$232.58–$348.75
Use 12041 for qualifying intermediate repairs of the same sites when the length is 2.5 cm or less; 12042 begins at 2.6 cm.
On this page
CMS RVU26D · Effective 2026-10-01
12042 Intermediate wound repair Medicare reimbursement rates
Reports intermediate layered closure of a 2.6–7.5 cm wound on the neck, hand, foot, or external genitalia, or qualifying extensive cleaning of a contaminated wound. Compare 12042 office and facility rates across CMS payment localities.
Amounts below use the non-QP conversion factor for participating physicians. These are base physician payments before claim-level adjustments, not patient costs or total hospital charges.
What does Medicare pay for 12042?
The service location and office or facility setting determine which base rate applies. These are the supported base rates for the 109 payment areas shown below, using the same CMS release.
Office / nonfacility
$271.32–$400.50
109 of 109 localities have a supported rate.
Lowest: Arkansas
Highest: San Jose-Sunnyvale-Santa Clara (San Benito Cnty)
A spread of $129.18 per service.
These are locality ranges, not averages or address-specific quotes. A facility-setting amount covers the physician service; it does not include a hospital’s separate bill. Choose a locality below to inspect its calculation, compare other payment areas, or price a percentage of Medicare.
Where 12042 pays more and less
109 payment localities
$271.32 to $400.50
Wound repair
About 12042: Intermediate repair of neck, hand, foot, or genital wound
Reports intermediate layered closure of a 2.6–7.5 cm wound on the neck, hand, foot, or external genitalia, or qualifying extensive cleaning of a contaminated wound.
This code covers intermediate repair of wounds on the neck, hands, feet, or external genitalia when the qualifying length is 2.6–7.5 cm. It describes layered closure involving deeper tissue as well as skin, or single-layer closure of a heavily contaminated wound that requires extensive cleaning or removal of particulate matter. Emergency clinicians, surgeons, dermatologists, and other clinicians performing wound repair may report it in an office, emergency department, or outpatient facility.
Select the code using the wound’s documented length, anatomic site, and repair method. Record the site, measured length, tissue layers closed, and, for a contaminated wound closed in one layer, the extensive cleaning performed. Related postoperative visits during the 10-day global period are included. When multiple procedures are performed in the same session, the highest-valued procedure is paid in full and other procedures are subject to the standard multiple-procedure reduction. Modifier 50 is inappropriate for this code. Medicare does not pay an assistant at surgery, and co-surgeons and team surgery are not permitted.
CMS billing rules for 12042
- Global period
- Minor procedure with a 10-day global period: related postoperative visits for 10 days are included.
- Multiple procedures
- Standard multiple procedure reduction: the highest-valued procedure is paid in full and others at 50% when performed in the same session.
- Bilateral procedures
- Bilateral adjustment does not apply; the descriptor or anatomy makes modifier 50 inappropriate.
- Assistant at surgery
- Statutory restriction: assistant at surgery is not paid.
- Co-surgeons
- Co-surgeons not permitted.
- Team surgery
- Team surgery not permitted.
Where the value comes from
- Work RVU2.72 · 30%
- Practice expense (office) RVU6.11 · 67%
- Malpractice RVU0.30 · 3%
68.3K
Medicare services in 2024 · #682 by national volume
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.
12042 compared with similar codes
Office rate ranges across all CMS payment localities, from the same CMS release.
$266.25–$397.37
Both represent intermediate repair in the 2.6–7.5 cm range, but 12032 is for the scalp, axillae, trunk, or extremities, including hands and feet, under its site grouping.
$277.26–$408.51
Use 12052 for intermediate repairs of the face, ears, eyelids, nose, lips, or mucous membranes; 12042 is for the neck, hands, feet, or external genitalia.
$122.11–$181.27
12002 is a simple repair code for its specified sites and length range. Choose 12042 when the documented repair meets intermediate criteria.
See how rates vary across the country
12042 · Office / nonfacility · Non-QP. Choose a state to explore its payment localities. A range means the amount varies within that state.
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.
$271.32
$360.97
Color shows the midpoint of each state’s locality range.
View all state and territory rates as a table
| State / territory | Rate range | Localities |
|---|---|---|
| AK | $359.14 | 1 |
| AL | $275.09 | 1 |
| AR | $271.32 | 1 |
| AZ | $297.18 | 1 |
| CA | $321.44–$400.50 | 29 |
| CO | $316.91 | 1 |
| CT | $324.59 | 1 |
| DC | $347.31 | 1 |
| DE | $301.94 | 1 |
| FL | $301.01–$328.64 | 3 |
| GA | $284.83–$310.50 | 2 |
| GU | $328.69 | 1 |
| HI | $328.69 | 1 |
| IA | $281.56 | 1 |
| ID | $283.34 | 1 |
| IL | $292.84–$319.58 | 4 |
| IN | $284.90 | 1 |
| KS | $280.39 | 1 |
| KY | $281.45 | 1 |
| LA | $281.06–$294.27 | 2 |
| MA | $315.19–$347.16 | 2 |
| MD | $307.49–$347.31 | 3 |
| ME | $284.84–$299.42 | 2 |
| MI | $288.49–$304.68 | 2 |
| MN | $303.81 | 1 |
| MO | $276.53–$295.17 | 3 |
| MS | $273.97 | 1 |
| MT | $304.93 | 1 |
| NC | $287.66 | 1 |
| ND | $299.00 | 1 |
| NE | $283.00 | 1 |
| NH | $312.06 | 1 |
| NJ | $328.33–$344.01 | 2 |
| NM | $290.03 | 1 |
| NV | $303.48 | 1 |
| NY | $291.77–$357.92 | 5 |
| OH | $287.28 | 1 |
| OK | $280.88 | 1 |
| OR | $301.16–$326.49 | 2 |
| PA | $287.66–$316.89 | 2 |
| PR | $307.04 | 1 |
| RI | $312.33 | 1 |
| SC | $287.94 | 1 |
| SD | $298.30 | 1 |
| TN | $281.74 | 1 |
| TX | $285.87–$315.83 | 8 |
| UT | $291.68 | 1 |
| VA | $298.53–$347.31 | 2 |
| VI | $307.04 | 1 |
| VT | $297.96 | 1 |
| WA | $314.55–$353.99 | 2 |
| WI | $289.44 | 1 |
| WV | $282.53 | 1 |
| WY | $302.34 | 1 |
Compare 12042 by payment locality
Find the payment area for your service address, then open its rate page for calculation inputs, release history and the percentage-of-Medicare tool. A city may cross payment-area boundaries; the ZIP lookup above helps resolve the location.
109 of 109 payment localities
| Payment locality | Office | Facility |
|---|---|---|
| Alabama | Office $275.09 | Facility $155.56 |
| Alaska* | Office $359.14 | Facility $213.65 |
| Arizona | Office $297.18 | Facility $164.81 |
| Arkansas | Office $271.32 | Facility $153.97 |
| Atlanta | Office $310.50 | Facility $171.71 |
| Austin | Office $315.83 | Facility $171.29 |
| Bakersfield | Office $322.35 | Facility $172.63 |
| Baltimore/Surr. Cntys | Office $323.68 | Facility $177.09 |
| Beaumont | Office $285.87 | Facility $161.56 |
| Brazoria | Office $301.64 | Facility $166.26 |
| Chicago | Office $319.58 | Facility $182.29 |
| Chico | Office $321.44 | Facility $171.71 |
| Colorado | Office $316.91 | Facility $171.55 |
| Connecticut | Office $324.59 | Facility $177.46 |
| Dallas | Office $303.53 | Facility $167.47 |
| Dc + Md/Va Suburbs | Office $347.31 | Facility $186.39 |
| Delaware | Office $301.94 | Facility $166.97 |
| Detroit | Office $304.68 | Facility $172.85 |
| East St. Louis | Office $298.78 | Facility $173.10 |
| El Centro | Office $321.49 | Facility $171.76 |
| Fort Lauderdale | Office $315.70 | Facility $177.31 |
| Fort Worth | Office $301.62 | Facility $166.92 |
| Fresno | Office $321.44 | Facility $171.71 |
| Galveston | Office $302.52 | Facility $166.87 |
| Hanford-Corcoran | Office $321.44 | Facility $171.71 |
| Hawaii, Guam | Office $328.69 | Facility $173.37 |
| Houston | Office $308.02 | Facility $172.36 |
| Idaho | Office $283.34 | Facility $157.66 |
| Indiana | Office $284.90 | Facility $158.26 |
| Iowa | Office $281.56 | Facility $156.56 |
| Kansas | Office $280.39 | Facility $156.89 |
| Kentucky | Office $281.45 | Facility $160.00 |
| Los Angeles-Long Beach-Anaheim (Los Angeles/Orange Cnty) | Office $342.65 | Facility $181.05 |
| Madera | Office $321.44 | Facility $171.71 |
| Manhattan | Office $349.70 | Facility $190.96 |
| Merced | Office $321.44 | Facility $171.71 |
| Metropolitan Boston | Office $347.16 | Facility $184.05 |
| Metropolitan Kansas City | Office $292.27 | Facility $163.99 |
| Metropolitan Philadelphia | Office $316.89 | Facility $174.68 |
| Metropolitan St. Louis | Office $295.17 | Facility $165.12 |
| Miami | Office $328.64 | Facility $186.43 |
| Minnesota | Office $303.81 | Facility $163.24 |
| Mississippi | Office $273.97 | Facility $156.35 |
| Modesto | Office $321.44 | Facility $171.71 |
| Montana** | Office $304.93 | Facility $168.32 |
| Napa | Office $370.64 | Facility $190.59 |
| Nebraska | Office $283.00 | Facility $156.91 |
| Nevada** | Office $303.48 | Facility $166.73 |
| New Hampshire | Office $312.06 | Facility $169.85 |
| New Mexico | Office $290.03 | Facility $164.75 |
| New Orleans | Office $294.27 | Facility $165.72 |
| North Carolina | Office $287.66 | Facility $160.20 |
| North Dakota** | Office $299.00 | Facility $162.39 |
| Northern Nj | Office $344.01 | Facility $185.54 |
| Nyc Suburbs/Long Island | Office $357.92 | Facility $195.49 |
| Ohio | Office $287.28 | Facility $162.55 |
| Oklahoma | Office $280.88 | Facility $158.89 |
| Oxnard-Thousand Oaks-Ventura | Office $340.86 | Facility $179.39 |
| Portland | Office $326.49 | Facility $174.72 |
| Poughkpsie/N Nyc Suburbs | Office $330.53 | Facility $180.94 |
| Puerto Rico | Office $307.04 | Facility $168.93 |
| Queens | Office $352.34 | Facility $190.86 |
| Redding | Office $321.44 | Facility $171.71 |
| Rest Of California | Office $321.44 | Facility $171.71 |
| Rest Of Florida | Office $301.01 | Facility $170.41 |
| Rest Of Georgia | Office $284.83 | Facility $162.98 |
| Rest Of Illinois | Office $292.84 | Facility $168.11 |
| Rest Of Louisiana | Office $281.06 | Facility $160.16 |
| Rest Of Maine | Office $284.84 | Facility $159.16 |
| Rest Of Maryland | Office $307.49 | Facility $169.24 |
| Rest Of Massachusetts | Office $315.19 | Facility $171.34 |
| Rest Of Michigan | Office $288.49 | Facility $163.76 |
| Rest Of Missouri | Office $276.53 | Facility $158.77 |
| Rest Of New Jersey | Office $328.33 | Facility $179.15 |
| Rest Of New York | Office $291.77 | Facility $161.99 |
| Rest Of Oregon | Office $301.16 | Facility $165.09 |
| Rest Of Pennsylvania | Office $287.66 | Facility $162.26 |
| Rest Of Texas | Office $293.57 | Facility $163.93 |
| Rest Of Washington | Office $314.55 | Facility $170.70 |
| Rhode Island | Office $312.33 | Facility $171.21 |
| Riverside-San Bernardino-Ontario | Office $324.70 | Facility $174.98 |
| Sacramento-Roseville-Folsom | Office $336.84 | Facility $177.96 |
| Salinas | Office $335.57 | Facility $177.24 |
| San Diego-Chula Vista-Carlsbad | Office $343.09 | Facility $179.70 |
| San Francisco-Oakland-Berkeley (Marin Cnty) | Office $391.83 | Facility $199.21 |
| San Francisco-Oakland-Berkeley (San Francisco/San Mateo/Alameda/Contra Costa Cnty) | Office $391.49 | Facility $198.87 |
| San Jose-Sunnyvale-Santa Clara (San Benito Cnty) | Office $400.50 | Facility $203.51 |
| San Jose-Sunnyvale-Santa Clara (Santa Clara Cnty) | Office $399.10 | Facility $202.11 |
| San Luis Obispo-Paso Robles | Office $330.21 | Facility $174.61 |
| Santa Cruz-Watsonville | Office $346.09 | Facility $180.11 |
| Santa Maria-Santa Barbara | Office $336.72 | Facility $177.43 |
| Santa Rosa-Petaluma | Office $349.56 | Facility $181.80 |
| Seattle (King Cnty) | Office $353.99 | Facility $186.36 |
| South Carolina | Office $287.94 | Facility $161.71 |
| South Dakota** | Office $298.30 | Facility $161.69 |
| Southern Maine | Office $299.42 | Facility $164.04 |
| Stockton | Office $321.44 | Facility $171.71 |
| Suburban Chicago | Office $318.83 | Facility $178.53 |
| Tennessee | Office $281.74 | Facility $157.56 |
| Utah | Office $291.68 | Facility $163.27 |
| Vallejo | Office $370.15 | Facility $190.10 |
| Vermont | Office $297.96 | Facility $162.72 |
| Virgin Islands | Office $307.04 | Facility $168.93 |
| Virginia | Office $298.53 | Facility $164.25 |
| Visalia | Office $321.44 | Facility $171.71 |
| West Virginia | Office $282.53 | Facility $163.82 |
| Wisconsin | Office $289.44 | Facility $158.57 |
| Wyoming** | Office $302.34 | Facility $165.74 |
| Yuba City | Office $321.44 | Facility $171.71 |
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12042 billing questions
How is 12042 distinguished from 12041?
Both cover intermediate repair of the same anatomic group. Use 12041 for a qualifying wound length of 2.5 cm or less and 12042 for 2.6–7.5 cm.
Can lengths of multiple wounds be combined?
For wounds of the same repair classification in the same anatomic grouping, use their combined length to select the applicable code. Document each wound’s site and measurement.
What repair details support reporting 12042?
Document the wound location and length, the layers closed, and the closure performed. For a single-layer closure, document heavy contamination and the extensive cleaning or particulate removal.
Is modifier 50 appropriate for wounds on both sides?
No. CMS identifies bilateral adjustment as inappropriate for this code; modifier 50 should not be used.
Are postoperative visits separately reported during the global period?
Related postoperative visits during the 10-day global period are included in the procedure.
How does Medicare handle other procedures performed in the same session?
The highest-valued procedure is paid in full, and other procedures are subject to the standard multiple-procedure reduction.
Where these rates come from
FeeBase calculates base physician payments from CMS work, practice-expense, and malpractice RVUs, adjusted by each locality’s geographic indices and the applicable conversion factor. Unavailable or separately priced services are labeled rather than assigned a made-up amount.
Source: RVU26D. Effective 2026-10-01 through the day before 2027-01-01.
1,41612036,,Intmd rpr s/a/t/ext 20.1-30,A,,4.12,9.35,,3.07,,0.90,14.37,8.09,0,010,0.10,0.80,0.10,2,0,1,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
1,41712037,,Intmd rpr s/tr/ext >30.0 cm,A,,4.88,10.10,,3.26,,1.07,16.05,9.21,0,010,0.10,0.80,0.10,2,0,0,1,0,9,,33.4009,09,0,99,0.00,0.00,0.00
1,41812041,,Intmd rpr n-hf/genit 2.5cm/<,A,,2.05,5.57,,1.57,,0.25,7.87,3.87,0,010,0.10,0.80,0.10,2,0,1,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
1,41912042,,Intmd rpr n-hf/genit2.6-7.5,A,,2.72,6.11,,2.02,,0.30,9.13,5.04,0,010,0.10,0.80,0.10,2,0,1,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
1,42012044,,Intmd rpr n-hf/genit7.6-12.5,A,,3.11,8.07,,2.16,,0.44,11.62,5.71,0,010,0.10,0.80,0.10,2,0,1,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
1,42112045,,Intmd rpr n-hf/genit12.6-20,A,,3.66,9.22,,3.68,,0.70,13.58,8.04,0,010,0.10,0.80,0.10,2,0,1,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
1,42212046,,Intmd rpr n-hf/genit20.1-30,A,,4.19,11.37,,4.07,,1.12,16.68,9.38,0,010,0.10,0.80,0.10,2,0,0,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00