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

In Puerto Rico, Medicare pays $261.80 for 12031 in the office and $133.82 when it’s performed in a hospital or facility.

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.

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 Puerto Rico 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. Puerto Rico pays $261.80. The RVUs are the same everywhere; the geographic indexes change the dollars.

Every other payment area

12031 rates by state

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

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.

Payment rules and modifiers for 12031

12031 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

Codes related to 12031

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

How 12031 has changed in Puerto Rico

Price 12031 for an earlier date of service

Where the Puerto Rico rate applies

Puerto Rico is a Medicare payment area, not a city. Our Census mapping connects it to 292 cities and communities in Puerto Rico. Some span more than one payment area; confirm with the service ZIP.

• Aceitunas
• Adjuntas
• Aguada
• Aguadilla
• Aguas Buenas
• Aguas Claras
• Aguilita
• Aibonito

Browse all communities in Puerto Rico

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