$60.19RVU18D
2018-07-01$120.66$60.19RVU18C
2018-04-01$120.66$60.19RVU18B
2018-01-01$120.66$60.19RVU18AR1
2017-10-01$117.31$60.12RVU17D
2017-07-01$117.31$60.12RVU17C
2017-04-01$117.31$60.12RVU17B
2017-01-01$117.31$60.12RVU17A
2016-10-01$116.92$60.09RVU16D
2016-07-01$116.92$60.09RVU16C
2016-04-01$116.92$60.09RVU16B
2016-01-01$116.92$60.09RVU16A
2015-10-01$123.52$64.67RVU15D
2015-07-01$123.52$64.67RVU15C
2015-04-01$122.90$64.34RVU15B
2015-01-01$122.90$64.34RVU15A
2014-10-01$121.16$64.46RVU14D
2014-07-01$121.16$64.46RVU14C
2014-04-01$121.16$64.46RVU14B
2014-01-01$121.16$64.46RVU14A
2013-10-01$122.93$61.79RVU13D
2013-07-01$122.93$61.79RVU13C
2013-04-01$122.93$61.79RVU13B
2013-01-01$122.93$61.79RVU13AR

Price 12013 for an earlier date of service

Where the Colorado rate applies

Colorado is a Medicare payment area, not a city. Our Census mapping connects it to 485 cities and communities in Colorado. Some span more than one payment area; confirm with the service ZIP.

  • Acres Green
  • Aetna Estates
  • Aguilar
  • Air Force Academy
  • Akron
  • Alamosa
  • Alamosa East
  • Allenspark

Browse all communities in Colorado

12013 billing questions

How does 12013 differ from 12011 and 12014?

These codes cover the same anatomic group and simple-repair level. Choose 12013 for a repaired length of 2.6–5.0 cm; 12011 is for shorter repairs and 12014 for longer repairs.

Can separate wound lengths be combined?

Combine lengths for multiple simple repairs in the same classification and anatomic group when selecting the length level. Document each site and length, along with the total used for code selection.

When is an intermediate repair code more appropriate?

Use an intermediate repair code when the documented repair involves layered closure of deeper tissue or otherwise meets the intermediate-repair criteria. A superficial, simple closure supports 12013 instead.

Should modifier 50 be reported for wounds on both sides?

No. CMS identifies bilateral adjustment as inappropriate for this code; do not report modifier 50 for bilateral wounds.

How does Medicare handle other procedures performed in the same session?

The highest-valued procedure is paid in full, and other procedures in the same session are subject to the standard multiple-procedure reduction. Same-day preoperative and postoperative care is included in this code’s 0-day global period.

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 12013PPRRVU2026_Oct_nonQPP.csv, line 1,404 (RVU26D)
Geographic factors for ColoradoGPCI2026.csv, line 37 (RVU26D)

Open CMS sourceHow we calculate rates

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