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CPT code 12035: Wound repair, intermediate, 12.6–20 cm2026 Medicare rate & RVUs in Delaware

Reports intermediate repair of qualifying scalp, axillary, trunk, or extremity wounds when the summed repair length is 12.6 to 20.0 cm.

CMS RVU26DEffective Oct 1, 2026One payment locality5.7K Medicare services in 2024

In Delaware, Medicare pays $409.29 for 12035 in the office and $221.85 when it’s performed in a hospital or facility.

$409.29Office (non-facility)
$221.85Hospital or facility
−1.2%vs the national office rate ($414.17)

Check a contract rate as a % of Medicare · 12035 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 12035 for the payment locality that covers the ZIP.

On this page 11 sections
  1. Rate in Delaware
  2. What 12035 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 12035 covers

This code covers intermediate repair of wounds on the scalp, axillae, trunk, or extremities, excluding the hands and feet. The repair generally closes deeper subcutaneous tissue or superficial fascia as well as the skin. A heavily contaminated wound may qualify when extensive cleaning is needed, even if closure is in one layer. Emergency physicians, surgeons, and other clinicians who repair traumatic or surgical wounds may perform this service in an office, emergency department, or operating room.

Select the code by the qualifying wound site, repair complexity, and summed length of wounds in the same anatomic grouping and repair classification; the total must be 12.6 to 20.0 cm. Document each wound’s location and length, the closure technique and layers repaired, and extensive cleaning when that is the basis for intermediate repair. Related postoperative visits during the 10-day global period are included. When multiple procedures occur in the same session, the highest-valued procedure is paid in full and other procedures are subject to a 50% reduction. Modifier 50 is not appropriate for this code. Assistant-at-surgery payment is 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 Delaware compares for 12035

Across 109 of 109 payment localities, the office rate for 12035 runs from $364.71 in Arkansas to $540.66 in San Benito County, CA. Delaware pays $409.29. The RVUs are the same everywhere; the geographic indexes change the dollars.

12035 in Delaware vs other payment areas
  1. Delaware · this page$409.29
  2. Los Angeles, CA · California$463.04+$53.75
  3. Washington, DC area · District of Columbia$472.42+$63.13
  4. Miami, FL · Florida$457.30+$48.01
  5. Chicago, IL · Illinois$443.18+$33.89
  6. Manhattan, NY · New York$478.89+$69.60
  7. Alaska · Alaska$479.99+$70.70

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

Every other payment area

12035 in every other Medicare payment locality
Payment localityOfficeFacility
AlabamaAlabama$370.24$204.24
ArkansasArkansas$364.71$201.74
ArizonaArizona$402.52$218.69
Bakersfield, CACalifornia$435.08$227.15
Chico, CACalifornia$433.34$225.41
El Centro, CACalifornia$433.44$225.51
Fresno, CACalifornia$433.34$225.41
Hanford, CACalifornia$433.34$225.41

12035 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.

$364.71

$487.00

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

View every state and territory as a table
12035 office rate range by state
State / territoryOffice rate rangeLocalities
AK$479.991
AL$370.241
AR$364.711
AZ$402.521
CA$433.34–$540.6629
CO$428.891
CT$442.321
DC$472.421
DE$409.291
FL$412.29–$457.303
GA$387.95–$423.152
GU$443.751
HI$443.751
IA$377.921
ID$380.891
IL$401.51–$443.184
IN$383.121
KS$377.061
KY$381.381
LA$381.15–$400.492
MA$426.61–$470.802
MD$416.97–$472.423
ME$383.98–$404.012
MI$392.52–$418.592
MN$407.701
MO$375.05–$400.793
MS$369.911
MT$414.131
NC$387.961
ND$401.871
NE$379.761
NH$423.041
NJ$446.46–$467.492
NM$395.131
NV$410.991
NY$394.04–$492.055
OH$390.011
OK$379.641
OR$406.90–$441.722
PA$390.11–$431.682
PR$416.941
RI$423.321
SC$389.821
SD$400.421
TN$379.141
TX$387.54–$428.258
UT$395.281
VA$403.33–$472.422
VI$416.941
VT$401.151
WA$425.52–$479.542
WI$388.101
WV$386.471
WY$408.791

See 12035 in every payment locality

How the 12035 rate is calculated

Each of 12035’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 · 12035

RVUs × geographic indexes × conversion factor

Office or facility?

Work3.41

3.41 RVUs× 1.000 GPCI

Practice expense8.37

8.37 RVUs× 1.000 GPCI

Malpractice0.62

0.62 RVUs× 1.000 GPCI

Adjusted RVUs

12.4000

Conversion factor

$33.4009

Medicare rate

$414.17

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

The exact Delaware inputs and CMS source lines

PPRRVU2026_Oct_nonQPP.csv

1,415

Code
12035
Physician work
3.41
Practice expense
8.37
Malpractice
0.62

GPCI2026.csv

40

Locality
Delaware
Physician work
1.005
Practice expense
0.988
Malpractice
0.899
Office calculation for 12035 in Delaware
ComponentRVULocality factorAdjusted
Physician work3.41× 1.0053.4270
Practice expense8.37× 0.9888.2696
Malpractice0.62× 0.8990.5574
Total RVUs12.2540
Conversion factor× 33.4009

Office rate, Delaware$409.29

Office: (3.41 × 1.005 + 8.37 × 0.988 + 0.62 × 0.899) × $33.4009 = $409.29

Facility: (3.41 × 1.005 + 2.69 × 0.988 + 0.62 × 0.899) × $33.4009 = $221.85

Open 12035 in the RVU calculator

Payment rules and modifiers for 12035

12035 has a 10-day global period: related visits in that window are included in the surgery payment.

CMS payment indicators · 12035

Wound repair, intermediate, 12.6–20 cm

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 · 12035

Wound repair, intermediate, 12.6–20 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.

SurgeryVisit
Sep 28, 2026Oct 14, 2026

What modifiers do to the payment

Modifier 51 · payment effect

With and without the modifier

12035 without 51 · national office

$414.17

Wound repair, intermediate, 12.6–20 cm

12035-51 · Second procedure: 50%

$207.09

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 12035

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

Codes related to 12035
CodeHow it relatesOffice range, Delaware
Same family
12034Wound repair, intermediate, 7.6–12.5 cmIntermediate repair for the same general site group, at a shorter total length.$331.15
12036Wound repair, intermediate, 20.1–30 cmIntermediate repair for the same general site group, at a longer total length.$473.88
12037Intermediate repair, over 30 cm, scalp/trunk/extremitiesIntermediate repair for the same general site group, when total length exceeds 30 cm.$529.24
Used instead
12045Intermediate wound repair, neck, hands, feet, or genitaliaIntermediate repair at a different anatomic site group, for 12.6 to 20 cm.$448.14
12055Wound repair, face and mucous membranesIntermediate repair of face or mucous membrane sites, for 12.6 to 20 cm.$539.10
12016Simple wound repair, face group, 12.6–20 cmSimple repair of specified face sites at the same length range, when intermediate repair criteria are not met.$264.00

How 12035 has changed in Delaware

12035 · Office / nonfacility

$409.29

Effective 2026-10-01

The base rate is $33.46 higher than on 2025-10-01, moving from $375.83 to $409.29 (8.9%).

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

    $375.83changed to$409.29

    • Conversion factor 32.3465 changed to 33.4009
    • Work RVU 3.50 changed to 3.41
    • Practice expense RVU 7.55 changed to 8.37
    • Malpractice RVU 0.63 changed to 0.62
    • Work GPCI 1.009 changed to 1.005
    • Practice expense GPCI 0.992 changed to 0.988
    • Malpractice GPCI 0.949 changed to 0.899

    Held through RVU26B, RVU26C, RVU26D.

  2. January 1, 2025

    RVU25A

    $387.76changed to$375.83

    • Conversion factor 33.2875 changed to 32.3465
    • Practice expense RVU 7.58 changed to 7.55

    Held through RVU25B, RVU25C, RVU25D.

  3. March 9, 2024

    RVU24AR

    $381.43changed to$387.76

    • Conversion factor 32.7442 changed to 33.2875

    Held through RVU24B, RVU24C, RVU24D.

  4. January 1, 2024

    RVU24A

    $398.10changed to$381.43

    • Conversion factor 33.8872 changed to 32.7442
    • Practice expense RVU 7.57 changed to 7.58
    • Malpractice RVU 0.64 changed to 0.63
    • Work GPCI 1.007 changed to 1.009
    • Practice expense GPCI 1.007 changed to 0.992
    • Malpractice GPCI 0.938 changed to 0.949

  5. January 1, 2023

    RVU23A

    $407.87changed to$398.10

    • Conversion factor 34.6062 changed to 33.8872
    • Practice expense RVU 7.51 changed to 7.57
    • Work GPCI 1.005 changed to 1.007
    • Practice expense GPCI 1.022 changed to 1.007
    • Malpractice GPCI 0.927 changed to 0.938

    Held through RVU23B, RVU23C, RVU23D.

  6. January 1, 2022

    RVU22A

    $413.75changed to$407.87

    • Conversion factor 34.8931 changed to 34.6062
    • Practice expense RVU 7.58 changed to 7.51

    Held through RVU22B, RVU22C, RVU22D.

  7. January 1, 2021

    RVU21A

    $404.58changed to$413.75

    • Conversion factor 36.0896 changed to 34.8931
    • Practice expense RVU 6.91 changed to 7.58
    • Malpractice RVU 0.62 changed to 0.64
    • Work GPCI 1.006 changed to 1.005
    • Practice expense GPCI 1.021 changed to 1.022
    • Malpractice GPCI 1.023 changed to 0.927

    Held through RVU21B, RVU21C, RVU21D.

  8. January 1, 2020

    RVU20A

    $402.00changed to$404.58

    • Conversion factor 36.0391 changed to 36.0896
    • Practice expense RVU 6.84 changed to 6.91
    • Malpractice RVU 0.59 changed to 0.62
    • Work GPCI 1.007 changed to 1.006
    • Practice expense GPCI 1.019 changed to 1.021
    • Malpractice GPCI 1.119 changed to 1.023

    Held through RVU20B, RVU20C, RVU20D.

  9. January 1, 2019

    RVU19A

    $398.63changed to$402.00

    • Conversion factor 35.9996 changed to 36.0391
    • Practice expense RVU 6.76 changed to 6.84

    Held through RVU19B, RVU19C, RVU19D.

  10. January 1, 2018

    RVU18AR1

    $397.41changed to$398.63

    • Conversion factor 35.8887 changed to 35.9996
    • Practice expense RVU 6.71 changed to 6.76
    • Malpractice RVU 0.60 changed to 0.59
    • Work GPCI 1.010 changed to 1.007
    • Practice expense GPCI 1.025 changed to 1.019
    • Malpractice GPCI 1.101 changed to 1.119

    Held through RVU18B, RVU18C, RVU18D.

  11. January 1, 2017

    RVU17A

    $398.89changed to$397.41

    • Conversion factor 35.8043 changed to 35.8887
    • Practice expense RVU 6.74 changed to 6.71
    • Work GPCI 1.012 changed to 1.010
    • Practice expense GPCI 1.031 changed to 1.025
    • Malpractice GPCI 1.083 changed to 1.101

    Held through RVU17B, RVU17C, RVU17D.

  12. January 1, 2016

    RVU16A

    $398.83changed to$398.89

    • Conversion factor 35.9335 changed to 35.8043
    • Practice expense RVU 6.71 changed to 6.74
    • Malpractice RVU 0.59 changed to 0.60

    Held through RVU16B, RVU16C, RVU16D.

  13. July 1, 2015

    RVU15C

    $396.84changed to$398.83

    • Conversion factor 35.7547 changed to 35.9335

    Held through RVU15D.

  14. January 1, 2015

    RVU15A

    $394.77changed to$396.84

    • Conversion factor 35.8228 changed to 35.7547
    • Practice expense RVU 6.68 changed to 6.71
    • Malpractice RVU 0.62 changed to 0.59
    • Practice expense GPCI 1.038 changed to 1.031
    • Malpractice GPCI 0.878 changed to 1.083

    Held through RVU15B.

  15. January 1, 2014

    RVU14A

    $403.19changed to$394.77

    • Conversion factor 34.0230 changed to 35.8228
    • Practice expense RVU 7.54 changed to 6.68
    • Malpractice RVU 0.65 changed to 0.62
    • Practice expense GPCI 1.044 changed to 1.038
    • Malpractice GPCI 0.672 changed to 0.878

    Held through RVU14B, RVU14C, RVU14D.

  16. January 1, 2013

    RVU13AR

    Earliest loaded release: $403.19

    Held through RVU13B, RVU13C, RVU13D.

Rates in every CMS release
Effective fromOfficeFacilityCMS release
2026-10-01$409.29$221.85RVU26D
2026-07-01$409.29$221.85RVU26C
2026-04-01$409.29$221.85RVU26B
2026-01-01$409.29$221.85RVU26A
2025-10-01$375.83$235.29RVU25D
2025-07-01$375.83$235.29RVU25C
2025-04-01$375.83$235.29RVU25B
2025-01-01$375.83$235.29RVU25A
2024-10-01$387.76$240.15RVU24D
2024-07-01$387.76$240.15RVU24C
2024-04-01$387.76$240.15RVU24B
2024-03-09$387.76$240.15RVU24AR
2024-01-01$381.43$236.23RVU24A
2023-10-01$398.10$243.52RVU23D
2023-07-01$398.10$243.52RVU23C
2023-04-01$398.10$243.52RVU23B
2023-01-01$398.10$243.52RVU23A
2022-10-01$407.87$246.59RVU22D
2022-07-01$407.87$246.59RVU22C
2022-04-01$407.87$246.59RVU22B
2022-01-01$407.87$246.59RVU22A
2021-10-01$413.75$247.57RVU21D
2021-07-01$413.75$247.57RVU21C
2021-04-01$413.75$247.57RVU21B
2021-01-01$413.75$247.57RVU21A
2020-10-01$404.58$253.87RVU20D
2020-07-01$404.58$253.87RVU20C
2020-04-01$404.58$253.87RVU20B
2020-01-01$404.58$253.87RVU20A
2019-10-01$402.00$254.37RVU19D
2019-07-01$402.00$254.37RVU19C
2019-04-01$402.00$254.37RVU19B
2019-01-01$402.00$254.37RVU19A
2018-10-01$398.63$254.46RVU18D
2018-07-01$398.63$254.46RVU18C
2018-04-01$398.63$254.46RVU18B
2018-01-01$398.63$254.46RVU18AR1
2017-10-01$397.41$253.94RVU17D
2017-07-01$397.41$253.94RVU17C
2017-04-01$397.41$253.94RVU17B
2017-01-01$397.41$253.94RVU17A
2016-10-01$398.89$253.81RVU16D
2016-07-01$398.89$253.81RVU16C
2016-04-01$398.89$253.81RVU16B
2016-01-01$398.89$253.81RVU16A
2015-10-01$398.83$254.34RVU15D
2015-07-01$398.83$254.34RVU15C
2015-04-01$396.84$253.07RVU15B
2015-01-01$396.84$253.07RVU15A
2014-10-01$394.77$250.13RVU14D
2014-07-01$394.77$250.13RVU14C
2014-04-01$394.77$250.13RVU14B
2014-01-01$394.77$250.13RVU14A
2013-10-01$403.19$245.13RVU13D
2013-07-01$403.19$245.13RVU13C
2013-04-01$403.19$245.13RVU13B
2013-01-01$403.19$245.13RVU13AR

Price 12035 for an earlier date of service

Where the Delaware rate applies

Delaware is a Medicare payment area, not a city. Our Census mapping connects it to 79 cities and communities in Delaware. Some span more than one payment area; confirm with the service ZIP.

  • Arden
  • Ardencroft
  • Ardentown
  • Bear
  • Bellefonte
  • Bethany Beach
  • Bethel
  • Blades

Browse all communities in Delaware

12035 billing questions

How is 12035 distinguished from 12034 or 12036?

Use 12035 when the qualifying intermediate repairs total 12.6 to 20.0 cm. Code 12034 covers the shorter 7.6-to-12.5-cm range, while 12036 covers 20.1 to 30.0 cm.

Which wound sites belong under 12035?

This code is for qualifying wounds of the scalp, axillae, trunk, or extremities, excluding hands and feet. Neck, hand, foot, and external genitalia repairs are represented in a different intermediate-repair series.

Does a single-layer closure ever qualify as intermediate repair?

Yes. A heavily contaminated wound can qualify when extensive cleaning is required, even if it is closed in one layer. Document the contamination and cleaning performed.

What length should be documented when several wounds are repaired?

Record each wound’s length and site. Lengths may be combined when the wounds share the same repair classification and anatomic grouping; the qualifying total for 12035 is 12.6 to 20.0 cm.

Can modifier 50 be reported for bilateral wounds?

Modifier 50 is not appropriate for 12035. Select and report the repair based on the applicable site, complexity, and length.

Are follow-up visits included after the repair?

Related postoperative visits for 10 days are included in the global period. When other procedures are performed in the same session, the highest-valued procedure is paid in full and others are subject to the standard 50% multiple-procedure 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 12035PPRRVU2026_Oct_nonQPP.csv, line 1,415 (RVU26D)
Geographic factors for DelawareGPCI2026.csv, line 40 (RVU26D)

Open CMS sourceHow we calculate rates

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