Billing code 12007: Wound repairMedicare rate & RVUs

Medicare pays $255.85 for 12007 nationally in the office and $133.94 in a hospital or facility. Local office rates run $225.98–$318.79.

Medicare allowed amount for participating (non-QP) physicians, before deductible, coinsurance and claim adjustments. Not a patient’s bill or a hospital charge.

What 12007 covers

This code describes simple closure of superficial wounds in the scalp, neck, axillae, external genitalia, or trunk when the qualifying repaired length exceeds 30 cm. Simple repair involves closure of the superficial wound layers without the layered work that characterizes an intermediate repair. Emergency department and urgent care clinicians commonly report it for extensive lacerations; surgeons and other clinicians may perform the repair in office or facility settings.

Select the code based on repair complexity, listed body-site group, and total repaired length. Add lengths of wounds in the same complexity and anatomic grouping; the documentation should identify each site, wound length, and the simple closure performed. This is a minor procedure with a 0-day global period, so same-day preoperative and postoperative care is included. When multiple procedures occur in one session, the highest-valued is paid in full and others are subject to the standard 50% reduction. Modifier 50 is inappropriate. Assistant-at-surgery payment is restricted; co-surgeon payment requires supporting documentation, and team surgery is 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.

Where 12007 pays more and less

The same RVUs, adjusted for each area’s costs. Open a locality for its calculation, history and nearby areas.

109 of 109 payment localities

12007 rates by state

Office rate range in each state. Select a state to see its payment localities.

How the 12007 rate is calculated

Each of 12007’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.

Payment rules and modifiers for 12007

The CMS indicators that decide how 12007 is paid alongside other services.

What modifiers do to the payment

When to use modifier 51

12007 compared with similar codes

How to choose

12006Simple wound repair

Both codes cover simple repair in the same site group. Choose 12007 only when the qualifying total repaired length exceeds 30 cm; 12006 applies through 30.0 cm.

12018Wound repair

This is the corresponding long-length simple-repair code for the face, ears, eyelids, nose, lips, and mucous membranes, rather than the site group covered by 12007.

12037Intermediate repair

12037 represents intermediate repair, not simple closure, for its scalp, axilla, trunk, and extremity site group. Choose by the documented repair complexity and applicable site group.

12047Intermediate repair

12047 is for intermediate repair over 30 cm in its site group, which includes the neck and external genitalia. Use it when the repair requires intermediate-level work rather than simple closure.

Codes related to 12007

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

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

Open CMS sourceHow we calculate rates