Billing code 12021: Wound dehiscence careMedicare rate & RVUs
Report this service when a superficial surgical wound has separated and the clinician treats the dehiscence by packing the wound rather than simple closure.
Medicare pays $185.71 for 12021 nationally in the office and $134.61 in a hospital or facility. Local office rates run $164.40–$237.40.
Medicare rate · 12021
Wound dehiscence care
Swap in your local Medicare rate.
- Work RVUs
- 1.84
- Total RVUs
- 5.56
- Global days
- 010
National rate · 2026
$185.71
Office setting, before claim adjustments.
See every locality for 12021 → · Billed by an NP, PA or therapist? →
Medicare allowed amount for participating (non-QP) physicians, before deductible, coinsurance and claim adjustments. Not a patient’s bill or a hospital charge.
On this page 10 sections
What 12021 covers
12021 describes treatment of a superficial surgical incision that has separated, when the clinician manages the open area with packing. A surgeon may provide this care after an operation, or a clinician may treat the patient in an office or facility when the wound is assessed and packed. The code concerns treatment of the dehiscence, not repair of a new traumatic laceration. The documented wound should be superficial and the treatment should include packing.
Choose 12021 when packing is used; 12020 is the related option when the superficial dehiscence is treated with simple closure. Document the surgical wound’s location and condition, its superficial nature, and the packing treatment. The 10-day global period includes related postoperative visits during that period. When multiple procedures occur in one session, the highest-valued procedure is paid in full and other procedures are subject to the standard 50% reduction. Modifier 50 is inappropriate. Medicare does not pay an assistant at surgery for this service, and co-surgery 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.
Where 12021 pays more and less
The same RVUs, adjusted for each area’s costs. Open a locality for its calculation, history and nearby areas.
109 payment localities
$164.40 to $237.40
109 of 109 payment localities
| Payment locality | Office | Facility |
|---|---|---|
| Alabama | $166.77 | $122.06 |
| Alaska* | $218.85 | $164.42 |
| Arizona | $180.61 | $131.09 |
| Arkansas | $164.40 | $120.50 |
| Atlanta | $189.92 | $138.00 |
| Austin | $191.14 | $137.08 |
| Bakersfield | $193.44 | $137.43 |
| Baltimore/Surr. Cntys | $197.57 | $142.74 |
| Beaumont | $174.74 | $128.23 |
| Brazoria | $182.76 | $132.11 |
| Chicago | $200.98 | $149.62 |
| Chico | $192.51 | $136.50 |
| Colorado | $191.28 | $136.91 |
| Connecticut | $197.97 | $142.93 |
| Dallas | $184.24 | $133.35 |
| Dc + Md/Va Suburbs | $210.43 | $150.23 |
| Delaware | $183.54 | $133.05 |
| Detroit | $189.31 | $139.99 |
| East St. Louis | $187.83 | $140.81 |
| El Centro | $192.56 | $136.56 |
| Fort Lauderdale | $196.09 | $144.32 |
| Fort Worth | $183.26 | $132.87 |
| Fresno | $192.51 | $136.50 |
| Galveston | $183.51 | $132.77 |
| Hanford-Corcoran | $192.51 | $136.50 |
| Hawaii, Guam | $196.58 | $138.48 |
| Houston | $189.55 | $138.81 |
| Idaho | $170.84 | $123.83 |
| Indiana | $171.78 | $124.40 |
| Iowa | $169.44 | $122.68 |
| Kansas | $169.37 | $123.17 |
| Kentucky | $172.20 | $126.77 |
| Los Angeles-Long Beach-Anaheim (Los Angeles/Orange Cnty) | $205.25 | $144.79 |
| Madera | $192.51 | $136.50 |
| Manhattan | $214.44 | $155.06 |
| Merced | $192.51 | $136.50 |
| Metropolitan Boston | $208.98 | $147.97 |
| Metropolitan Kansas City | $178.55 | $130.56 |
| Metropolitan Philadelphia | $193.58 | $140.39 |
| Metropolitan St. Louis | $180.30 | $131.65 |
| Miami | $207.20 | $154.01 |
| Minnesota | $181.23 | $128.65 |
| Mississippi | $167.09 | $123.09 |
| Modesto | $192.51 | $136.50 |
| Montana** | $185.69 | $134.58 |
| Napa | $220.16 | $152.81 |
| Nebraska | $170.13 | $122.97 |
| Nevada** | $183.98 | $132.83 |
| New Hampshire | $188.97 | $135.77 |
| New Mexico | $178.53 | $131.66 |
| New Orleans | $180.53 | $132.44 |
| North Carolina | $174.14 | $126.46 |
| North Dakota** | $179.16 | $128.06 |
| Northern Nj | $208.45 | $149.17 |
| Nyc Suburbs/Long Island | $220.49 | $159.73 |
| Ohio | $175.95 | $129.29 |
| Oklahoma | $171.14 | $125.50 |
| Oxnard-Thousand Oaks-Ventura | $203.88 | $143.48 |
| Portland | $196.44 | $139.66 |
| Poughkpsie/N Nyc Suburbs | $201.55 | $145.59 |
| Puerto Rico | $186.79 | $135.12 |
| Queens | $215.12 | $154.72 |
| Redding | $192.51 | $136.50 |
| Rest Of California | $192.51 | $136.50 |
| Rest Of Florida | $186.27 | $137.42 |
| Rest Of Georgia | $175.60 | $130.01 |
| Rest Of Illinois | $182.06 | $135.41 |
| Rest Of Louisiana | $172.22 | $127.00 |
| Rest Of Maine | $172.48 | $125.47 |
| Rest Of Maryland | $186.78 | $135.06 |
| Rest Of Massachusetts | $190.46 | $136.64 |
| Rest Of Michigan | $177.28 | $130.62 |
| Rest Of Missouri | $169.80 | $125.75 |
| Rest Of New Jersey | $199.65 | $143.85 |
| Rest Of New York | $176.77 | $128.23 |
| Rest Of Oregon | $181.98 | $131.08 |
| Rest Of Pennsylvania | $175.82 | $128.91 |
| Rest Of Texas | $178.87 | $130.37 |
| Rest Of Washington | $189.87 | $136.06 |
| Rhode Island | $189.42 | $136.63 |
| Riverside-San Bernardino-Ontario | $196.06 | $140.06 |
| Sacramento-Roseville-Folsom | $201.26 | $141.83 |
| Salinas | $200.50 | $141.27 |
| San Diego-Chula Vista-Carlsbad | $204.70 | $143.58 |
| San Francisco-Oakland-Berkeley (Marin Cnty) | $232.01 | $159.95 |
| San Francisco-Oakland-Berkeley (San Francisco/San Mateo/Alameda/Contra Costa Cnty) | $231.63 | $159.58 |
| San Jose-Sunnyvale-Santa Clara (San Benito Cnty) | $237.40 | $163.71 |
| San Jose-Sunnyvale-Santa Clara (Santa Clara Cnty) | $235.87 | $162.18 |
| San Luis Obispo-Paso Robles | $197.38 | $139.17 |
| Santa Cruz-Watsonville | $206.23 | $144.14 |
| Santa Maria-Santa Barbara | $201.11 | $141.52 |
| Santa Rosa-Petaluma | $208.25 | $145.50 |
| Seattle (King Cnty) | $212.47 | $149.76 |
| South Carolina | $175.45 | $128.23 |
| South Dakota** | $178.39 | $127.29 |
| Southern Maine | $180.62 | $129.98 |
| Stockton | $192.51 | $136.50 |
| Suburban Chicago | $197.71 | $145.22 |
| Tennessee | $170.30 | $123.85 |
| Utah | $177.79 | $129.75 |
| Vallejo | $219.62 | $152.27 |
| Vermont | $179.13 | $128.54 |
| Virgin Islands | $186.79 | $135.12 |
| Virginia | $180.54 | $130.31 |
| Visalia | $192.51 | $136.50 |
| West Virginia | $175.63 | $131.22 |
| Wisconsin | $173.33 | $124.37 |
| Wyoming** | $182.84 | $131.74 |
| Yuba City | $192.51 | $136.50 |
12021 rates by state
Office rate range in each state. Select a state to see its payment localities.
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.
$164.40
$218.85
Color shows the midpoint of each state’s locality range.
View every state and territory as a table
| State / territory | Office rate range | Localities |
|---|---|---|
| AK | $218.85 | 1 |
| AL | $166.77 | 1 |
| AR | $164.40 | 1 |
| AZ | $180.61 | 1 |
| CA | $192.51–$237.40 | 29 |
| CO | $191.28 | 1 |
| CT | $197.97 | 1 |
| DC | $210.43 | 1 |
| DE | $183.54 | 1 |
| FL | $186.27–$207.20 | 3 |
| GA | $175.60–$189.92 | 2 |
| GU | $196.58 | 1 |
| HI | $196.58 | 1 |
| IA | $169.44 | 1 |
| ID | $170.84 | 1 |
| IL | $182.06–$200.98 | 4 |
| IN | $171.78 | 1 |
| KS | $169.37 | 1 |
| KY | $172.20 | 1 |
| LA | $172.22–$180.53 | 2 |
| MA | $190.46–$208.98 | 2 |
| MD | $186.78–$210.43 | 3 |
| ME | $172.48–$180.62 | 2 |
| MI | $177.28–$189.31 | 2 |
| MN | $181.23 | 1 |
| MO | $169.80–$180.30 | 3 |
| MS | $167.09 | 1 |
| MT | $185.69 | 1 |
| NC | $174.14 | 1 |
| ND | $179.16 | 1 |
| NE | $170.13 | 1 |
| NH | $188.97 | 1 |
| NJ | $199.65–$208.45 | 2 |
| NM | $178.53 | 1 |
| NV | $183.98 | 1 |
| NY | $176.77–$220.49 | 5 |
| OH | $175.95 | 1 |
| OK | $171.14 | 1 |
| OR | $181.98–$196.44 | 2 |
| PA | $175.82–$193.58 | 2 |
| PR | $186.79 | 1 |
| RI | $189.42 | 1 |
| SC | $175.45 | 1 |
| SD | $178.39 | 1 |
| TN | $170.30 | 1 |
| TX | $174.74–$191.14 | 8 |
| UT | $177.79 | 1 |
| VA | $180.54–$210.43 | 2 |
| VI | $186.79 | 1 |
| VT | $179.13 | 1 |
| WA | $189.87–$212.47 | 2 |
| WI | $173.33 | 1 |
| WV | $175.63 | 1 |
| WY | $182.84 | 1 |
How the 12021 rate is calculated
Each of 12021’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 · 12021
RVUs × geographic indexes × conversion factor
Swap in your local Medicare rate.
Work 1.84Practice expense 3.39Malpractice 0.33
All indexes start at 1.000 (the national rate). Enter a ZIP or drag a slider.
Payment rules and modifiers for 12021
12021 has a 10-day global period: related visits in that window are included in the surgery payment.
CMS payment indicators · 12021
Wound dehiscence care
| Rule | CMS value | What it means |
|---|---|---|
| Global period | 010 | Minor procedure: the day of the procedure plus 10 days after are included. |
| Multiple procedures | 2 | Standard reduction: highest-valued procedure at 100%, others at 50%. |
| Bilateral (modifier 50) | 0 | The 150% bilateral adjustment doesn’t apply. |
| Assistant at surgery (80/81/82/AS) | 1 | Not paid (statutory restriction). |
| Co-surgeons (62) | 0 | Not permitted. |
| Team surgery (66) | 0 | Not permitted. |
| Professional/technical | 0 | Physician service: no professional/technical split. |
| Split (54/55/56) | 0.10/0.80/0.10 | Share of the payment for pre-op, the procedure itself, and post-op care. |
Global surgery period · 12021
Wound dehiscence care
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.
What modifiers do to the payment
Modifier 51 · payment effect
With and without the modifier
12021 without 51 · national office
$185.71
Wound dehiscence care
12021-51 · Second procedure: 50%
$92.86
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%).
12021 compared with similar codes
Compare codes
12021 vs 12020 vs 13160 vs 10180: national Medicare rates
Swap in your local Medicare rate.
How to choose
- 12020Wound dehiscence
- Both address superficial wound dehiscence. Choose 12021 when the wound is packed and 12020 when simple closure is performed.
- 13160Wound closure
- 13160 is for extensive or complicated secondary closure of a surgical wound or dehiscence; 12021 is for superficial dehiscence treated with packing.
- 10180Wound drainage
- 10180 describes complex incision and drainage of a postoperative wound infection. Choose 12021 for superficial dehiscence treated with packing.
12021 billing questions
How do I choose between 12021 and 12020?
Use 12021 when the superficial dehiscence is treated with packing. Use 12020 when the treatment is simple closure.
Can I report both 12020 and 12021 for the same dehiscence?
They describe different treatment approaches for superficial wound dehiscence. Select the code that matches the treatment documented for that wound.
What documentation supports 12021?
Record that a surgical wound has separated, that the dehiscence is superficial, and that the clinician treated it with packing. Include the wound location and relevant findings.
Are related postoperative visits included?
Yes. The 10-day global period includes related postoperative visits during that period.
Which modifiers and multiple-procedure rules should I consider?
Modifier 50 is inappropriate for this code. 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 50% reduction; assistant-at-surgery payment is restricted, and co-surgery and team surgery 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
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