CPT code 12036: Wound repair2026 Medicare rate & RVUs

Medicare pays $479.97 for 12036 nationally in the office and $270.21 in a hospital or facility. Local office rates run $421.36–$619.20.

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

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.

Where 12036 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

12036 rates by state

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

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.

Payment rules and modifiers for 12036

12036 has a 10-day global period: related visits in that window are included in the surgery payment.

What modifiers do to the payment

When to use modifier 51

12036 compared with similar codes

How to choose

12035Wound repair

Use 12035 for the same general site grouping and intermediate repair method when the total length is 12.6–20 cm. This code covers 20.1–30 cm.

12037Intermediate repair

Use 12037 for the same general site grouping and intermediate repair method when the total length exceeds 30 cm. This code ends at 30 cm.

12046Intermediate repair

Both codes represent intermediate repair in the 20.1–30 cm range, but 12046 applies to a different anatomical grouping, including the neck or external genitalia.

12017Wound repair

Code 12017 describes simple repair in a different site grouping. Choose this code when the repair is intermediate and the wound sites and total length fit its descriptor.

Codes related to 12036

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