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

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 Delaware, Medicare pays $473.88 for 12036 in the office and $266.63 when it’s performed in a hospital or facility.

$473.88Office (non-facility)
$266.63Hospital or facility
−1.3%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 Delaware
  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 Delaware 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. Delaware pays $473.88. The RVUs are the same everywhere; the geographic indexes change the dollars.

12036 in Delaware vs other payment areas
  1. Delaware · this page$473.88
  2. Los Angeles, CA · California$532.66+$58.78
  3. Washington, DC area · District of Columbia$546.39+$72.51
  4. Miami, FL · Florida$538.74+$64.86
  5. Chicago, IL · Illinois$521.42+$47.54
  6. Manhattan, NY · New York$556.99+$83.11
  7. Alaska · Alaska$555.58+$81.70

Other areas in Delaware 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 Delaware 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

40

Locality
Delaware
Physician work
1.005
Practice expense
0.988
Malpractice
0.899
Office calculation for 12036 in Delaware
ComponentRVULocality factorAdjusted
Physician work4.12× 1.0054.1406
Practice expense9.35× 0.9889.2378
Malpractice0.90× 0.8990.8091
Total RVUs14.1875
Conversion factor× 33.4009

Office rate, Delaware$473.88

Office: (4.12 × 1.005 + 9.35 × 0.988 + 0.9 × 0.899) × $33.4009 = $473.88

Facility: (4.12 × 1.005 + 3.07 × 0.988 + 0.9 × 0.899) × $33.4009 = $266.63

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, Delaware
Same family
12035Wound repair, intermediate, 12.6–20 cmIntermediate repair for the same general site grouping when total length is 12.6–20 cm.$409.29
12037Intermediate repair, over 30 cm, scalp/trunk/extremitiesIntermediate repair for the same general site grouping when total length exceeds 30 cm.$529.24
12034Wound repair, intermediate, 7.6–12.5 cmIntermediate repair for the same general site grouping when total length is 7.6–12.5 cm.$331.15
12046Intermediate repair, 20.1–30 cm, specified sitesIntermediate repair for a different anatomical grouping, with a 20.1–30 cm total length.$549.49
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 Delaware

12036 · Office / nonfacility

$473.88

Effective 2026-10-01

The base rate is $53.36 higher than on 2025-10-01, moving from $420.52 to $473.88 (12.7%).

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

    $420.52changed to$473.88

    • 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 1.009 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

    $432.06changed to$420.52

    • 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

    $425.01changed to$432.06

    • Conversion factor 32.7442 changed to 33.2875

    Held through RVU24B, RVU24C, RVU24D.

  4. January 1, 2024

    RVU24A

    $441.31changed to$425.01

    • 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 1.007 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

    $454.01changed to$441.31

    • 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 1.005 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

    $455.80changed to$454.01

    • 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

    $452.47changed to$455.80

    • Conversion factor 36.0896 changed to 34.8931
    • Practice expense RVU 7.27 changed to 7.86
    • 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

    $445.30changed to$452.47

    • 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 1.007 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

    $443.38changed to$445.30

    • 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

    $439.78changed to$443.38

    • 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 1.010 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

    $439.72changed to$439.78

    • 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 1.012 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

    $438.32changed to$439.72

    • 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

    $436.14changed to$438.32

    • Conversion factor 35.7547 changed to 35.9335

    Held through RVU15D.

  14. January 1, 2015

    RVU15A

    $434.51changed to$436.14

    • 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 1.038 changed to 1.031
    • Malpractice GPCI 0.878 changed to 1.083

    Held through RVU15B.

  15. January 1, 2014

    RVU14A

    $437.67changed to$434.51

    • 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 1.044 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: $437.67

    Held through RVU13B, RVU13C, RVU13D.

Rates in every CMS release
Effective fromOfficeFacilityCMS release
2026-10-01$473.88$266.63RVU26D
2026-07-01$473.88$266.63RVU26C
2026-04-01$473.88$266.63RVU26B
2026-01-01$473.88$266.63RVU26A
2025-10-01$420.52$275.16RVU25D
2025-07-01$420.52$275.16RVU25C
2025-04-01$420.52$275.16RVU25B
2025-01-01$420.52$275.16RVU25A
2024-10-01$432.06$280.82RVU24D
2024-07-01$432.06$280.82RVU24C
2024-04-01$432.06$280.82RVU24B
2024-03-09$432.06$280.82RVU24AR
2024-01-01$425.01$276.24RVU24A
2023-10-01$441.31$284.00RVU23D
2023-07-01$441.31$284.00RVU23C
2023-04-01$441.31$284.00RVU23B
2023-01-01$441.31$284.00RVU23A
2022-10-01$454.01$290.26RVU22D
2022-07-01$454.01$290.26RVU22C
2022-04-01$454.01$290.26RVU22B
2022-01-01$454.01$290.26RVU22A
2021-10-01$455.80$290.33RVU21D
2021-07-01$455.80$290.33RVU21C
2021-04-01$455.80$290.33RVU21B
2021-01-01$455.80$290.33RVU21A
2020-10-01$452.47$298.08RVU20D
2020-07-01$452.47$298.08RVU20C
2020-04-01$452.47$298.08RVU20B
2020-01-01$452.47$298.08RVU20A
2019-10-01$445.30$296.57RVU19D
2019-07-01$445.30$296.57RVU19C
2019-04-01$445.30$296.57RVU19B
2019-01-01$445.30$296.57RVU19A
2018-10-01$443.38$297.38RVU18D
2018-07-01$443.38$297.38RVU18C
2018-04-01$443.38$297.38RVU18B
2018-01-01$443.38$297.38RVU18AR1
2017-10-01$439.78$295.21RVU17D
2017-07-01$439.78$295.21RVU17C
2017-04-01$439.78$295.21RVU17B
2017-01-01$439.78$295.21RVU17A
2016-10-01$439.72$295.01RVU16D
2016-07-01$439.72$295.01RVU16C
2016-04-01$439.72$295.01RVU16B
2016-01-01$439.72$295.01RVU16A
2015-10-01$438.32$294.95RVU15D
2015-07-01$438.32$294.95RVU15C
2015-04-01$436.14$293.48RVU15B
2015-01-01$436.14$293.48RVU15A
2014-10-01$434.51$289.86RVU14D
2014-07-01$434.51$289.86RVU14C
2014-04-01$434.51$289.86RVU14B
2014-01-01$434.51$289.86RVU14A
2013-10-01$437.67$281.73RVU13D
2013-07-01$437.67$281.73RVU13C
2013-04-01$437.67$281.73RVU13B
2013-01-01$437.67$281.73RVU13AR

Price 12036 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

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 DelawareGPCI2026.csv, line 40 (RVU26D)

Open CMS sourceHow we calculate rates

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