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CPT code 12046: Intermediate repair, 20.1–30 cm, specified sites2026 Medicare rate & RVUs in Puerto Rico

Report this code for intermediate layered closure of wounds totaling 20.1–30 cm on the neck, hands, feet, or external genitalia.

CMS RVU26DEffective Oct 1, 2026One payment locality76 Medicare services in 2024

In Puerto Rico, Medicare pays $560.74 for 12046 in the office and $314.23 when it’s performed in a hospital or facility.

$560.74Office (non-facility)
$314.23Hospital or facility
+0.6%vs the national office rate ($557.13)

Check a contract rate as a % of Medicare · 12046 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 12046 for the payment locality that covers the ZIP.

On this page 11 sections
  1. Rate in Puerto Rico
  2. What 12046 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 12046 covers

This code describes intermediate repair of one or more wounds on the neck, hands, feet, or external genitalia, when their reportable lengths total 20.1–30 cm. The closure includes repair of deeper tissue, such as subcutaneous tissue or superficial fascia, as well as skin. Physicians and other qualified practitioners may perform these repairs in settings such as an emergency department or operating room, often after trauma or excision leaves a wound requiring layered closure.

Select the code from the documented repair complexity, anatomical grouping, and total repaired length. Record each wound’s location and length and the layers closed; combine lengths only as permitted within the applicable repair group. This code has a 10-day global period, including related postoperative visits during that period. When multiple procedures are performed in the same session, the highest-valued procedure is paid in full and the others are subject to the standard multiple-procedure reduction. Modifier 50 is inappropriate. Assistant-at-surgery payment requires documented medical necessity; 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 Puerto Rico compares for 12046

Across 109 of 109 payment localities, the office rate for 12046 runs from $485.44 in Arkansas to $723.02 in San Benito County, CA. Puerto Rico pays $560.74. The RVUs are the same everywhere; the geographic indexes change the dollars.

12046 in Puerto Rico vs other payment areas
  1. Puerto Rico · this page$560.74
  2. Los Angeles, CA · California$619.79+$59.05
  3. Washington, DC area · District of Columbia$636.51+$75.77
  4. Miami, FL · Florida$629.90+$69.16
  5. Chicago, IL · Illinois$608.45+$47.71
  6. Manhattan, NY · New York$649.53+$88.79
  7. Alaska · Alaska$634.99+$74.25

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

Every other payment area

12046 in every other Medicare payment locality
Payment localityOfficeFacility
AlabamaAlabama$493.42$280.07
ArkansasArkansas$485.44$275.99
ArizonaArizona$539.97$303.70
Bakersfield, CACalifornia$581.62$314.38
Chico, CACalifornia$578.61$311.37
El Centro, CACalifornia$578.79$311.56
Fresno, CACalifornia$578.61$311.37
Hanford, CACalifornia$578.61$311.37

12046 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.

$485.44

$650.82

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

View every state and territory as a table
12046 office rate range by state
State / territoryOffice rate rangeLocalities
AK$634.991
AL$493.421
AR$485.441
AZ$539.971
CA$578.61–$723.0229
CO$574.921
CT$597.021
DC$636.511
DE$549.491
FL$559.23–$629.903
GA$523.29–$571.142
GU$593.411
HI$593.411
IA$502.291
ID$507.031
IL$545.15–$608.454
IN$510.181
KS$502.111
KY$511.791
LA$511.88–$539.812
MA$571.90–$632.422
MD$560.02–$636.513
ME$512.60–$539.912
MI$528.91–$569.502
MN$541.801
MO$503.75–$538.973
MS$494.581
MT$557.051
NC$518.181
ND$534.911
NE$504.621
NH$568.021
NJ$601.29–$629.252
NM$533.131
NV$551.261
NY$527.03–$669.925
OH$524.391
OK$508.151
OR$544.50–$591.942
PA$523.93–$582.442
PR$560.741
RI$568.281
SC$522.651
SD$532.291
TN$505.251
TX$520.29–$575.178
UT$530.531
VA$539.67–$636.512
VI$560.741
VT$534.851
WA$570.13–$643.492
WI$515.291
WV$523.501
WY$547.401

See 12046 in every payment locality

How the 12046 rate is calculated

Each of 12046’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 · 12046

RVUs × geographic indexes × conversion factor

Office or facility?

Work4.19

4.19 RVUs× 1.000 GPCI

Practice expense11.37

11.37 RVUs× 1.000 GPCI

Malpractice1.12

1.12 RVUs× 1.000 GPCI

Adjusted RVUs

16.6800

Conversion factor

$33.4009

Medicare rate

$557.13

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

The exact Puerto Rico inputs and CMS source lines

PPRRVU2026_Oct_nonQPP.csv

1,422

Code
12046
Physician work
4.19
Practice expense
11.37
Malpractice
1.12

GPCI2026.csv

91

Locality
Puerto Rico
Physician work
1.000
Practice expense
1.011
Malpractice
0.985
Office calculation for 12046 in Puerto Rico
ComponentRVULocality factorAdjusted
Physician work4.19× 1.0004.1900
Practice expense11.37× 1.01111.4951
Malpractice1.12× 0.9851.1032
Total RVUs16.7883
Conversion factor× 33.4009

Office rate, Puerto Rico$560.74

Office: (4.19 × 1 + 11.37 × 1.011 + 1.12 × 0.985) × $33.4009 = $560.74

Facility: (4.19 × 1 + 4.07 × 1.011 + 1.12 × 0.985) × $33.4009 = $314.23

Open 12046 in the RVU calculator

Payment rules and modifiers for 12046

12046 has a 10-day global period: related visits in that window are included in the surgery payment.

CMS payment indicators · 12046

Intermediate repair, 20.1–30 cm, specified sites

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)0Not paid without supporting documentation.
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 · 12046

Intermediate repair, 20.1–30 cm, specified sites

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

12046 without 51 · national office

$557.13

Intermediate repair, 20.1–30 cm, specified sites

12046-51 · Second procedure: 50%

$278.57

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 12046

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

Codes related to 12046
CodeHow it relatesOffice range, Puerto Rico
Same family
12045Intermediate wound repair, neck, hands, feet, or genitaliaIntermediate repair at the same sites for the immediately shorter total-length band.$456.62
12047Intermediate repair, neck, hands, feet, genitalia; over 30 cmIntermediate repair at the same sites when total length exceeds 30 cm.$614.05
12044Intermediate repair, neck, hands, feet, or genitaliaIntermediate repair at the same sites for a shorter total-length band.$390.86
12036Wound repair, intermediate, 20.1–30 cmIntermediate repair in a different anatomical grouping, with the same 20.1–30 cm length band.$482.96
12056Wound repair, face, 20.1–30 cmIntermediate repair of the face or mucous membranes in the same length band.$627.72

How 12046 has changed in Puerto Rico

12046 · Office / nonfacility

$560.74

Effective 2026-10-01

The base rate is $73.03 higher than on 2025-10-01, moving from $487.71 to $560.74 (15.0%).

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

    $487.71changed to$560.74

    • Conversion factor 32.3465 changed to 33.4009
    • Work RVU 4.30 changed to 4.19
    • Practice expense RVU 9.63 changed to 11.37
    • Malpractice RVU 1.10 changed to 1.12
    • Practice expense GPCI 1.007 changed to 1.011
    • Malpractice GPCI 0.982 changed to 0.985

    Held through RVU26B, RVU26C, RVU26D.

  2. January 1, 2025

    RVU25A

    $503.22changed to$487.71

    • Conversion factor 33.2875 changed to 32.3465
    • Practice expense RVU 9.65 changed to 9.63
    • Malpractice RVU 1.12 changed to 1.10

    Held through RVU25B, RVU25C, RVU25D.

  3. March 9, 2024

    RVU24AR

    $495.01changed to$503.22

    • Conversion factor 32.7442 changed to 33.2875

    Held through RVU24B, RVU24C, RVU24D.

  4. January 1, 2024

    RVU24A

    $511.36changed to$495.01

    • Conversion factor 33.8872 changed to 32.7442
    • Malpractice RVU 1.08 changed to 1.12
    • Practice expense GPCI 1.008 changed to 1.007
    • Malpractice GPCI 0.984 changed to 0.982

  5. October 1, 2023

    RVU23D

    $509.32changed to$511.36

    • Practice expense GPCI 1.000 changed to 1.008
    • Malpractice GPCI 1.000 changed to 0.984

  6. January 1, 2023

    RVU23A

    $525.06changed to$509.32

    • Conversion factor 34.6062 changed to 33.8872
    • Practice expense RVU 9.72 changed to 9.65
    • Malpractice RVU 1.09 changed to 1.08
    • Practice expense GPCI 1.008 changed to 1.000
    • Malpractice GPCI 0.986 changed to 1.000

    Held through RVU23B, RVU23C.

  7. January 1, 2022

    RVU22A

    $525.94changed to$525.06

    • Conversion factor 34.8931 changed to 34.6062
    • Practice expense RVU 9.67 changed to 9.72
    • Malpractice RVU 1.04 changed to 1.09

    Held through RVU22B, RVU22C, RVU22D.

  8. January 1, 2021

    RVU21A

    $509.12changed to$525.94

    • Conversion factor 36.0896 changed to 34.8931
    • Practice expense RVU 8.71 changed to 9.67
    • Malpractice GPCI 0.988 changed to 0.986

    Held through RVU21B, RVU21C, RVU21D.

  9. January 1, 2020

    RVU20A

    $500.55changed to$509.12

    • Conversion factor 36.0391 changed to 36.0896
    • Practice expense RVU 8.50 changed to 8.71
    • Practice expense GPCI 1.007 changed to 1.008
    • Malpractice GPCI 0.990 changed to 0.988

    Held through RVU20B, RVU20C, RVU20D.

  10. July 1, 2019

    RVU19C

    $499.12changed to$500.55

    • Malpractice RVU 1.00 changed to 1.04

    Held through RVU19D.

  11. January 1, 2019

    RVU19A

    $494.93changed to$499.12

    • Conversion factor 35.9996 changed to 36.0391
    • Practice expense RVU 8.37 changed to 8.50
    • Malpractice RVU 1.03 changed to 1.00

    Held through RVU19B.

  12. January 1, 2018

    RVU18AR1

    $429.50changed to$494.93

    • Conversion factor 35.8887 changed to 35.9996
    • Practice expense RVU 8.23 changed to 8.37
    • Malpractice RVU 0.97 changed to 1.03
    • Practice expense GPCI 0.856 changed to 1.007
    • Malpractice GPCI 0.642 changed to 0.990

    Held through RVU18B, RVU18C, RVU18D.

  13. January 1, 2017

    RVU17A

    $373.05changed to$429.50

    • Conversion factor 35.8043 changed to 35.8887
    • Practice expense RVU 8.26 changed to 8.23
    • Malpractice RVU 1.01 changed to 0.97
    • Practice expense GPCI 0.705 changed to 0.856
    • Malpractice GPCI 0.293 changed to 0.642

    Held through RVU17B, RVU17C, RVU17D.

  14. January 1, 2016

    RVU16A

    $376.64changed to$373.05

    • Conversion factor 35.9335 changed to 35.8043
    • Practice expense RVU 8.34 changed to 8.26
    • Malpractice RVU 1.03 changed to 1.01

    Held through RVU16B, RVU16C, RVU16D.

  15. July 1, 2015

    RVU15C

    $374.76changed to$376.64

    • Conversion factor 35.7547 changed to 35.9335

    Held through RVU15D.

  16. January 1, 2015

    RVU15A

    $367.31changed to$374.76

    • Conversion factor 35.8228 changed to 35.7547
    • Practice expense RVU 8.29 changed to 8.34
    • Malpractice RVU 0.80 changed to 1.03
    • Practice expense GPCI 0.692 changed to 0.705
    • Malpractice GPCI 0.271 changed to 0.293

    Held through RVU15B.

  17. January 1, 2014

    RVU14A

    $407.16changed to$367.31

    • Conversion factor 34.0230 changed to 35.8228
    • Practice expense RVU 11.00 changed to 8.29
    • Malpractice RVU 0.84 changed to 0.80
    • Practice expense GPCI 0.678 changed to 0.692
    • Malpractice GPCI 0.249 changed to 0.271

    Held through RVU14B, RVU14C, RVU14D.

  18. January 1, 2013

    RVU13AR

    Earliest loaded release: $407.16

    Held through RVU13B, RVU13C, RVU13D.

Rates in every CMS release
Effective fromOfficeFacilityCMS release
2026-10-01$560.74$314.23RVU26D
2026-07-01$560.74$314.23RVU26C
2026-04-01$560.74$314.23RVU26B
2026-01-01$560.74$314.23RVU26A
2025-10-01$487.71$312.14RVU25D
2025-07-01$487.71$312.14RVU25C
2025-04-01$487.71$312.14RVU25B
2025-01-01$487.71$312.14RVU25A
2024-10-01$503.22$319.19RVU24D
2024-07-01$503.22$319.19RVU24C
2024-04-01$503.22$319.19RVU24B
2024-03-09$503.22$319.19RVU24AR
2024-01-01$495.01$313.98RVU24A
2023-10-01$511.36$322.12RVU23D
2023-07-01$509.32$321.59RVU23C
2023-04-01$509.32$321.59RVU23B
2023-01-01$509.32$321.59RVU23A
2022-10-01$525.06$327.97RVU22D
2022-07-01$525.06$327.97RVU22C
2022-04-01$525.06$327.97RVU22B
2022-01-01$525.06$327.97RVU22A
2021-10-01$525.94$326.16RVU21D
2021-07-01$525.94$326.16RVU21C
2021-04-01$525.94$326.16RVU21B
2021-01-01$525.94$326.16RVU21A
2020-10-01$509.12$328.32RVU20D
2020-07-01$509.12$328.32RVU20C
2020-04-01$509.12$328.32RVU20B
2020-01-01$509.12$328.32RVU20A
2019-10-01$500.55$325.26RVU19D
2019-07-01$500.55$325.26RVU19C
2019-04-01$499.12$323.84RVU19B
2019-01-01$499.12$323.84RVU19A
2018-10-01$494.93$323.46RVU18D
2018-07-01$494.93$323.46RVU18C
2018-04-01$494.93$323.46RVU18B
2018-01-01$494.93$323.46RVU18AR1
2017-10-01$429.50$288.19RVU17D
2017-07-01$429.50$288.19RVU17C
2017-04-01$429.50$288.19RVU17B
2017-01-01$429.50$288.19RVU17A
2016-10-01$373.05$255.93RVU16D
2016-07-01$373.05$255.93RVU16C
2016-04-01$373.05$255.93RVU16B
2016-01-01$373.05$255.93RVU16A
2015-10-01$376.64$257.06RVU15D
2015-07-01$376.64$257.06RVU15C
2015-04-01$374.76$255.79RVU15B
2015-01-01$374.76$255.79RVU15A
2014-10-01$367.31$252.04RVU14D
2014-07-01$367.31$252.04RVU14C
2014-04-01$367.31$252.04RVU14B
2014-01-01$367.31$252.04RVU14A
2013-10-01$407.16$268.75RVU13D
2013-07-01$407.16$268.75RVU13C
2013-04-01$407.16$268.75RVU13B
2013-01-01$407.16$268.75RVU13AR

Price 12046 for an earlier date of service

Where the Puerto Rico rate applies

Puerto Rico is a Medicare payment area, not a city. Our Census mapping connects it to 292 cities and communities in Puerto Rico. Some span more than one payment area; confirm with the service ZIP.

  • Aceitunas
  • Adjuntas
  • Aguada
  • Aguadilla
  • Aguas Buenas
  • Aguas Claras
  • Aguilita
  • Aibonito

Browse all communities in Puerto Rico

12046 billing questions

How is the 20.1–30 cm length determined?

Use the documented total repaired length for wounds in this code’s anatomical grouping and repair category. The note should identify each wound’s site and length.

When should I choose this instead of 12045 or 12047?

Choose 12046 when the applicable total length is 20.1–30 cm. Code 12045 covers the immediately shorter length band, while 12047 is for lengths greater than 30 cm.

Can simple closure of the same wound be billed separately?

Do not separately report simple repair for the same wound when the intermediate layered repair includes closure of the skin. The documentation should support the deeper-layer work that makes the repair intermediate.

Should modifier 50 be added for wounds on both sides?

No. CMS identifies bilateral adjustment as inappropriate for this code; report the service based on the applicable wound grouping and documented total length.

What happens when another procedure is performed in the same session?

The highest-valued procedure is paid in full, and other procedures in the session are subject to the standard multiple-procedure reduction. Related postoperative visits during the 10-day global period are included.

Can an assistant or co-surgeon be reported?

Assistant-at-surgery payment is available only when medical necessity is documented. Co-surgeons and team surgery are not permitted for this code.

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 12046PPRRVU2026_Oct_nonQPP.csv, line 1,422 (RVU26D)
Geographic factors for Puerto RicoGPCI2026.csv, line 91 (RVU26D)

Open CMS sourceHow we calculate rates

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