CPT code 12034: Wound repair, intermediate, 7.6–12.5 cm2026 Medicare rate & RVUs in Missouri
Reports intermediate layered closure of qualifying wounds on the scalp, axillae, trunk, or extremities, excluding hands and feet, totaling 7.6–12.5 cm.
Medicare pays $303.32–$323.91 for 12034 in the office in Missouri, from Rest of Missouri to Metropolitan St. Louis, MO. Which amount applies depends on the service address.
Medicare allowed amount for participating (non-QP) physicians, before deductible, coinsurance and claim adjustments. Not a patient’s bill or a hospital charge.
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On this page 9 sections
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 in Missouri
The same RVUs, adjusted for each area’s costs. Open a locality for its calculation, history and nearby areas.
3 payment localities
$303.32 to $323.91
| Payment locality | Office | Facility |
|---|---|---|
| Metropolitan Kansas City, MO | $320.67 | $175.45 |
| Metropolitan St. Louis, MO | $323.91 | $176.69 |
| Rest of Missouri | $303.32 | $170.01 |
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.
How the rate is built · 12034
RVUs × geographic indexes × conversion factor
Work2.90
2.90 RVUs× 1.000 GPCI
Practice expense6.73
6.73 RVUs× 1.000 GPCI
Malpractice0.39
0.39 RVUs× 1.000 GPCI
Adjusted RVUs
10.0200
Conversion factor
$33.4009
Medicare rate
$334.68
Every GPCI starts at 1.000, the national rate. Enter a ZIP or drag a slider.
Payment rules and modifiers for 12034
12034 has a 10-day global period: related visits in that window are included in the surgery payment.
CMS payment indicators · 12034
Wound repair, intermediate, 7.6–12.5 cm
| Rule | CMS value | What it means |
|---|---|---|
| Global period | 010 | Minor procedure: the day of the procedure plus 10 days after are included. |
| Multiple procedures | 2 | Standard reduction: highest-valued procedure at 100%, others at 50%. |
| Bilateral (modifier 50) | 0 | The 150% bilateral adjustment doesn’t apply. |
| Assistant at surgery (80/81/82/AS) | 1 | Not paid (statutory restriction). |
| Co-surgeons (62) | 0 | Not permitted. |
| Team surgery (66) | 0 | Not permitted. |
| Professional/technical | 0 | Physician service: no professional/technical split. |
| Split (54/55/56) | 0.10/0.80/0.10 | Share of the payment for pre-op, the procedure itself, and post-op care. |
Global surgery period · 12034
Wound repair, intermediate, 7.6–12.5 cm
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.
What modifiers do to the payment
Modifier 51 · payment effect
With and without the modifier
12034 without 51 · national office
$334.68
Wound repair, intermediate, 7.6–12.5 cm
12034-51 · Second procedure: 50%
$167.34
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%).
12034 compared with similar codes
Compare codes · National
5 codes, side by side
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.
12034 billing questions
What makes this an intermediate repair rather than a simple repair?
Intermediate repair involves layered closure of deeper tissue as well as skin, or single-layer closure of a heavily contaminated wound requiring extensive cleaning. A routine skin-layer closure is not enough to support this code.
Which wound locations qualify?
The covered group is scalp, axillae, trunk, and extremities, excluding hands and feet. Face and mucous membrane repairs, and repairs in the separate neck, genitalia, hands, or feet group, use different code selections.
How should multiple wounds be counted?
Add lengths of wounds that share the same repair category and anatomic group to select the length-based code. Document the individual wound sites and lengths; Medicare’s multiple-procedure payment reduction is a separate issue when multiple procedures are performed in one session.
Is modifier 50 appropriate for wounds on both sides?
No. Modifier 50 is not appropriate for this code; select the repair code from the applicable anatomic group and total repaired length.
Are postoperative visits separately reported during the global period?
Related postoperative visits during the 10-day global period are included in the procedure’s payment.
Can an assistant or co-surgeon be reported?
Medicare does not pay an assistant at surgery for this service. Co-surgeons and team surgery are not permitted.
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
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