CPT code 12020: Wound dehiscence, simple closure2026 Medicare rate & RVUs

Medicare pays $316.64 for 12020 nationally in the office and $178.69 in a hospital or facility. Local office rates run $279.30–$414.75.

Medicare allowed amount for participating (non-QP) physicians, before deductible, coinsurance and claim adjustments. Not a patient’s bill or a hospital charge.

What 12020 covers

This service treats a superficial surgical wound that has separated after the original closure. A physician or other qualified clinician managing the wound may cleanse and assess the site, then reapproximate the separated edges with a simple closure. Typical cases involve separation limited to the skin or superficial tissue of an incision; a deeper disruption is not the service described by this code. The code is for treating dehiscence, not for closing a new traumatic laceration.

Report the service when the record identifies the prior surgical wound, documents the separation and its superficial extent, and supports simple closure. Packing distinguishes the related 12021 service. Medicare assigns a 10-day global period, so related postoperative visits during those 10 days are included. When multiple procedures are performed in the same 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.

Where 12020 pays more and less

The same RVUs, adjusted for each area’s costs. Open a locality for its calculation, history and nearby areas.

109 of 109 payment localities

12020 rates by state

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

How the 12020 rate is calculated

Each of 12020’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.

Payment rules and modifiers for 12020

12020 has a 10-day global period: related visits in that window are included in the surgery payment.

What modifiers do to the payment

When to use modifier 51

12020 compared with similar codes

How to choose

12021Wound dehiscence careWith packing

Both address superficial wound dehiscence; 12021 is the related service when packing is used, while 12020 represents simple closure.

13160Wound closureExtensive or complicated

Use 13160 for extensive or complicated secondary closure of a surgical wound; 12020 is for superficial dehiscence treated with simple closure.

12001Simple wound repair2.5 cm or less

12001 repairs a new simple laceration by applicable site and length. 12020 treats separation of a previously closed superficial surgical wound.

Codes related to 12020

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

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

Open CMS sourceHow we calculate rates