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

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 Connecticut, Medicare pays $155.78 for 12013 in the office and $59.01 when it’s performed in a hospital or facility.

$155.78Office (non-facility)
$59.01Hospital or facility
+7.0%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 Connecticut
  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 Connecticut 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. Connecticut pays $155.78. The RVUs are the same everywhere; the geographic indexes change the dollars.

12013 in Connecticut vs other payment areas
  1. Connecticut · this page$155.78
  2. Los Angeles, CA · California$161.95+$6.17
  3. Washington, DC area · District of Columbia$166.03+$10.25
  4. Miami, FL · Florida$163.39+$7.61
  5. Chicago, IL · Illinois$158.07+$2.29
  6. Manhattan, NY · New York$169.15+$13.37
  7. Alaska · Alaska$167.75+$11.97

Other areas in Connecticut 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.

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.

$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 Connecticut 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

38

Locality
Connecticut
Physician work
1.020
Practice expense
1.077
Malpractice
1.210
Office calculation for 12013 in Connecticut
ComponentRVULocality factorAdjusted
Physician work1.19× 1.0201.2138
Practice expense2.90× 1.0773.1233
Malpractice0.27× 1.2100.3267
Total RVUs4.6638
Conversion factor× 33.4009

Office rate, Connecticut$155.78

Office: (1.19 × 1.02 + 2.9 × 1.077 + 0.27 × 1.21) × $33.4009 = $155.78

Facility: (1.19 × 1.02 + 0.21 × 1.077 + 0.27 × 1.21) × $33.4009 = $59.01

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

Codes related to 12013

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

Codes related to 12013
CodeHow it relatesOffice range, Connecticut
Same family
12011Wound repair, face, 2.5 cm or lessSame simple-repair anatomic group, for repaired lengths of 2.5 cm or less.$149.41
12014Wound repair, facial sites, 5.1–7.5 cmSame simple-repair anatomic group, for repaired lengths of 5.1–7.5 cm.$184.31
Used instead
12001Simple wound repair, 2.5 cm or lessSimple repair for a different anatomic group, including scalp, trunk, and extremities.$121.91
12052Wound repair, face, 2.6–5 cmIntermediate repair in the same anatomic group for a 2.6–5.0 cm wound.$332.17

How 12013 has changed in Connecticut

12013 · Office / nonfacility

$155.78

Effective 2026-10-01

The base rate is $33.73 higher than on 2025-10-01, moving from $122.05 to $155.78 (27.6%).

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

    $122.05changed to$155.78

    • 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 1.022 changed to 1.020
    • Practice expense GPCI 1.091 changed to 1.077
    • Malpractice GPCI 1.207 changed to 1.210

    Held through RVU26B, RVU26C, RVU26D.

  2. January 1, 2025

    RVU25A

    $125.96changed to$122.05

    • 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

    $123.90changed to$125.96

    • Conversion factor 32.7442 changed to 33.2875

    Held through RVU24B, RVU24C, RVU24D.

  4. January 1, 2024

    RVU24A

    $128.95changed to$123.90

    • 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 1.030 changed to 1.022
    • Practice expense GPCI 1.102 changed to 1.091
    • Malpractice GPCI 1.070 changed to 1.207

  5. January 1, 2023

    RVU23A

    $129.80changed to$128.95

    • 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 1.037 changed to 1.030
    • Practice expense GPCI 1.114 changed to 1.102
    • Malpractice GPCI 0.934 changed to 1.070

    Held through RVU23B, RVU23C, RVU23D.

  6. January 1, 2022

    RVU22A

    $130.16changed to$129.80

    • 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

    $128.29changed to$130.16

    • 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 1.029 changed to 1.037
    • Practice expense GPCI 1.113 changed to 1.114
    • Malpractice GPCI 1.094 changed to 0.934

    Held through RVU21B, RVU21C, RVU21D.

  8. January 1, 2020

    RVU20A

    $126.32changed to$128.29

    • 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
    • Work GPCI 1.021 changed to 1.029
    • Practice expense GPCI 1.112 changed to 1.113
    • Malpractice GPCI 1.255 changed to 1.094

    Held through RVU20B, RVU20C, RVU20D.

  9. January 1, 2019

    RVU19A

    $129.38changed to$126.32

    • 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

    $126.14changed to$129.38

    • Conversion factor 35.8887 changed to 35.9996
    • Practice expense RVU 1.84 changed to 1.92
    • Work GPCI 1.023 changed to 1.021
    • Practice expense GPCI 1.117 changed to 1.112
    • Malpractice GPCI 1.244 changed to 1.255

    Held through RVU18B, RVU18C, RVU18D.

  11. January 1, 2017

    RVU17A

    $126.08changed to$126.14

    • Conversion factor 35.8043 changed to 35.8887
    • Work GPCI 1.024 changed to 1.023
    • Practice expense GPCI 1.121 changed to 1.117
    • Malpractice GPCI 1.232 changed to 1.244

    Held through RVU17B, RVU17C, RVU17D.

  12. January 1, 2016

    RVU16A

    $133.38changed to$126.08

    • 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

    $132.72changed to$133.38

    • Conversion factor 35.7547 changed to 35.9335

    Held through RVU15D.

  14. January 1, 2015

    RVU15A

    $131.51changed to$132.72

    • 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 1.116 changed to 1.121
    • Malpractice GPCI 1.234 changed to 1.232

    Held through RVU15B.

  15. January 1, 2014

    RVU14A

    $134.37changed to$131.51

    • 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 1.110 changed to 1.116
    • Malpractice GPCI 1.235 changed to 1.234

    Held through RVU14B, RVU14C, RVU14D.

  16. January 1, 2013

    RVU13AR

    Earliest loaded release: $134.37

    Held through RVU13B, RVU13C, RVU13D.

Rates in every CMS release
Effective fromOfficeFacilityCMS release
2026-10-01$155.78$59.01RVU26D
2026-07-01$155.78$59.01RVU26C
2026-04-01$155.78$59.01RVU26B
2026-01-01$155.78$59.01RVU26A
2025-10-01$122.05$59.23RVU25D
2025-07-01$122.05$59.23RVU25C
2025-04-01$122.05$59.23RVU25B
2025-01-01$122.05$59.23RVU25A
2024-10-01$125.96$60.95RVU24D
2024-07-01$125.96$60.95RVU24C
2024-04-01$125.96$60.95RVU24B
2024-03-09$125.96$60.95RVU24AR
2024-01-01$123.90$59.96RVU24A
2023-10-01$128.95$61.73RVU23D
2023-07-01$128.95$61.73RVU23C
2023-04-01$128.95$61.73RVU23B
2023-01-01$128.95$61.73RVU23A
2022-10-01$129.80$61.56RVU22D
2022-07-01$129.80$61.56RVU22C
2022-04-01$129.80$61.56RVU22B
2022-01-01$129.80$61.56RVU22A
2021-10-01$130.16$61.75RVU21D
2021-07-01$130.16$61.75RVU21C
2021-04-01$130.16$61.75RVU21B
2021-01-01$130.16$61.75RVU21A
2020-10-01$128.29$65.23RVU20D
2020-07-01$128.29$65.23RVU20C
2020-04-01$128.29$65.23RVU20B
2020-01-01$128.29$65.23RVU20A
2019-10-01$126.32$63.40RVU19D
2019-07-01$126.32$63.40RVU19C
2019-04-01$126.32$63.40RVU19B
2019-01-01$126.32$63.40RVU19A
2018-10-01$129.38$63.33RVU18D
2018-07-01$129.38$63.33RVU18C
2018-04-01$129.38$63.33RVU18B
2018-01-01$129.38$63.33RVU18AR1
2017-10-01$126.14$63.20RVU17D
2017-07-01$126.14$63.20RVU17C
2017-04-01$126.14$63.20RVU17B
2017-01-01$126.14$63.20RVU17A
2016-10-01$126.08$63.07RVU16D
2016-07-01$126.08$63.07RVU16C
2016-04-01$126.08$63.07RVU16B
2016-01-01$126.08$63.07RVU16A
2015-10-01$133.38$68.13RVU15D
2015-07-01$133.38$68.13RVU15C
2015-04-01$132.72$67.79RVU15B
2015-01-01$132.72$67.79RVU15A
2014-10-01$131.51$68.74RVU14D
2014-07-01$131.51$68.74RVU14C
2014-04-01$131.51$68.74RVU14B
2014-01-01$131.51$68.74RVU14A
2013-10-01$134.37$66.77RVU13D
2013-07-01$134.37$66.77RVU13C
2013-04-01$134.37$66.77RVU13B
2013-01-01$134.37$66.77RVU13AR

Price 12013 for an earlier date of service

Where the Connecticut rate applies

Connecticut is a Medicare payment area, not a city. Our Census mapping connects it to 215 cities and communities in Connecticut. Some span more than one payment area; confirm with the service ZIP.

  • Ansonia
  • Ball Pond
  • Baltic
  • Bantam
  • Bethel
  • Bethlehem Village
  • Bigelow Corners
  • Blue Hills

Browse all communities in Connecticut

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 ConnecticutGPCI2026.csv, line 38 (RVU26D)

Open CMS sourceHow we calculate rates

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