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

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 Queens, NY, Medicare pays $169.79 for 12013 in the office and $63.59 when it’s performed in a hospital or facility.

$169.79Office (non-facility)
$63.59Hospital or facility
+16.6%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 Queens, NY
  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 Queens, NY 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. Queens, NY pays $169.79. The RVUs are the same everywhere; the geographic indexes change the dollars.

12013 in Queens, NY vs other payment areas
  1. Queens, NY · this page$169.79
  2. Manhattan, NY · New York$169.15−$0.64
  3. NYC suburbs and Long Island, NY · New York$174.21+$4.42
  4. Poughkeepsie and northern NYC suburbs, NY · New York$158.51−$11.28
  5. Rest of New York · New York$138.11−$31.68
  6. Los Angeles, CA · California$161.95−$7.84
  7. Washington, DC area · District of Columbia$166.03−$3.76

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

Every other payment area

12013 in every other Medicare payment locality
Payment localityOfficeFacility
Miami, FLFlorida$163.39$69.86
Chicago, ILIllinois$158.07$67.77
AlaskaAlaska$167.75$72.06
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

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 Queens, NY 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

81

Locality
Queens, NY
Physician work
1.064
Practice expense
1.182
Malpractice
1.442
Office calculation for 12013 in Queens, NY
ComponentRVULocality factorAdjusted
Physician work1.19× 1.0641.2662
Practice expense2.90× 1.1823.4278
Malpractice0.27× 1.4420.3893
Total RVUs5.0833
Conversion factor× 33.4009

Office rate, Queens, NY$169.79

Office: (1.19 × 1.064 + 2.9 × 1.182 + 0.27 × 1.442) × $33.4009 = $169.79

Facility: (1.19 × 1.064 + 0.21 × 1.182 + 0.27 × 1.442) × $33.4009 = $63.59

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, Queens, NY
Same family
12011Wound repair, face, 2.5 cm or lessSame simple-repair anatomic group, for repaired lengths of 2.5 cm or less.$162.92
12014Wound repair, facial sites, 5.1–7.5 cmSame simple-repair anatomic group, for repaired lengths of 5.1–7.5 cm.$200.81
Used instead
12001Simple wound repair, 2.5 cm or lessSimple repair for a different anatomic group, including scalp, trunk, and extremities.$132.96
12052Wound repair, face, 2.6–5 cmIntermediate repair in the same anatomic group for a 2.6–5.0 cm wound.$360.66

How 12013 has changed in Queens, NY

12013 · Office / nonfacility

$169.79

Effective 2026-10-01

The base rate is $37.17 higher than on 2025-10-01, moving from $132.62 to $169.79 (28.0%).

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

    $132.62changed to$169.79

    • 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 1.065 changed to 1.064
    • Practice expense GPCI 1.195 changed to 1.182
    • Malpractice GPCI 1.462 changed to 1.442

    Held through RVU26B, RVU26C, RVU26D.

  2. January 1, 2025

    RVU25A

    $136.87changed to$132.62

    • 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

    $134.64changed to$136.87

    • Conversion factor 32.7442 changed to 33.2875

    Held through RVU24B, RVU24C, RVU24D.

  4. January 1, 2024

    RVU24A

    $146.34changed to$134.64

    • 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 1.061 changed to 1.065
    • Practice expense GPCI 1.212 changed to 1.195
    • Malpractice GPCI 2.061 changed to 1.462

  5. January 1, 2023

    RVU23A

    $152.95changed to$146.34

    • 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 1.056 changed to 1.061
    • Practice expense GPCI 1.228 changed to 1.212
    • Malpractice GPCI 2.661 changed to 2.061

    Held through RVU23B, RVU23C, RVU23D.

  6. January 1, 2022

    RVU22A

    $152.86changed to$152.95

    • 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

    $147.29changed to$152.86

    • 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 1.054 changed to 1.056
    • Practice expense GPCI 1.214 changed to 1.228
    • Malpractice GPCI 2.391 changed to 2.661

    Held through RVU21B, RVU21C, RVU21D.

  8. January 1, 2020

    RVU20A

    $138.82changed to$147.29

    • 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 1.052 changed to 1.054
    • Practice expense GPCI 1.200 changed to 1.214
    • Malpractice GPCI 2.121 changed to 2.391

    Held through RVU20B, RVU20C, RVU20D.

  9. January 1, 2019

    RVU19A

    $142.13changed to$138.82

    • 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

    $138.43changed to$142.13

    • Conversion factor 35.8887 changed to 35.9996
    • Practice expense RVU 1.84 changed to 1.92
    • Malpractice GPCI 2.151 changed to 2.121

    Held through RVU18B, RVU18C, RVU18D.

  11. January 1, 2017

    RVU17A

    $138.22changed to$138.43

    • Conversion factor 35.8043 changed to 35.8887
    • Practice expense GPCI 1.199 changed to 1.200
    • Malpractice GPCI 2.181 changed to 2.151

    Held through RVU17B, RVU17C, RVU17D.

  12. January 1, 2016

    RVU16A

    $146.04changed to$138.22

    • 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

    $145.31changed to$146.04

    • Conversion factor 35.7547 changed to 35.9335

    Held through RVU15D.

  14. January 1, 2015

    RVU15A

    $142.74changed to$145.31

    • 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
    • Work GPCI 1.057 changed to 1.052
    • Practice expense GPCI 1.197 changed to 1.199
    • Malpractice GPCI 1.836 changed to 2.181

    Held through RVU15B.

  15. January 1, 2014

    RVU14A

    $144.08changed to$142.74

    • 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
    • Work GPCI 1.062 changed to 1.057
    • Practice expense GPCI 1.195 changed to 1.197
    • Malpractice GPCI 1.491 changed to 1.836

    Held through RVU14B, RVU14C, RVU14D.

  16. January 1, 2013

    RVU13AR

    Earliest loaded release: $144.08

    Held through RVU13B, RVU13C, RVU13D.

Rates in every CMS release
Effective fromOfficeFacilityCMS release
2026-10-01$169.79$63.59RVU26D
2026-07-01$169.79$63.59RVU26C
2026-04-01$169.79$63.59RVU26B
2026-01-01$169.79$63.59RVU26A
2025-10-01$132.62$63.81RVU25D
2025-07-01$132.62$63.81RVU25C
2025-04-01$132.62$63.81RVU25B
2025-01-01$132.62$63.81RVU25A
2024-10-01$136.87$65.67RVU24D
2024-07-01$136.87$65.67RVU24C
2024-04-01$136.87$65.67RVU24B
2024-03-09$136.87$65.67RVU24AR
2024-01-01$134.64$64.60RVU24A
2023-10-01$146.34$72.41RVU23D
2023-07-01$146.34$72.41RVU23C
2023-04-01$146.34$72.41RVU23B
2023-01-01$146.34$72.41RVU23A
2022-10-01$152.95$77.73RVU22D
2022-07-01$152.95$77.73RVU22C
2022-04-01$152.95$77.73RVU22B
2022-01-01$152.95$77.73RVU22A
2021-10-01$152.86$77.45RVU21D
2021-07-01$152.86$77.45RVU21C
2021-04-01$152.86$77.45RVU21B
2021-01-01$152.86$77.45RVU21A
2020-10-01$147.29$78.51RVU20D
2020-07-01$147.29$78.51RVU20C
2020-04-01$147.29$78.51RVU20B
2020-01-01$147.29$78.51RVU20A
2019-10-01$138.82$70.93RVU19D
2019-07-01$138.82$70.93RVU19C
2019-04-01$138.82$70.93RVU19B
2019-01-01$138.82$70.93RVU19A
2018-10-01$142.13$70.85RVU18D
2018-07-01$142.13$70.85RVU18C
2018-04-01$142.13$70.85RVU18B
2018-01-01$142.13$70.85RVU18AR1
2017-10-01$138.43$70.81RVU17D
2017-07-01$138.43$70.81RVU17C
2017-04-01$138.43$70.81RVU17B
2017-01-01$138.43$70.81RVU17A
2016-10-01$138.22$70.82RVU16D
2016-07-01$138.22$70.82RVU16C
2016-04-01$138.22$70.82RVU16B
2016-01-01$138.22$70.82RVU16A
2015-10-01$146.04$76.24RVU15D
2015-07-01$146.04$76.24RVU15C
2015-04-01$145.31$75.87RVU15B
2015-01-01$145.31$75.87RVU15A
2014-10-01$142.74$75.41RVU14D
2014-07-01$142.74$75.41RVU14C
2014-04-01$142.74$75.41RVU14B
2014-01-01$142.74$75.41RVU14A
2013-10-01$144.08$71.30RVU13D
2013-07-01$144.08$71.30RVU13C
2013-04-01$144.08$71.30RVU13B
2013-01-01$144.08$71.30RVU13AR

Price 12013 for an earlier date of service

Where the Queens, NY rate applies

Queens, NY is a Medicare payment area, not a city. Our Census mapping connects it to 1 cities and communities in New York. Some span more than one payment area; confirm with the service ZIP.

Browse all communities in New York

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 Queens, NYGPCI2026.csv, line 81 (RVU26D)

Open CMS sourceHow we calculate rates

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