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

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 Houston, TX, Medicare pays $148.66 for 12013 in the office and $59.44 when it’s performed in a hospital or facility.

$148.66Office (non-facility)
$59.44Hospital or facility
+2.1%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 Houston, TX
  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 Houston, TX 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. Houston, TX pays $148.66. The RVUs are the same everywhere; the geographic indexes change the dollars.

12013 in Houston, TX vs other payment areas
  1. Houston, TX · this page$148.66
  2. Austin, TX · Texas$150.30+$1.64
  3. Beaumont, TX · Texas$136.27−$12.39
  4. Brazoria, TX · Texas$143.09−$5.57
  5. Dallas, TX · Texas$144.32−$4.34
  6. Fort Worth, TX · Texas$143.47−$5.19
  7. Galveston, TX · Texas$143.72−$4.94

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

Every other payment area

12013 in every other Medicare payment locality
Payment localityOfficeFacility
Rest of TexasTexas$139.81$54.55
Los Angeles, CACalifornia$161.95$55.66
Washington, DC areaDistrict of Columbia$166.03$60.19
Miami, FLFlorida$163.39$69.86
Chicago, ILIllinois$158.07$67.77
Manhattan, NYNew York$169.15$64.74
AlaskaAlaska$167.75$72.06
AlabamaAlabama$129.61$50.99

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 Houston, TX 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

102

Locality
Houston, TX
Physician work
1.008
Practice expense
0.993
Malpractice
1.376
Office calculation for 12013 in Houston, TX
ComponentRVULocality factorAdjusted
Physician work1.19× 1.0081.1995
Practice expense2.90× 0.9932.8797
Malpractice0.27× 1.3760.3715
Total RVUs4.4507
Conversion factor× 33.4009

Office rate, Houston, TX$148.66

Office: (1.19 × 1.008 + 2.9 × 0.993 + 0.27 × 1.376) × $33.4009 = $148.66

Facility: (1.19 × 1.008 + 0.21 × 0.993 + 0.27 × 1.376) × $33.4009 = $59.44

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 Houston, TX

12013 · Office / nonfacility

$148.66

Effective 2026-10-01

The base rate is $31.20 higher than on 2025-10-01, moving from $117.46 to $148.66 (26.6%).

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

    $117.46changed to$148.66

    • 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 1.014 changed to 1.008
    • Practice expense GPCI 1.003 changed to 0.993
    • Malpractice GPCI 1.409 changed to 1.376

    Held through RVU26B, RVU26C, RVU26D.

  2. January 1, 2025

    RVU25A

    $121.21changed to$117.46

    • 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

    $119.24changed to$121.21

    • Conversion factor 32.7442 changed to 33.2875

    Held through RVU24B, RVU24C, RVU24D.

  4. January 1, 2024

    RVU24A

    $123.34changed to$119.24

    • 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 1.023 changed to 1.014
    • Practice expense GPCI 1.016 changed to 1.003
    • Malpractice GPCI 1.154 changed to 1.409
  5. January 1, 2023

    RVU23A

    $123.33changed to$123.34

    • 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 1.032 changed to 1.023
    • Practice expense GPCI 1.029 changed to 1.016
    • Malpractice GPCI 0.900 changed to 1.154

    Held through RVU23B, RVU23C, RVU23D.

  6. January 1, 2022

    RVU22A

    $123.68changed to$123.33

    • 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

    $120.49changed to$123.68

    • 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 1.026 changed to 1.032
    • Practice expense GPCI 1.020 changed to 1.029
    • Malpractice GPCI 0.918 changed to 0.900

    Held through RVU21B, RVU21C, RVU21D.

  8. January 1, 2020

    RVU20A

    $117.69changed to$120.49

    • 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 1.020 changed to 1.026
    • Practice expense GPCI 1.012 changed to 1.020
    • Malpractice GPCI 0.936 changed to 0.918

    Held through RVU20B, RVU20C, RVU20D.

  9. January 1, 2019

    RVU19A

    $120.47changed to$117.69

    • 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

    $117.06changed to$120.47

    • Conversion factor 35.8887 changed to 35.9996
    • Practice expense RVU 1.84 changed to 1.92
    • Practice expense GPCI 1.009 changed to 1.012
    • Malpractice GPCI 0.946 changed to 0.936

    Held through RVU18B, RVU18C, RVU18D.

  11. January 1, 2017

    RVU17A

    $116.60changed to$117.06

    • Conversion factor 35.8043 changed to 35.8887
    • Work GPCI 1.019 changed to 1.020
    • Practice expense GPCI 1.006 changed to 1.009
    • Malpractice GPCI 0.955 changed to 0.946

    Held through RVU17B, RVU17C, RVU17D.

  12. January 1, 2016

    RVU16A

    $123.17changed to$116.60

    • 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

    $122.55changed to$123.17

    • Conversion factor 35.7547 changed to 35.9335

    Held through RVU15D.

  14. January 1, 2015

    RVU15A

    $121.20changed to$122.55

    • 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 1.014 changed to 1.019
    • Practice expense GPCI 1.004 changed to 1.006
    • Malpractice GPCI 0.939 changed to 0.955

    Held through RVU15B.

  15. January 1, 2014

    RVU14A

    $123.50changed to$121.20

    • 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 1.009 changed to 1.014
    • Practice expense GPCI 1.002 changed to 1.004
    • Malpractice GPCI 0.923 changed to 0.939

    Held through RVU14B, RVU14C, RVU14D.

  16. January 1, 2013

    RVU13AR

    Earliest loaded release: $123.50

    Held through RVU13B, RVU13C, RVU13D.

Rates in every CMS release
Effective fromOfficeFacilityCMS release
2026-10-01$148.66$59.44RVU26D
2026-07-01$148.66$59.44RVU26C
2026-04-01$148.66$59.44RVU26B
2026-01-01$148.66$59.44RVU26A
2025-10-01$117.46$59.71RVU25D
2025-07-01$117.46$59.71RVU25C
2025-04-01$117.46$59.71RVU25B
2025-01-01$117.46$59.71RVU25A
2024-10-01$121.21$61.45RVU24D
2024-07-01$121.21$61.45RVU24C
2024-04-01$121.21$61.45RVU24B
2024-03-09$121.21$61.45RVU24AR
2024-01-01$119.24$60.45RVU24A
2023-10-01$123.34$61.37RVU23D
2023-07-01$123.34$61.37RVU23C
2023-04-01$123.34$61.37RVU23B
2023-01-01$123.34$61.37RVU23A
2022-10-01$123.33$60.30RVU22D
2022-07-01$123.33$60.30RVU22C
2022-04-01$123.33$60.30RVU22B
2022-01-01$123.33$60.30RVU22A
2021-10-01$123.68$60.49RVU21D
2021-07-01$123.68$60.49RVU21C
2021-04-01$123.68$60.49RVU21B
2021-01-01$123.68$60.49RVU21A
2020-10-01$120.49$62.70RVU20D
2020-07-01$120.49$62.70RVU20C
2020-04-01$120.49$62.70RVU20B
2020-01-01$120.49$62.70RVU20A
2019-10-01$117.69$60.43RVU19D
2019-07-01$117.69$60.43RVU19C
2019-04-01$117.69$60.43RVU19B
2019-01-01$117.69$60.43RVU19A
2018-10-01$120.47$60.36RVU18D
2018-07-01$120.47$60.36RVU18C
2018-04-01$120.47$60.36RVU18B
2018-01-01$120.47$60.36RVU18AR1
2017-10-01$117.06$60.21RVU17D
2017-07-01$117.06$60.21RVU17C
2017-04-01$117.06$60.21RVU17B
2017-01-01$117.06$60.21RVU17A
2016-10-01$116.60$60.05RVU16D
2016-07-01$116.60$60.05RVU16C
2016-04-01$116.60$60.05RVU16B
2016-01-01$116.60$60.05RVU16A
2015-10-01$123.17$64.60RVU15D
2015-07-01$123.17$64.60RVU15C
2015-04-01$122.55$64.28RVU15B
2015-01-01$122.55$64.28RVU15A
2014-10-01$121.20$64.73RVU14D
2014-07-01$121.20$64.73RVU14C
2014-04-01$121.20$64.73RVU14B
2014-01-01$121.20$64.73RVU14A
2013-10-01$123.50$62.48RVU13D
2013-07-01$123.50$62.48RVU13C
2013-04-01$123.50$62.48RVU13B
2013-01-01$123.50$62.48RVU13AR

Price 12013 for an earlier date of service

Where the Houston, TX rate applies

Houston, TX is a Medicare payment area, not a city. Our Census mapping connects it to 46 cities and communities in Texas. Some span more than one payment area; confirm with the service ZIP.

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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 Houston, TXGPCI2026.csv, line 102 (RVU26D)

Open CMS sourceHow we calculate rates

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