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CPT code 12036: Wound repair, intermediate, 20.1–30 cm2026 Medicare rate & RVUs in Connecticut

Reports intermediate wound closure with layered technique or extensive cleaning for scalp, axilla, trunk, or extremity wounds totaling 20.1 to 30 cm.

CMS RVU26DEffective Oct 1, 2026One payment locality1.2K Medicare services in 2024

In Connecticut, Medicare pays $513.08 for 12036 in the office and $287.17 when it’s performed in a hospital or facility.

$513.08Office (non-facility)
$287.17Hospital or facility
+6.9%vs the national office rate ($479.97)

Check a contract rate as a % of Medicare · 12036 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 12036 for the payment locality that covers the ZIP.

On this page 11 sections
  1. Rate in Connecticut
  2. What 12036 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 12036 covers

This code covers intermediate repair of wounds in the scalp, axillae, trunk, or extremities when the total repaired length is 20.1 to 30 cm. A clinician closes the skin and also repairs one or more deeper layers, such as subcutaneous tissue or superficial fascia. It can also describe a single-layer closure of a heavily contaminated wound that requires extensive cleaning or removal of embedded material. Physicians and other qualified clinicians commonly perform these repairs in emergency departments, operating rooms, and office procedure settings.

Choose the code based on the repair method, anatomical grouping, and documented total length—not wound depth alone. For wounds in the same repair class and anatomical grouping, combine their lengths; document each wound’s site, length, tissue layers repaired, and any extensive cleaning. Medicare includes related postoperative visits during the 10-day global period. When multiple procedures occur in one session, the highest-valued procedure is paid in full and the others at 50%. Modifier 50 is inappropriate for this descriptor. Medicare does not pay assistant-at-surgery services for this code; co-surgeon and team-surgery billing 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 Connecticut compares for 12036

Across 109 of 109 payment localities, the office rate for 12036 runs from $421.36 in Arkansas to $619.20 in San Benito County, CA. Connecticut pays $513.08. The RVUs are the same everywhere; the geographic indexes change the dollars.

12036 in Connecticut vs other payment areas
  1. Connecticut · this page$513.08
  2. Los Angeles, CA · California$532.66+$19.58
  3. Washington, DC area · District of Columbia$546.39+$33.31
  4. Miami, FL · Florida$538.74+$25.66
  5. Chicago, IL · Illinois$521.42+$8.34
  6. Manhattan, NY · New York$556.99+$43.91
  7. Alaska · Alaska$555.58+$42.50

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

Every other payment area

12036 in every other Medicare payment locality
Payment localityOfficeFacility
AlabamaAlabama$427.89$244.35
ArkansasArkansas$421.36$241.18
ArizonaArizona$465.96$262.71
Bakersfield, CACalifornia$500.81$270.92
Chico, CACalifornia$498.34$268.45
El Centro, CACalifornia$498.49$268.60
Fresno, CACalifornia$498.34$268.45
Hanford, CACalifornia$498.34$268.45

12036 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.

$421.36

$558.77

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

View every state and territory as a table
12036 office rate range by state
State / territoryOffice rate rangeLocalities
AK$555.581
AL$427.891
AR$421.361
AZ$465.961
CA$498.34–$619.2029
CO$495.031
CT$513.081
DC$546.391
DE$473.881
FL$481.35–$538.743
GA$452.01–$491.422
GU$510.101
HI$510.101
IA$435.301
ID$439.151
IL$469.73–$521.424
IN$441.721
KS$435.081
KY$442.751
LA$442.79–$465.632
MA$492.62–$542.892
MD$482.63–$546.393
ME$443.62–$466.072
MI$456.68–$489.662
MN$467.861
MO$436.09–$465.043
MS$428.721
MT$479.911
NC$448.191
ND$462.111
NE$437.231
NH$489.021
NJ$517.12–$540.652
NM$460.091
NV$475.261
NY$455.43–$573.565
OH$453.041
OK$439.851
OR$469.79–$509.142
PA$452.71–$501.052
PR$482.961
RI$489.641
SC$451.731
SD$460.011
TN$437.631
TX$449.73–$494.938
UT$458.171
VA$465.82–$546.392
VI$482.961
VT$462.001
WA$491.13–$552.242
WI$446.051
WV$452.021
WY$472.161

See 12036 in every payment locality

How the 12036 rate is calculated

Each of 12036’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 · 12036

RVUs × geographic indexes × conversion factor

Office or facility?

Work4.12

4.12 RVUs× 1.000 GPCI

Practice expense9.35

9.35 RVUs× 1.000 GPCI

Malpractice0.90

0.90 RVUs× 1.000 GPCI

Adjusted RVUs

14.3700

Conversion factor

$33.4009

Medicare rate

$479.97

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

The exact Connecticut inputs and CMS source lines

PPRRVU2026_Oct_nonQPP.csv

1,416

Code
12036
Physician work
4.12
Practice expense
9.35
Malpractice
0.90

GPCI2026.csv

38

Locality
Connecticut
Physician work
1.020
Practice expense
1.077
Malpractice
1.210
Office calculation for 12036 in Connecticut
ComponentRVULocality factorAdjusted
Physician work4.12× 1.0204.2024
Practice expense9.35× 1.07710.0699
Malpractice0.90× 1.2101.0890
Total RVUs15.3613
Conversion factor× 33.4009

Office rate, Connecticut$513.08

Office: (4.12 × 1.02 + 9.35 × 1.077 + 0.9 × 1.21) × $33.4009 = $513.08

Facility: (4.12 × 1.02 + 3.07 × 1.077 + 0.9 × 1.21) × $33.4009 = $287.17

Open 12036 in the RVU calculator

Payment rules and modifiers for 12036

12036 has a 10-day global period: related visits in that window are included in the surgery payment.

CMS payment indicators · 12036

Wound repair, intermediate, 20.1–30 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 · 12036

Wound repair, intermediate, 20.1–30 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

12036 without 51 · national office

$479.97

Wound repair, intermediate, 20.1–30 cm

12036-51 · Second procedure: 50%

$239.99

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 12036

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

Codes related to 12036
CodeHow it relatesOffice range, Connecticut
Same family
12035Wound repair, intermediate, 12.6–20 cmIntermediate repair for the same general site grouping when total length is 12.6–20 cm.$442.32
12037Intermediate repair, over 30 cm, scalp/trunk/extremitiesIntermediate repair for the same general site grouping when total length exceeds 30 cm.$572.83
12034Wound repair, intermediate, 7.6–12.5 cmIntermediate repair for the same general site grouping when total length is 7.6–12.5 cm.$356.66
12046Intermediate repair, 20.1–30 cm, specified sitesIntermediate repair for a different anatomical grouping, with a 20.1–30 cm total length.$597.02
Used instead
12017Wound repair, face and related sites, 20.1–30 cmSimple repair for a 20.1–30 cm wound in the face, ears, eyelids, nose, lips, or mucous membranes.No office rate

How 12036 has changed in Connecticut

12036 · Office / nonfacility

$513.08

Effective 2026-10-01

The base rate is $58.05 higher than on 2025-10-01, moving from $455.03 to $513.08 (12.8%).

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

    $455.03changed to$513.08

    • Conversion factor 32.3465 changed to 33.4009
    • Work RVU 4.23 changed to 4.12
    • Practice expense RVU 7.98 changed to 9.35
    • Malpractice RVU 0.86 changed to 0.90
    • Work GPCI 1.022 changed to 1.020
    • Practice expense GPCI 1.091 changed to 1.077
    • Malpractice GPCI 1.207 changed to 1.210

    Held through RVU26B, RVU26C, RVU26D.

  2. January 1, 2025

    RVU25A

    $467.61changed to$455.03

    • Conversion factor 33.2875 changed to 32.3465
    • Practice expense RVU 7.94 changed to 7.98
    • Malpractice RVU 0.88 changed to 0.86

    Held through RVU25B, RVU25C, RVU25D.

  3. March 9, 2024

    RVU24AR

    $459.98changed to$467.61

    • Conversion factor 32.7442 changed to 33.2875

    Held through RVU24B, RVU24C, RVU24D.

  4. January 1, 2024

    RVU24A

    $473.86changed to$459.98

    • Conversion factor 33.8872 changed to 32.7442
    • Practice expense RVU 7.92 changed to 7.94
    • Malpractice RVU 0.84 changed to 0.88
    • Work GPCI 1.030 changed to 1.022
    • Practice expense GPCI 1.102 changed to 1.091
    • Malpractice GPCI 1.070 changed to 1.207

  5. January 1, 2023

    RVU23A

    $483.97changed to$473.86

    • Conversion factor 34.6062 changed to 33.8872
    • Practice expense RVU 7.87 changed to 7.92
    • Malpractice RVU 0.89 changed to 0.84
    • Work GPCI 1.037 changed to 1.030
    • Practice expense GPCI 1.114 changed to 1.102
    • Malpractice GPCI 0.934 changed to 1.070

    Held through RVU23B, RVU23C, RVU23D.

  6. January 1, 2022

    RVU22A

    $485.96changed to$483.97

    • Conversion factor 34.8931 changed to 34.6062
    • Practice expense RVU 7.86 changed to 7.87
    • Malpractice RVU 0.84 changed to 0.89

    Held through RVU22B, RVU22C, RVU22D.

  7. January 1, 2021

    RVU21A

    $482.27changed to$485.96

    • Conversion factor 36.0896 changed to 34.8931
    • Practice expense RVU 7.27 changed to 7.86
    • Work GPCI 1.029 changed to 1.037
    • Practice expense GPCI 1.113 changed to 1.114
    • Malpractice GPCI 1.094 changed to 0.934

    Held through RVU21B, RVU21C, RVU21D.

  8. January 1, 2020

    RVU20A

    $475.01changed to$482.27

    • Conversion factor 36.0391 changed to 36.0896
    • Practice expense RVU 7.10 changed to 7.27
    • Malpractice RVU 0.77 changed to 0.84
    • Work GPCI 1.021 changed to 1.029
    • Practice expense GPCI 1.112 changed to 1.113
    • Malpractice GPCI 1.255 changed to 1.094

    Held through RVU20B, RVU20C, RVU20D.

  9. January 1, 2019

    RVU19A

    $472.94changed to$475.01

    • Conversion factor 35.9996 changed to 36.0391
    • Practice expense RVU 7.05 changed to 7.10
    • Malpractice RVU 0.78 changed to 0.77

    Held through RVU19B, RVU19C, RVU19D.

  10. January 1, 2018

    RVU18AR1

    $468.69changed to$472.94

    • Conversion factor 35.8887 changed to 35.9996
    • Practice expense RVU 6.96 changed to 7.05
    • Malpractice RVU 0.77 changed to 0.78
    • Work GPCI 1.023 changed to 1.021
    • Practice expense GPCI 1.117 changed to 1.112
    • Malpractice GPCI 1.244 changed to 1.255

    Held through RVU18B, RVU18C, RVU18D.

  11. January 1, 2017

    RVU17A

    $468.08changed to$468.69

    • Conversion factor 35.8043 changed to 35.8887
    • Practice expense RVU 6.93 changed to 6.96
    • Malpractice RVU 0.79 changed to 0.77
    • Work GPCI 1.024 changed to 1.023
    • Practice expense GPCI 1.121 changed to 1.117
    • Malpractice GPCI 1.232 changed to 1.244

    Held through RVU17B, RVU17C, RVU17D.

  12. January 1, 2016

    RVU16A

    $466.51changed to$468.08

    • Conversion factor 35.9335 changed to 35.8043
    • Practice expense RVU 6.86 changed to 6.93
    • Malpractice RVU 0.78 changed to 0.79

    Held through RVU16B, RVU16C, RVU16D.

  13. July 1, 2015

    RVU15C

    $464.19changed to$466.51

    • Conversion factor 35.7547 changed to 35.9335

    Held through RVU15D.

  14. January 1, 2015

    RVU15A

    $465.45changed to$464.19

    • Conversion factor 35.8228 changed to 35.7547
    • Practice expense RVU 6.91 changed to 6.86
    • Malpractice RVU 0.77 changed to 0.78
    • Practice expense GPCI 1.116 changed to 1.121
    • Malpractice GPCI 1.234 changed to 1.232

    Held through RVU15B.

  15. January 1, 2014

    RVU14A

    $472.20changed to$465.45

    • Conversion factor 34.0230 changed to 35.8228
    • Practice expense RVU 7.70 changed to 6.91
    • Malpractice RVU 0.81 changed to 0.77
    • Practice expense GPCI 1.110 changed to 1.116
    • Malpractice GPCI 1.235 changed to 1.234

    Held through RVU14B, RVU14C, RVU14D.

  16. January 1, 2013

    RVU13AR

    Earliest loaded release: $472.20

    Held through RVU13B, RVU13C, RVU13D.

Rates in every CMS release
Effective fromOfficeFacilityCMS release
2026-10-01$513.08$287.17RVU26D
2026-07-01$513.08$287.17RVU26C
2026-04-01$513.08$287.17RVU26B
2026-01-01$513.08$287.17RVU26A
2025-10-01$455.03$295.16RVU25D
2025-07-01$455.03$295.16RVU25C
2025-04-01$455.03$295.16RVU25B
2025-01-01$455.03$295.16RVU25A
2024-10-01$467.61$301.28RVU24D
2024-07-01$467.61$301.28RVU24C
2024-04-01$467.61$301.28RVU24B
2024-03-09$467.61$301.28RVU24AR
2024-01-01$459.98$296.37RVU24A
2023-10-01$473.86$301.71RVU23D
2023-07-01$473.86$301.71RVU23C
2023-04-01$473.86$301.71RVU23B
2023-01-01$473.86$301.71RVU23A
2022-10-01$483.97$305.47RVU22D
2022-07-01$483.97$305.47RVU22C
2022-04-01$483.97$305.47RVU22B
2022-01-01$483.97$305.47RVU22A
2021-10-01$485.96$305.60RVU21D
2021-07-01$485.96$305.60RVU21C
2021-04-01$485.96$305.60RVU21B
2021-01-01$485.96$305.60RVU21A
2020-10-01$482.27$313.97RVU20D
2020-07-01$482.27$313.97RVU20C
2020-04-01$482.27$313.97RVU20B
2020-01-01$482.27$313.97RVU20A
2019-10-01$475.01$312.70RVU19D
2019-07-01$475.01$312.70RVU19C
2019-04-01$475.01$312.70RVU19B
2019-01-01$475.01$312.70RVU19A
2018-10-01$472.94$313.61RVU18D
2018-07-01$472.94$313.61RVU18C
2018-04-01$472.94$313.61RVU18B
2018-01-01$472.94$313.61RVU18AR1
2017-10-01$468.69$311.14RVU17D
2017-07-01$468.69$311.14RVU17C
2017-04-01$468.69$311.14RVU17B
2017-01-01$468.69$311.14RVU17A
2016-10-01$468.08$310.75RVU16D
2016-07-01$468.08$310.75RVU16C
2016-04-01$468.08$310.75RVU16B
2016-01-01$468.08$310.75RVU16A
2015-10-01$466.51$310.62RVU15D
2015-07-01$466.51$310.62RVU15C
2015-04-01$464.19$309.07RVU15B
2015-01-01$464.19$309.07RVU15A
2014-10-01$465.45$309.94RVU14D
2014-07-01$465.45$309.94RVU14C
2014-04-01$465.45$309.94RVU14B
2014-01-01$465.45$309.94RVU14A
2013-10-01$472.20$306.41RVU13D
2013-07-01$472.20$306.41RVU13C
2013-04-01$472.20$306.41RVU13B
2013-01-01$472.20$306.41RVU13AR

Price 12036 for an earlier date of service

Where the Connecticut rate applies

Connecticut is a Medicare payment area, not a city. Our Census mapping connects it to 215 cities and communities in Connecticut. Some span more than one payment area; confirm with the service ZIP.

  • Ansonia
  • Ball Pond
  • Baltic
  • Bantam
  • Bethel
  • Bethlehem Village
  • Bigelow Corners
  • Blue Hills

Browse all communities in Connecticut

12036 billing questions

How is the 20.1–30 cm length determined when there are multiple wounds?

Combine lengths for wounds in the same repair class and anatomical grouping. Keep the documented lengths and sites clear enough to support the total reported.

When is this intermediate repair code appropriate instead of a simple repair code?

Use this code when the repair involves closure of one or more deeper tissue layers in addition to skin, or extensive cleaning of a heavily contaminated wound. A straightforward skin-only closure is a simple repair.

Are related wound checks separately payable during the global period?

Related postoperative visits during the 10-day global period are included in the procedure payment.

Can modifier 50 be used for wounds on both sides of the body?

No. Modifier 50 is inappropriate for this descriptor; report the repair based on the applicable wound group and total length.

How does Medicare handle this repair when other procedures are performed in the same session?

The highest-valued procedure is paid in full, and other procedures subject to the multiple procedure reduction are paid at 50%. Assistant-at-surgery payment is unavailable, and co-surgeon and team-surgery billing 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
RVUs for 12036PPRRVU2026_Oct_nonQPP.csv, line 1,416 (RVU26D)
Geographic factors for ConnecticutGPCI2026.csv, line 38 (RVU26D)

Open CMS sourceHow we calculate rates

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