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

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 New Mexico, Medicare pays $460.09 for 12036 in the office and $267.74 when it’s performed in a hospital or facility.

$460.09Office (non-facility)
$267.74Hospital or facility
−4.1%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 New Mexico
  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 New Mexico 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. New Mexico pays $460.09. The RVUs are the same everywhere; the geographic indexes change the dollars.

12036 in New Mexico vs other payment areas
  1. New Mexico · this page$460.09
  2. Los Angeles, CA · California$532.66+$72.57
  3. Washington, DC area · District of Columbia$546.39+$86.30
  4. Miami, FL · Florida$538.74+$78.65
  5. Chicago, IL · Illinois$521.42+$61.33
  6. Manhattan, NY · New York$556.99+$96.90
  7. Alaska · Alaska$555.58+$95.49

Other areas in New Mexico 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 New Mexico 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

77

Locality
New Mexico
Physician work
1.000
Practice expense
0.917
Malpractice
1.201
Office calculation for 12036 in New Mexico
ComponentRVULocality factorAdjusted
Physician work4.12× 1.0004.1200
Practice expense9.35× 0.9178.5739
Malpractice0.90× 1.2011.0809
Total RVUs13.7749
Conversion factor× 33.4009

Office rate, New Mexico$460.09

Office: (4.12 × 1 + 9.35 × 0.917 + 0.9 × 1.201) × $33.4009 = $460.09

Facility: (4.12 × 1 + 3.07 × 0.917 + 0.9 × 1.201) × $33.4009 = $267.74

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, New Mexico
Same family
12035Wound repair, intermediate, 12.6–20 cmIntermediate repair for the same general site grouping when total length is 12.6–20 cm.$395.13
12037Intermediate repair, over 30 cm, scalp/trunk/extremitiesIntermediate repair for the same general site grouping when total length exceeds 30 cm.$515.27
12034Wound repair, intermediate, 7.6–12.5 cmIntermediate repair for the same general site grouping when total length is 7.6–12.5 cm.$318.64
12046Intermediate repair, 20.1–30 cm, specified sitesIntermediate repair for a different anatomical grouping, with a 20.1–30 cm total length.$533.13
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 New Mexico

12036 · Office / nonfacility

$460.09

Effective 2026-10-01

The base rate is $56.28 higher than on 2025-10-01, moving from $403.81 to $460.09 (13.9%).

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

    $403.81changed to$460.09

    • 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
    • Practice expense GPCI 0.908 changed to 0.917
    • Malpractice GPCI 1.172 changed to 1.201

    Held through RVU26B, RVU26C, RVU26D.

  2. January 1, 2025

    RVU25A

    $415.12changed to$403.81

    • 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

    $408.35changed to$415.12

    • Conversion factor 32.7442 changed to 33.2875

    Held through RVU24B, RVU24C, RVU24D.

  4. January 1, 2024

    RVU24A

    $418.70changed to$408.35

    • 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
    • Practice expense GPCI 0.902 changed to 0.908
    • Malpractice GPCI 1.169 changed to 1.172

  5. January 1, 2023

    RVU23A

    $426.32changed to$418.70

    • 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
    • Practice expense GPCI 0.896 changed to 0.902
    • Malpractice GPCI 1.166 changed to 1.169

    Held through RVU23B, RVU23C, RVU23D.

  6. January 1, 2022

    RVU22A

    $427.51changed to$426.32

    • 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

    $427.48changed to$427.51

    • Conversion factor 36.0896 changed to 34.8931
    • Practice expense RVU 7.27 changed to 7.86
    • Practice expense GPCI 0.908 changed to 0.896
    • Malpractice GPCI 1.207 changed to 1.166

    Held through RVU21B, RVU21C, RVU21D.

  8. January 1, 2020

    RVU20A

    $422.71changed to$427.48

    • 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
    • Practice expense GPCI 0.921 changed to 0.908
    • Malpractice GPCI 1.247 changed to 1.207

    Held through RVU20B, RVU20C, RVU20D.

  9. January 1, 2019

    RVU19A

    $421.04changed to$422.71

    • 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

    $414.88changed to$421.04

    • 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
    • Practice expense GPCI 0.920 changed to 0.921
    • Malpractice GPCI 1.204 changed to 1.247

    Held through RVU18B, RVU18C, RVU18D.

  11. January 1, 2017

    RVU17A

    $412.32changed to$414.88

    • 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
    • Practice expense GPCI 0.919 changed to 0.920
    • Malpractice GPCI 1.161 changed to 1.204

    Held through RVU17B, RVU17C, RVU17D.

  12. January 1, 2016

    RVU16A

    $411.08changed to$412.32

    • 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

    $409.03changed to$411.08

    • Conversion factor 35.7547 changed to 35.9335

    Held through RVU15D.

  14. January 1, 2015

    RVU15A

    $408.53changed to$409.03

    • 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 0.918 changed to 0.919
    • Malpractice GPCI 1.079 changed to 1.161

    Held through RVU15B.

  15. January 1, 2014

    RVU14A

    $411.36changed to$408.53

    • 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 0.916 changed to 0.918
    • Malpractice GPCI 0.997 changed to 1.079

    Held through RVU14B, RVU14C, RVU14D.

  16. January 1, 2013

    RVU13AR

    Earliest loaded release: $411.36

    Held through RVU13B, RVU13C, RVU13D.

Rates in every CMS release
Effective fromOfficeFacilityCMS release
2026-10-01$460.09$267.74RVU26D
2026-07-01$460.09$267.74RVU26C
2026-04-01$460.09$267.74RVU26B
2026-01-01$460.09$267.74RVU26A
2025-10-01$403.81$270.76RVU25D
2025-07-01$403.81$270.76RVU25C
2025-04-01$403.81$270.76RVU25B
2025-01-01$403.81$270.76RVU25A
2024-10-01$415.12$276.69RVU24D
2024-07-01$415.12$276.69RVU24C
2024-04-01$415.12$276.69RVU24B
2024-03-09$415.12$276.69RVU24AR
2024-01-01$408.35$272.18RVU24A
2023-10-01$418.70$277.79RVU23D
2023-07-01$418.70$277.79RVU23C
2023-04-01$418.70$277.79RVU23B
2023-01-01$418.70$277.79RVU23A
2022-10-01$426.32$282.76RVU22D
2022-07-01$426.32$282.76RVU22C
2022-04-01$426.32$282.76RVU22B
2022-01-01$426.32$282.76RVU22A
2021-10-01$427.51$282.44RVU21D
2021-07-01$427.51$282.44RVU21C
2021-04-01$427.51$282.44RVU21B
2021-01-01$427.51$282.44RVU21A
2020-10-01$427.48$290.18RVU20D
2020-07-01$427.48$290.18RVU20C
2020-04-01$427.48$290.18RVU20B
2020-01-01$427.48$290.18RVU20A
2019-10-01$422.71$288.29RVU19D
2019-07-01$422.71$288.29RVU19C
2019-04-01$422.71$288.29RVU19B
2019-01-01$422.71$288.29RVU19A
2018-10-01$421.04$289.08RVU18D
2018-07-01$421.04$289.08RVU18C
2018-04-01$421.04$289.08RVU18B
2018-01-01$421.04$289.08RVU18AR1
2017-10-01$414.88$285.12RVU17D
2017-07-01$414.88$285.12RVU17C
2017-04-01$414.88$285.12RVU17B
2017-01-01$414.88$285.12RVU17A
2016-10-01$412.32$283.33RVU16D
2016-07-01$412.32$283.33RVU16C
2016-04-01$412.32$283.33RVU16B
2016-01-01$412.32$283.33RVU16A
2015-10-01$411.08$283.28RVU15D
2015-07-01$411.08$283.28RVU15C
2015-04-01$409.03$281.87RVU15B
2015-01-01$409.03$281.87RVU15A
2014-10-01$408.53$280.61RVU14D
2014-07-01$408.53$280.61RVU14C
2014-04-01$408.53$280.61RVU14B
2014-01-01$408.53$280.61RVU14A
2013-10-01$411.36$274.55RVU13D
2013-07-01$411.36$274.55RVU13C
2013-04-01$411.36$274.55RVU13B
2013-01-01$411.36$274.55RVU13AR

Price 12036 for an earlier date of service

Where the New Mexico rate applies

New Mexico is a Medicare payment area, not a city. Our Census mapping connects it to 528 cities and communities in New Mexico. Some span more than one payment area; confirm with the service ZIP.

  • Abeytas
  • Abiquiu
  • Acomita Lake
  • Adelino
  • Agua Fria
  • Alamillo
  • Alamo
  • Alamogordo

Browse all communities in New Mexico

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 New MexicoGPCI2026.csv, line 77 (RVU26D)

Open CMS sourceHow we calculate rates

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