FeeBase
Log inGet started
Menu

CPT code 12031: Wound repair, scalp, trunk, or extremity2026 Medicare rate & RVUs in Connecticut

Reports intermediate layered repair of a scalp, axillary, trunk, or extremity wound, excluding hands and feet, when the repair length is 2.5 cm or less.

CMS RVU26DEffective Oct 1, 2026One payment locality62.8K Medicare services in 2024

In Connecticut, Medicare pays $277.18 for 12031 in the office and $140.84 when it’s performed in a hospital or facility.

$277.18Office (non-facility)
$140.84Hospital or facility
+6.7%vs the national office rate ($259.86)

Check a contract rate as a % of Medicare · 12031 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 12031 for the payment locality that covers the ZIP.

On this page 11 sections
  1. Rate in Connecticut
  2. What 12031 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 12031 covers

This service is for a wound requiring more than a straightforward skin closure: the clinician closes one or more deeper tissue layers as well as the skin, or extensively cleans a heavily contaminated wound before closure. Typical settings include emergency departments, outpatient clinics, and surgical practices. The covered locations are the scalp, axillae, trunk, and extremities, but not the hands or feet. Intermediate repairs of the face and other separately classified sites use different codes.

Choose the code by the repair’s anatomic group, complexity, and documented length. For multiple intermediate wounds in the same anatomic group, add their lengths when selecting the code; report this level when the combined length is 2.5 cm or less. The note should describe the wound location and length, the layered closure or extensive cleaning, and the work performed. CMS assigns a 10-day global period, so related postoperative visits during that period are 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 multiple-procedure reduction. Bilateral adjustment is not appropriate; assistant-at-surgery payment is statutorily restricted, and co-surgeons and team surgery 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 Connecticut compares for 12031

Across 109 of 109 payment localities, the office rate for 12031 runs from $229.76 in Arkansas to $346.13 in San Benito County, CA. Connecticut pays $277.18. The RVUs are the same everywhere; the geographic indexes change the dollars.

12031 in Connecticut vs other payment areas
  1. Connecticut · this page$277.18
  2. Los Angeles, CA · California$294.18+$17.00
  3. Washington, DC area · District of Columbia$297.54+$20.36
  4. Miami, FL · Florida$279.27+$2.09
  5. Chicago, IL · Illinois$271.20−$5.98
  6. Manhattan, NY · New York$298.83+$21.65
  7. Alaska · Alaska$301.13+$23.95

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

Every other payment area

12031 in every other Medicare payment locality
Payment localityOfficeFacility
AlabamaAlabama$233.14$122.38
ArkansasArkansas$229.76$121.02
ArizonaArizona$252.95$130.29
Bakersfield, CACalifornia$276.05$137.31
Chico, CACalifornia$275.36$136.62
El Centro, CACalifornia$275.40$136.65
Fresno, CACalifornia$275.36$136.62
Hanford, CACalifornia$275.36$136.62

12031 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.

$229.76

$310.75

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

View every state and territory as a table
12031 office rate range by state
State / territoryOffice rate rangeLocalities
AK$301.131
AL$233.141
AR$229.761
AZ$252.951
CA$275.36–$346.1329
CO$270.931
CT$277.181
DC$297.541
DE$257.161
FL$255.49–$279.273
GA$241.13–$264.592
GU$282.251
HI$282.251
IA$239.331
ID$240.851
IL$247.91–$271.304
IN$242.261
KS$238.091
KY$238.441
LA$238.03–$249.872
MA$269.26–$297.972
MD$262.12–$297.543
ME$241.99–$255.342
MI$244.58–$258.582
MN$259.881
MO$233.85–$250.903
MS$231.851
MT$259.841
NC$244.551
ND$255.301
NE$240.681
NH$266.571
NJ$280.42–$294.412
NM$245.881
NV$258.761
NY$248.23–$305.965
OH$243.651
OK$238.131
OR$256.83–$279.702
PA$244.10–$270.182
PR$261.801
RI$266.441
SC$244.491
SD$254.761
TN$239.281
TX$242.48–$269.968
UT$247.851
VA$254.42–$297.542
VI$261.801
VT$254.191
WA$268.78–$304.172
WI$246.691
WV$238.671
WY$257.861

See 12031 in every payment locality

How the 12031 rate is calculated

Each of 12031’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 · 12031

RVUs × geographic indexes × conversion factor

Office or facility?

Work1.95

1.95 RVUs× 1.000 GPCI

Practice expense5.60

5.60 RVUs× 1.000 GPCI

Malpractice0.23

0.23 RVUs× 1.000 GPCI

Adjusted RVUs

7.7800

Conversion factor

$33.4009

Medicare rate

$259.86

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

The exact Connecticut inputs and CMS source lines

PPRRVU2026_Oct_nonQPP.csv

1,412

Code
12031
Physician work
1.95
Practice expense
5.60
Malpractice
0.23

GPCI2026.csv

38

Locality
Connecticut
Physician work
1.020
Practice expense
1.077
Malpractice
1.210
Office calculation for 12031 in Connecticut
ComponentRVULocality factorAdjusted
Physician work1.95× 1.0201.9890
Practice expense5.60× 1.0776.0312
Malpractice0.23× 1.2100.2783
Total RVUs8.2985
Conversion factor× 33.4009

Office rate, Connecticut$277.18

Office: (1.95 × 1.02 + 5.6 × 1.077 + 0.23 × 1.21) × $33.4009 = $277.18

Facility: (1.95 × 1.02 + 1.81 × 1.077 + 0.23 × 1.21) × $33.4009 = $140.84

Open 12031 in the RVU calculator

Payment rules and modifiers for 12031

12031 has a 10-day global period: related visits in that window are included in the surgery payment.

CMS payment indicators · 12031

Wound repair, scalp, trunk, or extremity

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 · 12031

Wound repair, scalp, trunk, or extremity

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

12031 without 51 · national office

$259.86

Wound repair, scalp, trunk, or extremity

12031-51 · Second procedure: 50%

$129.93

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 12031

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

Codes related to 12031
CodeHow it relatesOffice range, Connecticut
Same family
12032Intermediate repair, 2.6–7.5 cm, scalp/trunk/extremitiesSame site group and repair type, for a longer combined wound length.$319.51
12034Wound repair, intermediate, 7.6–12.5 cmSame site group and repair type, for a combined length of 7.6–12.5 cm.$356.66
12041Intermediate repair, neck, hands, feet, genitalia, 2.5 cm or lessIntermediate repair for the separate neck, hand, foot, and external genitalia site group.$280.31
Used instead
12001Simple wound repair, 2.5 cm or lessSimple repair for a short wound in the corresponding general site grouping when layered repair is not needed.$121.91

How 12031 has changed in Connecticut

12031 · Office / nonfacility

$277.18

Effective 2026-10-01

The base rate is $4.78 higher than on 2025-10-01, moving from $272.40 to $277.18 (1.8%).

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

    $272.40changed to$277.18

    • Conversion factor 32.3465 changed to 33.4009
    • Work RVU 2.00 changed to 1.95
    • Practice expense RVU 5.58 changed to 5.60
    • Malpractice RVU 0.24 changed to 0.23
    • Work GPCI 1.022 changed to 1.020
    • Practice expense GPCI 1.091 changed to 1.077
    • Malpractice GPCI 1.207 changed to 1.210

    Held through RVU26B, RVU26C, RVU26D.

  2. January 1, 2025

    RVU25A

    $283.64changed to$272.40

    • Conversion factor 33.2875 changed to 32.3465
    • Practice expense RVU 5.66 changed to 5.58
    • Malpractice RVU 0.25 changed to 0.24

    Held through RVU25B, RVU25C, RVU25D.

  3. March 9, 2024

    RVU24AR

    $279.01changed to$283.64

    • Conversion factor 32.7442 changed to 33.2875

    Held through RVU24B, RVU24C, RVU24D.

  4. January 1, 2024

    RVU24A

    $290.61changed to$279.01

    • Conversion factor 33.8872 changed to 32.7442
    • Practice expense RVU 5.67 changed to 5.66
    • Work GPCI 1.030 changed to 1.022
    • Practice expense GPCI 1.102 changed to 1.091
    • Malpractice GPCI 1.070 changed to 1.207

  5. January 1, 2023

    RVU23A

    $297.67changed to$290.61

    • Conversion factor 34.6062 changed to 33.8872
    • Practice expense RVU 5.65 changed to 5.67
    • Work GPCI 1.037 changed to 1.030
    • Practice expense GPCI 1.114 changed to 1.102
    • Malpractice GPCI 0.934 changed to 1.070

    Held through RVU23B, RVU23C, RVU23D.

  6. January 1, 2022

    RVU22A

    $295.86changed to$297.67

    • Conversion factor 34.8931 changed to 34.6062
    • Practice expense RVU 5.54 changed to 5.65

    Held through RVU22B, RVU22C, RVU22D.

  7. January 1, 2021

    RVU21A

    $281.76changed to$295.86

    • Conversion factor 36.0896 changed to 34.8931
    • Practice expense RVU 4.91 changed to 5.54
    • Malpractice RVU 0.26 changed to 0.25
    • Work GPCI 1.029 changed to 1.037
    • Practice expense GPCI 1.113 changed to 1.114
    • Malpractice GPCI 1.094 changed to 0.934

    Held through RVU21B, RVU21C, RVU21D.

  8. January 1, 2020

    RVU20A

    $274.77changed to$281.76

    • Conversion factor 36.0391 changed to 36.0896
    • Practice expense RVU 4.67 changed to 4.91
    • Malpractice RVU 0.31 changed to 0.26
    • Work GPCI 1.021 changed to 1.029
    • Practice expense GPCI 1.112 changed to 1.113
    • Malpractice GPCI 1.255 changed to 1.094

    Held through RVU20B, RVU20C, RVU20D.

  9. January 1, 2019

    RVU19A

    $266.41changed to$274.77

    • Conversion factor 35.9996 changed to 36.0391
    • Practice expense RVU 4.48 changed to 4.67
    • Malpractice RVU 0.30 changed to 0.31

    Held through RVU19B, RVU19C, RVU19D.

  10. January 1, 2018

    RVU18AR1

    $264.86changed to$266.41

    • Conversion factor 35.8887 changed to 35.9996
    • Practice expense RVU 4.43 changed to 4.48
    • Malpractice RVU 0.31 changed to 0.30
    • Work GPCI 1.023 changed to 1.021
    • Practice expense GPCI 1.117 changed to 1.112
    • Malpractice GPCI 1.244 changed to 1.255

    Held through RVU18B, RVU18C, RVU18D.

  11. January 1, 2017

    RVU17A

    $263.20changed to$264.86

    • Conversion factor 35.8043 changed to 35.8887
    • Practice expense RVU 4.39 changed to 4.43
    • Work GPCI 1.024 changed to 1.023
    • Practice expense GPCI 1.121 changed to 1.117
    • Malpractice GPCI 1.232 changed to 1.244

    Held through RVU17B, RVU17C, RVU17D.

  12. January 1, 2016

    RVU16A

    $263.27changed to$263.20

    • Conversion factor 35.9335 changed to 35.8043
    • Malpractice RVU 0.29 changed to 0.31

    Held through RVU16B, RVU16C, RVU16D.

  13. July 1, 2015

    RVU15C

    $261.96changed to$263.27

    • Conversion factor 35.7547 changed to 35.9335

    Held through RVU15D.

  14. January 1, 2015

    RVU15A

    $258.58changed to$261.96

    • Conversion factor 35.8228 changed to 35.7547
    • Practice expense RVU 4.29 changed to 4.39
    • Malpractice RVU 0.31 changed to 0.29
    • Practice expense GPCI 1.116 changed to 1.121
    • Malpractice GPCI 1.234 changed to 1.232

    Held through RVU15B.

  15. January 1, 2014

    RVU14A

    $266.67changed to$258.58

    • Conversion factor 34.0230 changed to 35.8228
    • Practice expense RVU 4.86 changed to 4.29
    • Malpractice RVU 0.32 changed to 0.31
    • Practice expense GPCI 1.110 changed to 1.116
    • Malpractice GPCI 1.235 changed to 1.234

    Held through RVU14B, RVU14C, RVU14D.

  16. January 1, 2013

    RVU13AR

    Earliest loaded release: $266.67

    Held through RVU13B, RVU13C, RVU13D.

Rates in every CMS release
Effective fromOfficeFacilityCMS release
2026-10-01$277.18$140.84RVU26D
2026-07-01$277.18$140.84RVU26C
2026-04-01$277.18$140.84RVU26B
2026-01-01$277.18$140.84RVU26A
2025-10-01$272.40$157.71RVU25D
2025-07-01$272.40$157.71RVU25C
2025-04-01$272.40$157.71RVU25B
2025-01-01$272.40$157.71RVU25A
2024-10-01$283.64$161.25RVU24D
2024-07-01$283.64$161.25RVU24C
2024-04-01$283.64$161.25RVU24B
2024-03-09$283.64$161.25RVU24AR
2024-01-01$279.01$158.62RVU24A
2023-10-01$290.61$163.27RVU23D
2023-07-01$290.61$163.27RVU23C
2023-04-01$290.61$163.27RVU23B
2023-01-01$290.61$163.27RVU23A
2022-10-01$297.67$163.51RVU22D
2022-07-01$297.67$163.51RVU22C
2022-04-01$297.67$163.51RVU22B
2022-01-01$297.67$163.51RVU22A
2021-10-01$295.86$164.09RVU21D
2021-07-01$295.86$164.09RVU21C
2021-04-01$295.86$164.09RVU21B
2021-01-01$295.86$164.09RVU21A
2020-10-01$281.76$168.89RVU20D
2020-07-01$281.76$168.89RVU20C
2020-04-01$281.76$168.89RVU20B
2020-01-01$281.76$168.89RVU20A
2019-10-01$274.77$171.37RVU19D
2019-07-01$274.77$171.37RVU19C
2019-04-01$274.77$171.37RVU19B
2019-01-01$274.77$171.37RVU19A
2018-10-01$266.41$171.53RVU18D
2018-07-01$266.41$171.53RVU18C
2018-04-01$266.41$171.53RVU18B
2018-01-01$266.41$171.53RVU18AR1
2017-10-01$264.86$171.45RVU17D
2017-07-01$264.86$171.45RVU17C
2017-04-01$264.86$171.45RVU17B
2017-01-01$264.86$171.45RVU17A
2016-10-01$263.20$170.49RVU16D
2016-07-01$263.20$170.49RVU16C
2016-04-01$263.20$170.49RVU16B
2016-01-01$263.20$170.49RVU16A
2015-10-01$263.27$170.62RVU15D
2015-07-01$263.27$170.62RVU15C
2015-04-01$261.96$169.77RVU15B
2015-01-01$261.96$169.77RVU15A
2014-10-01$258.58$168.22RVU14D
2014-07-01$258.58$168.22RVU14C
2014-04-01$258.58$168.22RVU14B
2014-01-01$258.58$168.22RVU14A
2013-10-01$266.67$169.23RVU13D
2013-07-01$266.67$169.23RVU13C
2013-04-01$266.67$169.23RVU13B
2013-01-01$266.67$169.23RVU13AR

Price 12031 for an earlier date of service

Where the Connecticut rate applies

Connecticut is a Medicare payment area, not a city. Our Census mapping connects it to 215 cities and communities in Connecticut. Some span more than one payment area; confirm with the service ZIP.

  • Ansonia
  • Ball Pond
  • Baltic
  • Bantam
  • Bethel
  • Bethlehem Village
  • Bigelow Corners
  • Blue Hills

Browse all communities in Connecticut

12031 billing questions

When is 12031 appropriate instead of a simple repair code?

Use 12031 when the wound needs layered closure of deeper tissue and skin, or extensive cleaning because it is heavily contaminated. A straightforward skin-only closure is reported from the simple-repair family instead.

How do I select the length level for multiple wounds?

Add the lengths of intermediate repairs in the same anatomic group, then select the code for that combined length. This code covers a combined length of 2.5 cm or less.

Can I report 12031 for a hand or foot wound?

No. Hands and feet are assigned to the separate intermediate-repair site group represented by 12041 and its related length levels.

Are related postoperative visits separately reported?

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

Can modifier 50 or an assistant-at-surgery modifier be used?

Bilateral adjustment does not apply to this code. CMS also identifies a statutory restriction on assistant-at-surgery payment.

What happens when another procedure is performed in the same session?

Under the standard multiple-procedure rule, the highest-valued procedure is paid in full and other procedures are subject to the 50% reduction.

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 12031PPRRVU2026_Oct_nonQPP.csv, line 1,412 (RVU26D)
Geographic factors for ConnecticutGPCI2026.csv, line 38 (RVU26D)

Open CMS sourceHow we calculate rates

Did this answer your question about what 12031 pays in Connecticut?

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

Fee sheets

Put 12031 and the rest of your codes on one sheet

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

Build my fee sheet