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

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 Utah, Medicare pays $302.25 for 12020 in the office and $172.58 when it’s performed in a hospital or facility.

$302.25Office (non-facility)
$172.58Hospital or facility
−4.5%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 Utah
  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 Utah 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. Utah pays $302.25. The RVUs are the same everywhere; the geographic indexes change the dollars.

12020 in Utah vs other payment areas
  1. Utah · this page$302.25
  2. Los Angeles, CA · California$354.80+$52.55
  3. Washington, DC area · District of Columbia$361.30+$59.05
  4. Miami, FL · Florida$347.43+$45.18
  5. Chicago, IL · Illinois$336.92+$34.67
  6. Manhattan, NY · New York$365.52+$63.27
  7. Alaska · Alaska$367.62+$65.37

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

Every other payment area

12020 in every other Medicare payment locality
Payment localityOfficeFacility
AlabamaAlabama$283.48$162.78
ArkansasArkansas$279.30$160.80
ArizonaArizona$307.89$174.22
Bakersfield, CACalifornia$333.36$182.17
Chico, CACalifornia$332.13$180.95
El Centro, CACalifornia$332.21$181.02
Fresno, CACalifornia$332.13$180.95
Hanford, CACalifornia$332.13$180.95

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 Utah 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

104

Locality
Utah
Physician work
1.000
Practice expense
0.940
Malpractice
0.898
Office calculation for 12020 in Utah
ComponentRVULocality factorAdjusted
Physician work2.60× 1.0002.6000
Practice expense6.45× 0.9406.0630
Malpractice0.43× 0.8980.3861
Total RVUs9.0491
Conversion factor× 33.4009

Office rate, Utah$302.25

Office: (2.6 × 1 + 6.45 × 0.94 + 0.43 × 0.898) × $33.4009 = $302.25

Facility: (2.6 × 1 + 2.32 × 0.94 + 0.43 × 0.898) × $33.4009 = $172.58

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, Utah
Same family
12021Wound dehiscence care, with packingRelated superficial wound dehiscence treatment when packing is used.$177.79
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.$108.45
12031Wound repair, scalp, trunk, or extremityIntermediate repair of a new wound in its applicable site and length range.$247.85

How 12020 has changed in Utah

12020 · Office / nonfacility

$302.25

Effective 2026-10-01

The base rate is $25.50 higher than on 2025-10-01, moving from $276.75 to $302.25 (9.2%).

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

    $276.75changed to$302.25

    • 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
    • Practice expense GPCI 0.933 changed to 0.940
    • Malpractice GPCI 0.930 changed to 0.898

    Held through RVU26B, RVU26C, RVU26D.

  2. January 1, 2025

    RVU25A

    $286.36changed to$276.75

    • 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

    $281.69changed to$286.36

    • Conversion factor 32.7442 changed to 33.2875

    Held through RVU24B, RVU24C, RVU24D.

  4. January 1, 2024

    RVU24A

    $289.16changed to$281.69

    • 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
    • Practice expense GPCI 0.926 changed to 0.933
    • Malpractice GPCI 0.865 changed to 0.930

  5. January 1, 2023

    RVU23A

    $291.37changed to$289.16

    • 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
    • Practice expense GPCI 0.919 changed to 0.926
    • Malpractice GPCI 0.799 changed to 0.865

    Held through RVU23B, RVU23C, RVU23D.

  6. January 1, 2022

    RVU22A

    $291.78changed to$291.37

    • 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

    $288.48changed to$291.78

    • Conversion factor 36.0896 changed to 34.8931
    • Practice expense RVU 5.31 changed to 5.82
    • Practice expense GPCI 0.923 changed to 0.919
    • Malpractice GPCI 0.982 changed to 0.799

    Held through RVU21B, RVU21C, RVU21D.

  8. January 1, 2020

    RVU20A

    $283.49changed to$288.48

    • 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
    • Practice expense GPCI 0.927 changed to 0.923
    • Malpractice GPCI 1.165 changed to 0.982

    Held through RVU20B, RVU20C, RVU20D.

  9. January 1, 2019

    RVU19A

    $277.42changed to$283.49

    • 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

    $275.00changed to$277.42

    • 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 0.925 changed to 0.927
    • Malpractice GPCI 1.167 changed to 1.165

    Held through RVU18B, RVU18C, RVU18D.

  11. January 1, 2017

    RVU17A

    $284.01changed to$275.00

    • 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
    • Practice expense GPCI 0.922 changed to 0.925
    • Malpractice GPCI 1.169 changed to 1.167

    Held through RVU17B, RVU17C, RVU17D.

  12. January 1, 2016

    RVU16A

    $274.51changed to$284.01

    • 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

    $273.15changed to$274.51

    • Conversion factor 35.7547 changed to 35.9335

    Held through RVU15D.

  14. January 1, 2015

    RVU15A

    $275.87changed to$273.15

    • 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
    • Practice expense GPCI 0.919 changed to 0.922
    • Malpractice GPCI 1.136 changed to 1.169

    Held through RVU15B.

  15. January 1, 2014

    RVU14A

    $274.26changed to$275.87

    • 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
    • Practice expense GPCI 0.916 changed to 0.919
    • Malpractice GPCI 1.102 changed to 1.136

    Held through RVU14B, RVU14C, RVU14D.

  16. January 1, 2013

    RVU13AR

    Earliest loaded release: $274.26

    Held through RVU13B, RVU13C, RVU13D.

Rates in every CMS release
Effective fromOfficeFacilityCMS release
2026-10-01$302.25$172.58RVU26D
2026-07-01$302.25$172.58RVU26C
2026-04-01$302.25$172.58RVU26B
2026-01-01$302.25$172.58RVU26A
2025-10-01$276.75$178.37RVU25D
2025-07-01$276.75$178.37RVU25C
2025-04-01$276.75$178.37RVU25B
2025-01-01$276.75$178.37RVU25A
2024-10-01$286.36$181.70RVU24D
2024-07-01$286.36$181.70RVU24C
2024-04-01$286.36$181.70RVU24B
2024-03-09$286.36$181.70RVU24AR
2024-01-01$281.69$178.73RVU24A
2023-10-01$289.16$182.16RVU23D
2023-07-01$289.16$182.16RVU23C
2023-04-01$289.16$182.16RVU23B
2023-01-01$289.16$182.16RVU23A
2022-10-01$291.37$181.33RVU22D
2022-07-01$291.37$181.33RVU22C
2022-04-01$291.37$181.33RVU22B
2022-01-01$291.37$181.33RVU22A
2021-10-01$291.78$183.08RVU21D
2021-07-01$291.78$183.08RVU21C
2021-04-01$291.78$183.08RVU21B
2021-01-01$291.78$183.08RVU21A
2020-10-01$288.48$189.21RVU20D
2020-07-01$288.48$189.21RVU20C
2020-04-01$288.48$189.21RVU20B
2020-01-01$288.48$189.21RVU20A
2019-10-01$283.49$191.28RVU19D
2019-07-01$283.49$191.28RVU19C
2019-04-01$283.49$191.28RVU19B
2019-01-01$283.49$191.28RVU19A
2018-10-01$277.42$190.98RVU18D
2018-07-01$277.42$190.98RVU18C
2018-04-01$277.42$190.98RVU18B
2018-01-01$277.42$190.98RVU18AR1
2017-10-01$275.00$190.34RVU17D
2017-07-01$275.00$190.34RVU17C
2017-04-01$275.00$190.34RVU17B
2017-01-01$275.00$190.34RVU17A
2016-10-01$284.01$196.86RVU16D
2016-07-01$284.01$196.86RVU16C
2016-04-01$284.01$196.86RVU16B
2016-01-01$284.01$196.86RVU16A
2015-10-01$274.51$190.36RVU15D
2015-07-01$274.51$190.36RVU15C
2015-04-01$273.15$189.41RVU15B
2015-01-01$273.15$189.41RVU15A
2014-10-01$275.87$189.62RVU14D
2014-07-01$275.87$189.62RVU14C
2014-04-01$275.87$189.62RVU14B
2014-01-01$275.87$189.62RVU14A
2013-10-01$274.26$185.75RVU13D
2013-07-01$274.26$185.75RVU13C
2013-04-01$274.26$185.75RVU13B
2013-01-01$274.26$185.75RVU13AR

Price 12020 for an earlier date of service

Where the Utah rate applies

Utah is a Medicare payment area, not a city. Our Census mapping connects it to 334 cities and communities in Utah. Some span more than one payment area; confirm with the service ZIP.

  • Alpine
  • Alta
  • Altamont
  • Alton
  • Amalga
  • American Fork
  • Aneth
  • Annabella

Browse all communities in Utah

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 UtahGPCI2026.csv, line 104 (RVU26D)

Open CMS sourceHow we calculate rates

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