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

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 Houston, TX, Medicare pays $261.96 for 12031 in the office and $136.26 when it’s performed in a hospital or facility.

$261.96Office (non-facility)
$136.26Hospital or facility
+0.8%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 Houston, TX
  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 Houston, TX 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. Houston, TX pays $261.96. The RVUs are the same everywhere; the geographic indexes change the dollars.

12031 in Houston, TX vs other payment areas
  1. Houston, TX · this page$261.96
  2. Austin, TX · Texas$269.96+$8.00
  3. Beaumont, TX · Texas$242.48−$19.48
  4. Brazoria, TX · Texas$257.01−$4.95
  5. Dallas, TX · Texas$258.61−$3.35
  6. Fort Worth, TX · Texas$256.84−$5.12
  7. Galveston, TX · Texas$257.75−$4.21

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

Every other payment area

12031 in every other Medicare payment locality
Payment localityOfficeFacility
Rest of TexasTexas$249.57$129.44
Los Angeles, CACalifornia$294.18$144.42
Washington, DC areaDistrict of Columbia$297.54$148.42
Miami, FLFlorida$279.27$147.49
Chicago, ILIllinois$271.20$143.98
Manhattan, NYNew York$298.83$151.73
AlaskaAlaska$301.13$166.32
AlabamaAlabama$233.14$122.38

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 Houston, TX 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

102

Locality
Houston, TX
Physician work
1.008
Practice expense
0.993
Malpractice
1.376
Office calculation for 12031 in Houston, TX
ComponentRVULocality factorAdjusted
Physician work1.95× 1.0081.9656
Practice expense5.60× 0.9935.5608
Malpractice0.23× 1.3760.3165
Total RVUs7.8429
Conversion factor× 33.4009

Office rate, Houston, TX$261.96

Office: (1.95 × 1.008 + 5.6 × 0.993 + 0.23 × 1.376) × $33.4009 = $261.96

Facility: (1.95 × 1.008 + 1.81 × 0.993 + 0.23 × 1.376) × $33.4009 = $136.26

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, Houston, TX
Same family
12032Intermediate repair, 2.6–7.5 cm, scalp/trunk/extremitiesSame site group and repair type, for a longer combined wound length.$302.40
12034Wound repair, intermediate, 7.6–12.5 cmSame site group and repair type, for a combined length of 7.6–12.5 cm.$338.78
12041Intermediate repair, neck, hands, feet, genitalia, 2.5 cm or lessIntermediate repair for the separate neck, hand, foot, and external genitalia site group.$265.25
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.$115.81

How 12031 has changed in Houston, TX

12031 · Office / nonfacility

$261.96

Effective 2026-10-01

The base rate is $4.39 higher than on 2025-10-01, moving from $257.57 to $261.96 (1.7%).

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

    $257.57changed to$261.96

    • 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 1.014 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

    $268.21changed to$257.57

    • 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

    $263.83changed to$268.21

    • Conversion factor 32.7442 changed to 33.2875

    Held through RVU24B, RVU24C, RVU24D.

  4. January 1, 2024

    RVU24A

    $274.32changed to$263.83

    • Conversion factor 33.8872 changed to 32.7442
    • Practice expense RVU 5.67 changed to 5.66
    • 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

    $280.41changed to$274.32

    • Conversion factor 34.6062 changed to 33.8872
    • Practice expense RVU 5.65 changed to 5.67
    • 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

    $278.78changed to$280.41

    • 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

    $263.41changed to$278.78

    • 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 1.026 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

    $254.30changed to$263.41

    • 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 1.020 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

    $246.76changed to$254.30

    • 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

    $244.16changed to$246.76

    • 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
    • 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

    $241.69changed to$244.16

    • Conversion factor 35.8043 changed to 35.8887
    • Practice expense RVU 4.39 changed to 4.43
    • 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

    $241.88changed to$241.69

    • 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

    $240.68changed to$241.88

    • Conversion factor 35.7547 changed to 35.9335

    Held through RVU15D.

  14. January 1, 2015

    RVU15A

    $237.37changed to$240.68

    • 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
    • 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

    $244.39changed to$237.37

    • 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
    • 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: $244.39

    Held through RVU13B, RVU13C, RVU13D.

Rates in every CMS release
Effective fromOfficeFacilityCMS release
2026-10-01$261.96$136.26RVU26D
2026-07-01$261.96$136.26RVU26C
2026-04-01$261.96$136.26RVU26B
2026-01-01$261.96$136.26RVU26A
2025-10-01$257.57$152.13RVU25D
2025-07-01$257.57$152.13RVU25C
2025-04-01$257.57$152.13RVU25B
2025-01-01$257.57$152.13RVU25A
2024-10-01$268.21$155.69RVU24D
2024-07-01$268.21$155.69RVU24C
2024-04-01$268.21$155.69RVU24B
2024-03-09$268.21$155.69RVU24AR
2024-01-01$263.83$153.15RVU24A
2023-10-01$274.32$156.92RVU23D
2023-07-01$274.32$156.92RVU23C
2023-04-01$274.32$156.92RVU23B
2023-01-01$274.32$156.92RVU23A
2022-10-01$280.41$156.49RVU22D
2022-07-01$280.41$156.49RVU22C
2022-04-01$280.41$156.49RVU22B
2022-01-01$280.41$156.49RVU22A
2021-10-01$278.78$157.07RVU21D
2021-07-01$278.78$157.07RVU21C
2021-04-01$278.78$157.07RVU21B
2021-01-01$278.78$157.07RVU21A
2020-10-01$263.41$159.97RVU20D
2020-07-01$263.41$159.97RVU20C
2020-04-01$263.41$159.97RVU20B
2020-01-01$263.41$159.97RVU20A
2019-10-01$254.30$160.20RVU19D
2019-07-01$254.30$160.20RVU19C
2019-04-01$254.30$160.20RVU19B
2019-01-01$254.30$160.20RVU19A
2018-10-01$246.76$160.42RVU18D
2018-07-01$246.76$160.42RVU18C
2018-04-01$246.76$160.42RVU18B
2018-01-01$246.76$160.42RVU18AR1
2017-10-01$244.16$159.78RVU17D
2017-07-01$244.16$159.78RVU17C
2017-04-01$244.16$159.78RVU17B
2017-01-01$244.16$159.78RVU17A
2016-10-01$241.69$158.49RVU16D
2016-07-01$241.69$158.49RVU16C
2016-04-01$241.69$158.49RVU16B
2016-01-01$241.69$158.49RVU16A
2015-10-01$241.88$158.74RVU15D
2015-07-01$241.88$158.74RVU15C
2015-04-01$240.68$157.95RVU15B
2015-01-01$240.68$157.95RVU15A
2014-10-01$237.37$156.09RVU14D
2014-07-01$237.37$156.09RVU14C
2014-04-01$237.37$156.09RVU14B
2014-01-01$237.37$156.09RVU14A
2013-10-01$244.39$156.44RVU13D
2013-07-01$244.39$156.44RVU13C
2013-04-01$244.39$156.44RVU13B
2013-01-01$244.39$156.44RVU13AR

Price 12031 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

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 Houston, TXGPCI2026.csv, line 102 (RVU26D)

Open CMS sourceHow we calculate rates

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