CPT code 12034: Wound repair, intermediate, 7.6–12.5 cm2026 Medicare rate & RVUs

Medicare pays $334.68 for 12034 nationally in the office and $180.03 in a hospital or facility. Local office rates run $296.66–$438.64.

Medicare allowed amount for participating (non-QP) physicians, before deductible, coinsurance and claim adjustments. Not a patient’s bill or a hospital charge.

What 12034 covers

This service covers closure of a wound that needs more than a simple skin-layer repair, such as layered closure involving deeper subcutaneous tissue or superficial fascia. It can also describe single-layer closure of a heavily contaminated wound after extensive cleaning. The wound must be on the scalp, axillae, trunk, or an extremity; hands and feet are classified elsewhere. Physicians and other qualified practitioners commonly perform these repairs in offices, emergency departments, and other outpatient settings after lacerations or similar injuries.

Select the code based on repair complexity, anatomic group, and total repaired length. Add lengths of qualifying wounds in the same repair category and anatomic group; document each wound’s site, length, tissue layers closed, and any extensive cleaning. The service has a 10-day global period, which includes related postoperative visits during that period. For multiple procedures in one session, Medicare pays the highest-valued procedure in full and other procedures at 50%. Modifier 50 is not appropriate. Medicare does not pay an assistant at surgery for this service; 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.

Where 12034 pays more and less

The same RVUs, adjusted for each area’s costs. Open a locality for its calculation, history and nearby areas.

109 of 109 payment localities

12034 rates by state

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

How the 12034 rate is calculated

Each of 12034’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 12034

12034 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

12034 compared with similar codes

How to choose

12004Simple wound repairNonfacial sites, 7.6–12.5 cm

Use 12004 for simple closure in the corresponding scalp, trunk, or extremity group and length range. Use 12034 when the wound requires intermediate repair.

12032Intermediate repair2.6–7.5 cm, scalp/trunk/extremities

Both codes cover intermediate repair in the same anatomic group; 12032 covers a shorter total repaired length.

12035Wound repairIntermediate, 12.6–20 cm

Both codes cover intermediate repair in the same anatomic group; 12035 applies when the total repaired length is longer.

12044Intermediate repairNeck, hands, feet, or genitalia

The length band is comparable, but 12044 is for the separate neck, hands, feet, or genitalia group rather than the scalp, axillae, trunk, or extremities.

Codes related to 12034

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

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