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CPT code 12016: Simple wound repair, face group, 12.6–20 cm2026 Medicare rate & RVUs in South Carolina

Simple closure of superficial wounds of the face, ears, eyelids, nose, lips, or mucous membranes, with a combined repair length of 12.6–20 cm.

CMS RVU26DEffective Oct 1, 2026One payment locality469 Medicare services in 2024

In South Carolina, Medicare pays $252.33 for 12016 in the office and $118.07 when it’s performed in a hospital or facility.

$252.33Office (non-facility)
$118.07Hospital or facility
−5.7%vs the national office rate ($267.54)

Check a contract rate as a % of Medicare · 12016 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 12016 for the payment locality that covers the ZIP.

On this page 11 sections
  1. Rate in South Carolina
  2. What 12016 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 12016 covers

This service covers straightforward, one-layer closure of superficial lacerations in the face-site group: the face, ears, eyelids, nose, lips, and mucous membranes. The wound is limited to superficial tissues rather than requiring layered repair of deeper structures. Physicians and other qualified clinicians commonly perform these repairs in emergency departments, urgent care, or office settings after injuries such as facial cuts.

Select the code using the combined length of qualifying simple repairs in this anatomic group during the session; document each wound’s site, measured length, and repair method. This length band is 12.6–20 cm. The code has a 0-day global period, so same-day preoperative and postoperative care is included. When multiple procedures occur in one session, the highest-valued procedure is paid in full and other procedures are subject to the standard 50% multiple-procedure reduction. Modifier 50 is inappropriate. Medicare does not pay an assistant at surgery for this service, and co-surgeon and team-surgery reporting 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 South Carolina compares for 12016

Across 109 of 109 payment localities, the office rate for 12016 runs from $235.10 in Arkansas to $338.39 in San Benito County, CA. South Carolina pays $252.33. The RVUs are the same everywhere; the geographic indexes change the dollars.

12016 in South Carolina vs other payment areas
  1. South Carolina · this page$252.33
  2. Los Angeles, CA · California$293.55+$41.22
  3. Washington, DC area · District of Columbia$303.03+$50.70
  4. Miami, FL · Florida$305.25+$52.92
  5. Chicago, IL · Illinois$295.34+$43.01
  6. Manhattan, NY · New York$310.98+$58.65
  7. Alaska · Alaska$312.38+$60.05

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

Every other payment area

12016 in every other Medicare payment locality
Payment localityOfficeFacility
AlabamaAlabama$238.70$111.57
ArkansasArkansas$235.10$110.29
ArizonaArizona$259.65$118.86
Bakersfield, CACalifornia$276.59$117.35
Chico, CACalifornia$274.93$115.69
El Centro, CACalifornia$275.03$115.79
Fresno, CACalifornia$274.93$115.69
Hanford, CACalifornia$274.93$115.69

12016 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.

$235.10

$312.38

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

View every state and territory as a table
12016 office rate range by state
State / territoryOffice rate rangeLocalities
AK$312.381
AL$238.701
AR$235.101
AZ$259.651
CA$274.93–$338.3929
CO$274.361
CT$285.881
DC$303.031
DE$264.001
FL$270.75–$305.253
GA$254.17–$274.462
GU$280.881
HI$280.881
IA$241.661
ID$244.001
IL$265.09–$295.344
IN$245.391
KS$242.081
KY$248.051
LA$248.29–$260.872
MA$273.28–$299.912
MD$268.66–$303.033
ME$247.04–$258.582
MI$256.25–$275.922
MN$257.841
MO$244.93–$259.903
MS$239.981
MT$267.501
NC$249.471
ND$255.441
NE$242.551
NH$271.551
NJ$287.72–$300.022
NM$258.361
NV$264.301
NY$253.49–$320.825
OH$253.791
OK$245.881
OR$260.85–$281.482
PA$253.30–$279.602
PR$269.001
RI$272.281
SC$252.331
SD$254.011
TN$243.551
TX$251.70–$274.788
UT$255.861
VA$258.83–$303.032
VI$269.001
VT$255.881
WA$272.28–$304.492
WI$246.721
WV$255.361
WY$262.241

See 12016 in every payment locality

How the 12016 rate is calculated

Each of 12016’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 · 12016

RVUs × geographic indexes × conversion factor

Office or facility?

Work2.61

2.61 RVUs× 1.000 GPCI

Practice expense4.79

4.79 RVUs× 1.000 GPCI

Malpractice0.61

0.61 RVUs× 1.000 GPCI

Adjusted RVUs

8.0100

Conversion factor

$33.4009

Medicare rate

$267.54

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

The exact South Carolina inputs and CMS source lines

PPRRVU2026_Oct_nonQPP.csv

1,407

Code
12016
Physician work
2.61
Practice expense
4.79
Malpractice
0.61

GPCI2026.csv

93

Locality
South Carolina
Physician work
1.000
Practice expense
0.924
Malpractice
0.850
Office calculation for 12016 in South Carolina
ComponentRVULocality factorAdjusted
Physician work2.61× 1.0002.6100
Practice expense4.79× 0.9244.4260
Malpractice0.61× 0.8500.5185
Total RVUs7.5545
Conversion factor× 33.4009

Office rate, South Carolina$252.33

Office: (2.61 × 1 + 4.79 × 0.924 + 0.61 × 0.85) × $33.4009 = $252.33

Facility: (2.61 × 1 + 0.44 × 0.924 + 0.61 × 0.85) × $33.4009 = $118.07

Open 12016 in the RVU calculator

Payment rules and modifiers for 12016

The CMS indicators that decide how 12016 is paid alongside other services.

CMS payment indicators · 12016

Simple wound repair, face group, 12.6–20 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

12016 without 51 · national office

$267.54

Simple wound repair, face group, 12.6–20 cm

12016-51 · Second procedure: 50%

$133.77

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 12016

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

Codes related to 12016
CodeHow it relatesOffice range, South Carolina
Same family
12011Wound repair, face, 2.5 cm or lessSame face-site group and simple repair type, but for a shorter length band.$131.08
12015Simple wound repair, face and related sites, 7.6-12.5 cmSame face-site group and simple repair type, for a total length of 7.6–12.5 cm.$198.55
12017Wound repair, face and related sites, 20.1–30 cmSame face-site group and simple repair type, for a longer length band.No office rate
12018Wound repair, face group, over 30 cmSame face-site group and simple repair type, for a total length greater than 30 cm.No office rate
Used instead
12005Simple wound repair, 12.6–20.0 cmSimple repair at the same length band for a different anatomic group, including scalp, trunk, or extremities.$198.86
12031Wound repair, scalp, trunk, or extremityIntermediate repair for a different site group and repair classification, rather than simple facial-group closure.$244.49

How 12016 has changed in South Carolina

12016 · Office / nonfacility

$252.33

Effective 2026-10-01

The base rate is $50.70 higher than on 2025-10-01, moving from $201.63 to $252.33 (25.1%).

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

    $201.63changed to$252.33

    • Conversion factor 32.3465 changed to 33.4009
    • Work RVU 2.68 changed to 2.61
    • Practice expense RVU 3.40 changed to 4.79
    • Malpractice RVU 0.55 changed to 0.61
    • Practice expense GPCI 0.913 changed to 0.924
    • Malpractice GPCI 0.817 changed to 0.850

    Held through RVU26B, RVU26C, RVU26D.

  2. January 1, 2025

    RVU25A

    $206.01changed to$201.63

    • Conversion factor 33.2875 changed to 32.3465
    • Practice expense RVU 3.36 changed to 3.40
    • Malpractice RVU 0.54 changed to 0.55

    Held through RVU25B, RVU25C, RVU25D.

  3. March 9, 2024

    RVU24AR

    $202.65changed to$206.01

    • Conversion factor 32.7442 changed to 33.2875

    Held through RVU24B, RVU24C, RVU24D.

  4. January 1, 2024

    RVU24A

    $208.81changed to$202.65

    • Conversion factor 33.8872 changed to 32.7442
    • Practice expense RVU 3.41 changed to 3.36
    • Malpractice RVU 0.51 changed to 0.54
    • Practice expense GPCI 0.908 changed to 0.913
    • Malpractice GPCI 0.756 changed to 0.817

  5. January 1, 2023

    RVU23A

    $210.25changed to$208.81

    • Conversion factor 34.6062 changed to 33.8872
    • Practice expense RVU 3.36 changed to 3.41
    • Malpractice RVU 0.52 changed to 0.51
    • Practice expense GPCI 0.903 changed to 0.908
    • Malpractice GPCI 0.695 changed to 0.756

    Held through RVU23B, RVU23C, RVU23D.

  6. January 1, 2022

    RVU22A

    $209.86changed to$210.25

    • Conversion factor 34.8931 changed to 34.6062
    • Practice expense RVU 3.30 changed to 3.36
    • Malpractice RVU 0.51 changed to 0.52

    Held through RVU22B, RVU22C, RVU22D.

  7. January 1, 2021

    RVU21A

    $205.32changed to$209.86

    • Conversion factor 36.0896 changed to 34.8931
    • Practice expense RVU 2.96 changed to 3.30
    • Malpractice RVU 0.52 changed to 0.51
    • Practice expense GPCI 0.907 changed to 0.903
    • Malpractice GPCI 0.624 changed to 0.695

    Held through RVU21B, RVU21C, RVU21D.

  8. January 1, 2020

    RVU20A

    $198.16changed to$205.32

    • Conversion factor 36.0391 changed to 36.0896
    • Practice expense RVU 2.86 changed to 2.96
    • Malpractice RVU 0.38 changed to 0.52
    • Practice expense GPCI 0.912 changed to 0.907
    • Malpractice GPCI 0.553 changed to 0.624

    Held through RVU20B, RVU20C, RVU20D.

  9. January 1, 2019

    RVU19A

    $196.10changed to$198.16

    • Conversion factor 35.9996 changed to 36.0391
    • Practice expense RVU 2.81 changed to 2.86
    • Malpractice RVU 0.37 changed to 0.38

    Held through RVU19B, RVU19C, RVU19D.

  10. January 1, 2018

    RVU18AR1

    $194.18changed to$196.10

    • Conversion factor 35.8887 changed to 35.9996
    • Practice expense RVU 2.73 changed to 2.81
    • Malpractice RVU 0.38 changed to 0.37
    • Malpractice GPCI 0.634 changed to 0.553

    Held through RVU18B, RVU18C, RVU18D.

  11. January 1, 2017

    RVU17A

    $195.74changed to$194.18

    • Conversion factor 35.8043 changed to 35.8887
    • Practice expense RVU 2.75 changed to 2.73
    • Malpractice RVU 0.39 changed to 0.38
    • Malpractice GPCI 0.715 changed to 0.634

    Held through RVU17B, RVU17C, RVU17D.

  12. January 1, 2016

    RVU16A

    $203.58changed to$195.74

    • Conversion factor 35.9335 changed to 35.8043
    • Practice expense RVU 2.96 changed to 2.75
    • Malpractice RVU 0.40 changed to 0.39

    Held through RVU16B, RVU16C, RVU16D.

  13. July 1, 2015

    RVU15C

    $202.57changed to$203.58

    • Conversion factor 35.7547 changed to 35.9335

    Held through RVU15D.

  14. January 1, 2015

    RVU15A

    $200.06changed to$202.57

    • Conversion factor 35.8228 changed to 35.7547
    • Practice expense RVU 2.89 changed to 2.96
    • Malpractice RVU 0.44 changed to 0.40
    • Practice expense GPCI 0.911 changed to 0.912
    • Malpractice GPCI 0.618 changed to 0.715

    Held through RVU15B.

  15. January 1, 2014

    RVU14A

    $200.76changed to$200.06

    • Conversion factor 34.0230 changed to 35.8228
    • Practice expense RVU 3.28 changed to 2.89
    • Malpractice RVU 0.46 changed to 0.44
    • Practice expense GPCI 0.909 changed to 0.911
    • Malpractice GPCI 0.520 changed to 0.618

    Held through RVU14B, RVU14C, RVU14D.

  16. January 1, 2013

    RVU13AR

    Earliest loaded release: $200.76

    Held through RVU13B, RVU13C, RVU13D.

Rates in every CMS release
Effective fromOfficeFacilityCMS release
2026-10-01$252.33$118.07RVU26D
2026-07-01$252.33$118.07RVU26C
2026-04-01$252.33$118.07RVU26B
2026-01-01$252.33$118.07RVU26A
2025-10-01$201.63$118.35RVU25D
2025-07-01$201.63$118.35RVU25C
2025-04-01$201.63$118.35RVU25B
2025-01-01$201.63$118.35RVU25A
2024-10-01$206.01$121.83RVU24D
2024-07-01$206.01$121.83RVU24C
2024-04-01$206.01$121.83RVU24B
2024-03-09$206.01$121.83RVU24AR
2024-01-01$202.65$119.84RVU24A
2023-10-01$208.81$122.65RVU23D
2023-07-01$208.81$122.65RVU23C
2023-04-01$208.81$122.65RVU23B
2023-01-01$208.81$122.65RVU23A
2022-10-01$210.25$124.31RVU22D
2022-07-01$210.25$124.31RVU22C
2022-04-01$210.25$124.31RVU22B
2022-01-01$210.25$124.31RVU22A
2021-10-01$209.86$124.47RVU21D
2021-07-01$209.86$124.47RVU21C
2021-04-01$209.86$124.47RVU21B
2021-01-01$209.86$124.47RVU21A
2020-10-01$205.32$127.09RVU20D
2020-07-01$205.32$127.09RVU20C
2020-04-01$205.32$127.09RVU20B
2020-01-01$205.32$127.09RVU20A
2019-10-01$198.16$124.21RVU19D
2019-07-01$198.16$124.21RVU19C
2019-04-01$198.16$124.21RVU19B
2019-01-01$198.16$124.21RVU19A
2018-10-01$196.10$123.87RVU18D
2018-07-01$196.10$123.87RVU18C
2018-04-01$196.10$123.87RVU18B
2018-01-01$196.10$123.87RVU18AR1
2017-10-01$194.18$125.12RVU17D
2017-07-01$194.18$125.12RVU17C
2017-04-01$194.18$125.12RVU17B
2017-01-01$194.18$125.12RVU17A
2016-10-01$195.74$125.86RVU16D
2016-07-01$195.74$125.86RVU16C
2016-04-01$195.74$125.86RVU16B
2016-01-01$195.74$125.86RVU16A
2015-10-01$203.58$130.83RVU15D
2015-07-01$203.58$130.83RVU15C
2015-04-01$202.57$130.18RVU15B
2015-01-01$202.57$130.18RVU15A
2014-10-01$200.06$130.22RVU14D
2014-07-01$200.06$130.22RVU14C
2014-04-01$200.06$130.22RVU14B
2014-01-01$200.06$130.22RVU14A
2013-10-01$200.76$124.06RVU13D
2013-07-01$200.76$124.06RVU13C
2013-04-01$200.76$124.06RVU13B
2013-01-01$200.76$124.06RVU13AR

Price 12016 for an earlier date of service

Where the South Carolina rate applies

South Carolina is a Medicare payment area, not a city. Our Census mapping connects it to 475 cities and communities in South Carolina. Some span more than one payment area; confirm with the service ZIP.

  • Abbeville
  • Abney Crossroads
  • Adams Run
  • Aiken
  • Alcolu
  • Allendale
  • Anderson
  • Andrews

Browse all communities in South Carolina

12016 billing questions

How is the 12.6–20 cm length determined when there are several facial wounds?

Add the lengths of simple repairs in the same face-site group performed during the session. Report the code matching that combined length and retain measurements for each wound.

When should 12015 or 12017 be selected instead?

Use 12015 for a shorter total length in the same site group and 12017 for a longer total length. The repair type and anatomic group remain the same.

Can modifier 50 be used for wounds on both sides of the face?

No. The CMS bilateral adjustment does not apply to this code, and modifier 50 is inappropriate.

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

The highest-valued procedure is paid in full; other procedures in that session are subject to the standard 50% multiple-procedure reduction.

Does the code include same-day follow-up care, and can an assistant surgeon be reported?

The 0-day global period includes same-day preoperative and postoperative care. Medicare does not pay an assistant at surgery for this service.

What documentation supports reporting this code rather than an intermediate repair?

Record the wound sites, individual lengths, and that the closure was a simple, one-layer repair of superficial tissue. An intermediate repair involves a different repair classification.

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 12016PPRRVU2026_Oct_nonQPP.csv, line 1,407 (RVU26D)
Geographic factors for South CarolinaGPCI2026.csv, line 93 (RVU26D)

Open CMS sourceHow we calculate rates

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