FeeBase
Log inGet started
Menu

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

Use this code when a separated superficial surgical wound is treated with simple closure, such as reapproximating the skin of an incision.

CMS RVU26DEffective Oct 1, 2026One payment locality3.5K Medicare services in 2024

In Houston, TX, Medicare pays $321.23 for 12020 in the office and $184.25 when it’s performed in a hospital or facility.

$321.23Office (non-facility)
$184.25Hospital or facility
+1.4%vs the national office rate ($316.64)

Check a contract rate as a % of Medicare · 12020 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 12020 for the payment locality that covers the ZIP.

On this page 11 sections
  1. Rate in Houston, TX
  2. What 12020 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 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.

How Houston, TX compares for 12020

Across 109 of 109 payment localities, the office rate for 12020 runs from $279.30 in Arkansas to $414.75 in San Benito County, CA. Houston, TX pays $321.23. The RVUs are the same everywhere; the geographic indexes change the dollars.

12020 in Houston, TX vs other payment areas
  1. Houston, TX · this page$321.23
  2. Austin, TX · Texas$327.67+$6.44
  3. Beaumont, TX · Texas$296.23−$25.00
  4. Brazoria, TX · Texas$312.24−$8.99
  5. Dallas, TX · Texas$314.52−$6.71
  6. Fort Worth, TX · Texas$312.55−$8.68
  7. Galveston, TX · Texas$313.36−$7.87

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

Every other payment area

12020 in every other Medicare payment locality
Payment localityOfficeFacility
Rest of TexasTexas$304.26$173.35
Los Angeles, CACalifornia$354.80$191.61
Washington, DC areaDistrict of Columbia$361.30$198.80
Miami, FLFlorida$347.43$203.83
Chicago, ILIllinois$336.92$198.29
Manhattan, NYNew York$365.52$205.22
AlaskaAlaska$367.62$220.70
AlabamaAlabama$283.48$162.78

12020 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.

$279.30

$373.44

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

View every state and territory as a table
12020 office rate range by state
State / territoryOffice rate rangeLocalities
AK$367.621
AL$283.481
AR$279.301
AZ$307.891
CA$332.13–$414.7529
CO$328.331
CT$337.981
DC$361.301
DE$313.041
FL$314.39–$347.433
GA$296.13–$323.232
GU$340.111
HI$340.111
IA$289.671
ID$291.841
IL$305.98–$336.924
IN$293.531
KS$288.831
KY$291.511
LA$291.26–$305.882
MA$326.53–$360.422
MD$318.92–$361.303
ME$293.98–$309.402
MI$299.75–$318.952
MN$312.781
MO$286.54–$306.333
MS$282.951
MT$316.611
NC$297.021
ND$308.111
NE$291.121
NH$323.681
NJ$341.33–$357.562
NM$301.651
NV$314.461
NY$301.60–$375.225
OH$298.011
OK$290.391
OR$311.51–$338.272
PA$298.18–$329.812
PR$318.791
RI$323.851
SC$298.111
SD$307.101
TN$290.391
TX$296.23–$327.678
UT$302.251
VA$308.76–$361.302
VI$318.791
VT$307.391
WA$325.75–$367.262
WI$297.651
WV$294.611
WY$312.911

See 12020 in every payment locality

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.

How the rate is built · 12020

RVUs × geographic indexes × conversion factor

Office or facility?

Work2.60

2.60 RVUs× 1.000 GPCI

Practice expense6.45

6.45 RVUs× 1.000 GPCI

Malpractice0.43

0.43 RVUs× 1.000 GPCI

Adjusted RVUs

9.4800

Conversion factor

$33.4009

Medicare rate

$316.64

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

1,410

Code
12020
Physician work
2.60
Practice expense
6.45
Malpractice
0.43

GPCI2026.csv

102

Locality
Houston, TX
Physician work
1.008
Practice expense
0.993
Malpractice
1.376
Office calculation for 12020 in Houston, TX
ComponentRVULocality factorAdjusted
Physician work2.60× 1.0082.6208
Practice expense6.45× 0.9936.4048
Malpractice0.43× 1.3760.5917
Total RVUs9.6173
Conversion factor× 33.4009

Office rate, Houston, TX$321.23

Office: (2.6 × 1.008 + 6.45 × 0.993 + 0.43 × 1.376) × $33.4009 = $321.23

Facility: (2.6 × 1.008 + 2.32 × 0.993 + 0.43 × 1.376) × $33.4009 = $184.25

Open 12020 in the RVU calculator

Payment rules and modifiers for 12020

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

CMS payment indicators · 12020

Wound dehiscence, simple closure

RuleCMS valueWhat it means
Global period010Minor procedure: the day of the procedure plus 10 days after are 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.
Split (54/55/56)0.10/0.80/0.10Share of the payment for pre-op, the procedure itself, and post-op care.

Global surgery period · 12020

Wound dehiscence, simple closure

10-day global period ends

Oct 11, 2026

Covers Oct 1, 2026 through Oct 11, 2026 (11 days).

Visit on Oct 31, 2026

After the global period ends: visits and procedures are billed normally.

SurgeryVisit
Sep 28, 2026Oct 14, 2026

What modifiers do to the payment

Modifier 51 · payment effect

With and without the modifier

12020 without 51 · national office

$316.64

Wound dehiscence, simple closure

12020-51 · Second procedure: 50%

$158.32

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 12020

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

Codes related to 12020
CodeHow it relatesOffice range, Houston, TX
Same family
12021Wound dehiscence care, with packingRelated superficial wound dehiscence treatment when packing is used.$189.55
Used instead
13160Wound closure, extensive or complicatedFor secondary closure of a surgical wound when the closure is extensive or complicated.No office rate
12001Simple wound repair, 2.5 cm or lessSimple repair of a new laceration in its applicable site and length range.$115.81
12031Wound repair, scalp, trunk, or extremityIntermediate repair of a new wound in its applicable site and length range.$261.96

How 12020 has changed in Houston, TX

12020 · Office / nonfacility

$321.23

Effective 2026-10-01

The base rate is $23.29 higher than on 2025-10-01, moving from $297.94 to $321.23 (7.8%).

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

    $297.94changed to$321.23

    • Conversion factor 32.3465 changed to 33.4009
    • Work RVU 2.67 changed to 2.60
    • Practice expense RVU 5.88 changed to 6.45
    • 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

    $308.14changed to$297.94

    • Conversion factor 33.2875 changed to 32.3465
    • Practice expense RVU 5.94 changed to 5.88
    • Malpractice RVU 0.42 changed to 0.43

    Held through RVU25B, RVU25C, RVU25D.

  3. March 9, 2024

    RVU24AR

    $303.11changed to$308.14

    • Conversion factor 32.7442 changed to 33.2875

    Held through RVU24B, RVU24C, RVU24D.

  4. January 1, 2024

    RVU24A

    $313.54changed to$303.11

    • Conversion factor 33.8872 changed to 32.7442
    • Practice expense RVU 5.93 changed to 5.94
    • Malpractice RVU 0.43 changed to 0.42
    • 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

    $318.22changed to$313.54

    • Conversion factor 34.6062 changed to 33.8872
    • Practice expense RVU 5.90 changed to 5.93
    • Malpractice RVU 0.41 changed to 0.43
    • 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

    $318.62changed to$318.22

    • Conversion factor 34.8931 changed to 34.6062
    • Practice expense RVU 5.82 changed to 5.90
    • Malpractice RVU 0.43 changed to 0.41

    Held through RVU22B, RVU22C, RVU22D.

  7. January 1, 2021

    RVU21A

    $308.58changed to$318.62

    • Conversion factor 36.0896 changed to 34.8931
    • Practice expense RVU 5.31 changed to 5.82
    • 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

    $297.62changed to$308.58

    • Conversion factor 36.0391 changed to 36.0896
    • Practice expense RVU 5.09 changed to 5.31
    • Malpractice RVU 0.41 changed to 0.43
    • 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

    $291.13changed to$297.62

    • Conversion factor 35.9996 changed to 36.0391
    • Practice expense RVU 4.93 changed to 5.09
    • Malpractice RVU 0.40 changed to 0.41

    Held through RVU19B, RVU19C, RVU19D.

  10. January 1, 2018

    RVU18AR1

    $288.37changed to$291.13

    • Conversion factor 35.8887 changed to 35.9996
    • Practice expense RVU 4.88 changed to 4.93
    • Malpractice RVU 0.41 changed to 0.40
    • 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

    $296.68changed to$288.37

    • Conversion factor 35.8043 changed to 35.8887
    • Practice expense RVU 5.01 changed to 4.88
    • Malpractice RVU 0.55 changed to 0.41
    • 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

    $287.88changed to$296.68

    • Conversion factor 35.9335 changed to 35.8043
    • Practice expense RVU 4.87 changed to 5.01
    • Malpractice RVU 0.41 changed to 0.55

    Held through RVU16B, RVU16C, RVU16D.

  13. July 1, 2015

    RVU15C

    $286.45changed to$287.88

    • Conversion factor 35.7547 changed to 35.9335

    Held through RVU15D.

  14. January 1, 2015

    RVU15A

    $289.55changed to$286.45

    • Conversion factor 35.8228 changed to 35.7547
    • Practice expense RVU 4.98 changed to 4.87
    • Malpractice RVU 0.40 changed to 0.41
    • 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

    $288.26changed to$289.55

    • Conversion factor 34.0230 changed to 35.8228
    • Practice expense RVU 5.38 changed to 4.98
    • Malpractice RVU 0.42 changed to 0.40
    • 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: $288.26

    Held through RVU13B, RVU13C, RVU13D.

Rates in every CMS release
Effective fromOfficeFacilityCMS release
2026-10-01$321.23$184.25RVU26D
2026-07-01$321.23$184.25RVU26C
2026-04-01$321.23$184.25RVU26B
2026-01-01$321.23$184.25RVU26A
2025-10-01$297.94$192.17RVU25D
2025-07-01$297.94$192.17RVU25C
2025-04-01$297.94$192.17RVU25B
2025-01-01$297.94$192.17RVU25A
2024-10-01$308.14$195.63RVU24D
2024-07-01$308.14$195.63RVU24C
2024-04-01$308.14$195.63RVU24B
2024-03-09$308.14$195.63RVU24AR
2024-01-01$303.11$192.43RVU24A
2023-10-01$313.54$196.14RVU23D
2023-07-01$313.54$196.14RVU23C
2023-04-01$313.54$196.14RVU23B
2023-01-01$313.54$196.14RVU23A
2022-10-01$318.22$195.01RVU22D
2022-07-01$318.22$195.01RVU22C
2022-04-01$318.22$195.01RVU22B
2022-01-01$318.22$195.01RVU22A
2021-10-01$318.62$196.90RVU21D
2021-07-01$318.62$196.90RVU21C
2021-04-01$318.62$196.90RVU21B
2021-01-01$318.62$196.90RVU21A
2020-10-01$308.58$198.88RVU20D
2020-07-01$308.58$198.88RVU20C
2020-04-01$308.58$198.88RVU20B
2020-01-01$308.58$198.88RVU20A
2019-10-01$297.62$196.96RVU19D
2019-07-01$297.62$196.96RVU19C
2019-04-01$297.62$196.96RVU19B
2019-01-01$297.62$196.96RVU19A
2018-10-01$291.13$196.77RVU18D
2018-07-01$291.13$196.77RVU18C
2018-04-01$291.13$196.77RVU18B
2018-01-01$291.13$196.77RVU18AR1
2017-10-01$288.37$196.03RVU17D
2017-07-01$288.37$196.03RVU17C
2017-04-01$288.37$196.03RVU17B
2017-01-01$288.37$196.03RVU17A
2016-10-01$296.68$201.59RVU16D
2016-07-01$296.68$201.59RVU16C
2016-04-01$296.68$201.59RVU16B
2016-01-01$296.68$201.59RVU16A
2015-10-01$287.88$196.06RVU15D
2015-07-01$287.88$196.06RVU15C
2015-04-01$286.45$195.09RVU15B
2015-01-01$286.45$195.09RVU15A
2014-10-01$289.55$195.32RVU14D
2014-07-01$289.55$195.32RVU14C
2014-04-01$289.55$195.32RVU14B
2014-01-01$289.55$195.32RVU14A
2013-10-01$288.26$191.44RVU13D
2013-07-01$288.26$191.44RVU13C
2013-04-01$288.26$191.44RVU13B
2013-01-01$288.26$191.44RVU13AR

Price 12020 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.

Browse all communities in Texas

12020 billing questions

When should 12020 be selected instead of 12021?

Use 12020 for treatment of superficial wound dehiscence with simple closure. When packing is used, the related code is 12021.

Can 12020 be used for a new laceration?

No. It addresses separation of a previously closed superficial surgical wound; a new laceration is selected from the repair codes according to its site and other coding criteria.

What documentation supports reporting 12020?

Document the prior surgical wound, the dehiscence and its superficial extent, and the simple closure performed. The record should make clear that this was treatment of wound separation rather than repair of a new injury.

Are related postoperative visits separately payable during the global period?

Related postoperative visits during the 10-day global period are included in the procedure payment.

Can modifier 50 or an assistant-at-surgery claim be reported?

Modifier 50 is inappropriate for this code. Medicare does not pay an assistant at surgery for this service.

How are other procedures in the same session handled?

Under the standard multiple procedure reduction, the highest-valued procedure is paid in full and other procedures performed in the same session are paid at 50%.

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 12020PPRRVU2026_Oct_nonQPP.csv, line 1,410 (RVU26D)
Geographic factors for Houston, TXGPCI2026.csv, line 102 (RVU26D)

Open CMS sourceHow we calculate rates

Did this answer your question about what 12020 pays in Houston, TX?

Tell us what you were actually trying to work out. We’ll answer you directly, or build the page that does.

Fee sheets · Coming soon

Put 12020 and the rest of your codes on one sheet

Your codes at your locality, with payer contracts beside Medicare.

Join the waitlist