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CMS RVU26D · Effective 2026-10-01

12016 in Austin

Office / nonfacility

$274.67

Base rate per service

Facility setting

$120.95

Base rate per service

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.

Wound repair

About 12016: Simple facial wound repair, 12.6–20 cm

Simple closure of superficial wounds of the face, ears, eyelids, nose, lips, or mucous membranes, with a combined repair length of 12.6–20 cm.

This service covers straightforward, one-layer closure of superficial lacerations in the face-site group: the face, ears, eyelids, nose, lips, and mucous membranes. The wound is limited to superficial tissues rather than requiring layered repair of deeper structures. Physicians and other qualified clinicians commonly perform these repairs in emergency departments, urgent care, or office settings after injuries such as facial cuts.

Select the code using the combined length of qualifying simple repairs in this anatomic group during the session; document each wound’s site, measured length, and repair method. This length band is 12.6–20 cm. The code has a 0-day global period, so same-day preoperative and postoperative care is included. When multiple procedures occur in one session, the highest-valued procedure is paid in full and other procedures are subject to the standard 50% multiple-procedure reduction. Modifier 50 is inappropriate. Medicare does not pay an assistant at surgery for this service, and co-surgeon and team-surgery reporting are not permitted.

CMS billing rules for 12016

Global period
Minor procedure with a 0-day global period: same-day preoperative and postoperative care is 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 RVU2.61 · 33%
  • Practice expense (office) RVU4.79 · 60%
  • Malpractice RVU0.61 · 8%

469

Medicare services in 2024 · #3620 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.

12016 compared with similar codes

Office rates for Austin, from the same CMS release.

12015

Simple wound repair

Face and related sites, 7.6-12.5 cm

$216.85

This is the shorter length band for simple repairs in the same face-site group. Choose 12016 when the combined qualifying repair length reaches 12.6 cm.

12017

Wound repair

Face and related sites, 20.1–30 cm

No office rate

This is the next longer length band for simple repairs in the same face-site group; 12016 covers a combined length of 12.6–20 cm.

12005

Simple wound repair

12.6–20.0 cm

$217.28

This covers simple repairs in a different anatomic group at the 12.6–20 cm length band. Choose based on wound site, not length alone.

12031

Wound repair

Scalp, trunk, or extremity

$269.96

This is an intermediate repair code for a different site group. Choose it when the repair meets intermediate-repair criteria, not for a superficial simple closure.

The same code, a different location

How does Austin compare?

In Beaumont, the office rate for 12016 is $251.70—$22.97 lower than the $274.67 rate in Austin. Both use the same code, release and participation basis.

12016 across payment areas

Same release and payment basis · bars start at $0

  1. Austin · This locality

    $274.67

  2. Beaumont

    $251.70

    $22.97 lower than Austin

  3. Brazoria

    $262.32

    $12.35 lower than Austin

  4. Dallas

    $264.79

    $9.88 lower than Austin

  5. Fort Worth

    $263.46

    $11.21 lower than Austin

  6. Galveston

    $263.61

    $11.06 lower than Austin

  7. Houston

    $274.78

    $0.11 higher than Austin

Other payment areas listed in Texas appear first, followed by selected cross-country examples. The chart compares amounts, not distance.

Across 109 of 109 CMS payment localities with a supported office rate, 12016 ranges from $235.10 in Arkansas to $338.39 in San Jose-Sunnyvale-Santa Clara (San Benito Cnty). This is a geographic range, not an average.

The code’s RVUs stay the same in these comparisons. Geographic adjustments to work, practice expense and malpractice change the dollar amount. A city name alone may not identify the payment area for a service address.

Compare all 108 other payment areas

  • Rest Of Texas

    Texas · 12016

    Office

    $257.41

    Facility

    $119.52

    $17.26 lower than Austin for the office setting.

  • Los Angeles-Long Beach-Anaheim (Los Angeles/Orange Cnty)

    California · 12016

    Office

    $293.55

    Facility

    $121.67

    $18.88 higher than Austin for the office setting.

  • Dc + Md/Va Suburbs

    District of Columbia · 12016

    Office

    $303.03

    Facility

    $131.87

    $28.36 higher than Austin for the office setting.

  • Miami

    Florida · 12016

    Office

    $305.25

    Facility

    $154.00

    $30.58 higher than Austin for the office setting.

  • Chicago

    Illinois · 12016

    Office

    $295.34

    Facility

    $149.32

    $20.67 higher than Austin for the office setting.

  • Manhattan

    New York · 12016

    Office

    $310.98

    Facility

    $142.15

    $36.31 higher than Austin for the office setting.

  • Alaska*

    Alaska · 12016

    Office

    $312.38

    Facility

    $157.64

    $37.71 higher than Austin for the office setting.

  • Alabama

    Alabama · 12016

    Office

    $238.70

    Facility

    $111.57

    $35.97 lower than Austin for the office setting.

  • Arkansas

    Arkansas · 12016

    Office

    $235.10

    Facility

    $110.29

    $39.57 lower than Austin for the office setting.

  • Arizona

    Arizona · 12016

    Office

    $259.65

    Facility

    $118.86

    $15.02 lower than Austin for the office setting.

  • Bakersfield

    California · 12016

    Office

    $276.59

    Facility

    $117.35

    $1.92 higher than Austin for the office setting.

  • Chico

    California · 12016

    Office

    $274.93

    Facility

    $115.69

    $0.26 higher than Austin for the office setting.

  • El Centro

    California · 12016

    Office

    $275.03

    Facility

    $115.79

    $0.36 higher than Austin for the office setting.

  • Fresno

    California · 12016

    Office

    $274.93

    Facility

    $115.69

    $0.26 higher than Austin for the office setting.

  • Hanford-Corcoran

    California · 12016

    Office

    $274.93

    Facility

    $115.69

    $0.26 higher than Austin for the office setting.

  • Madera

    California · 12016

    Office

    $274.93

    Facility

    $115.69

    $0.26 higher than Austin for the office setting.

  • Merced

    California · 12016

    Office

    $274.93

    Facility

    $115.69

    $0.26 higher than Austin for the office setting.

  • Modesto

    California · 12016

    Office

    $274.93

    Facility

    $115.69

    $0.26 higher than Austin for the office setting.

  • Napa

    California · 12016

    Office

    $313.89

    Facility

    $122.39

    $39.22 higher than Austin for the office setting.

  • Oxnard-Thousand Oaks-Ventura

    California · 12016

    Office

    $291.42

    Facility

    $119.68

    $16.75 higher than Austin for the office setting.

  • Redding

    California · 12016

    Office

    $274.93

    Facility

    $115.69

    $0.26 higher than Austin for the office setting.

  • Rest Of California

    California · 12016

    Office

    $274.93

    Facility

    $115.69

    $0.26 higher than Austin for the office setting.

  • Riverside-San Bernardino-Ontario

    California · 12016

    Office

    $281.47

    Facility

    $122.23

    $6.80 higher than Austin for the office setting.

  • Sacramento-Roseville-Folsom

    California · 12016

    Office

    $287.30

    Facility

    $118.33

    $12.63 higher than Austin for the office setting.

  • Salinas

    California · 12016

    Office

    $286.23

    Facility

    $117.83

    $11.56 higher than Austin for the office setting.

  • San Diego-Chula Vista-Carlsbad

    California · 12016

    Office

    $292.18

    Facility

    $118.41

    $17.51 higher than Austin for the office setting.

  • San Francisco-Oakland-Berkeley (Marin Cnty)

    California · 12016

    Office

    $330.40

    Facility

    $125.53

    $55.73 higher than Austin for the office setting.

  • San Francisco-Oakland-Berkeley (San Francisco/San Mateo/Alameda/Contra Costa Cnty)

    California · 12016

    Office

    $329.70

    Facility

    $124.84

    $55.03 higher than Austin for the office setting.

  • San Jose-Sunnyvale-Santa Clara (San Benito Cnty)

    California · 12016

    Office

    $338.39

    Facility

    $128.88

    $63.72 higher than Austin for the office setting.

  • San Jose-Sunnyvale-Santa Clara (Santa Clara Cnty)

    California · 12016

    Office

    $335.56

    Facility

    $126.05

    $60.89 higher than Austin for the office setting.

  • San Luis Obispo-Paso Robles

    California · 12016

    Office

    $281.81

    Facility

    $116.32

    $7.14 higher than Austin for the office setting.

  • Santa Cruz-Watsonville

    California · 12016

    Office

    $294.32

    Facility

    $117.78

    $19.65 higher than Austin for the office setting.

  • Santa Maria-Santa Barbara

    California · 12016

    Office

    $287.09

    Facility

    $117.67

    $12.42 higher than Austin for the office setting.

  • Santa Rosa-Petaluma

    California · 12016

    Office

    $297.18

    Facility

    $118.76

    $22.51 higher than Austin for the office setting.

  • Stockton

    California · 12016

    Office

    $274.93

    Facility

    $115.69

    $0.26 higher than Austin for the office setting.

  • Vallejo

    California · 12016

    Office

    $312.89

    Facility

    $121.39

    $38.22 higher than Austin for the office setting.

  • Visalia

    California · 12016

    Office

    $274.93

    Facility

    $115.69

    $0.26 higher than Austin for the office setting.

  • Yuba City

    California · 12016

    Office

    $274.93

    Facility

    $115.69

    $0.26 higher than Austin for the office setting.

  • Colorado

    Colorado · 12016

    Office

    $274.36

    Facility

    $119.77

    $0.31 lower than Austin for the office setting.

  • Connecticut

    Connecticut · 12016

    Office

    $285.88

    Facility

    $129.40

    $11.21 higher than Austin for the office setting.

  • Delaware

    Delaware · 12016

    Office

    $264.00

    Facility

    $120.45

    $10.67 lower than Austin for the office setting.

  • Fort Lauderdale

    Florida · 12016

    Office

    $286.08

    Facility

    $138.90

    $11.41 higher than Austin for the office setting.

  • Rest Of Florida

    Florida · 12016

    Office

    $270.75

    Facility

    $131.85

    $3.92 lower than Austin for the office setting.

  • Atlanta

    Georgia · 12016

    Office

    $274.46

    Facility

    $126.84

    $0.21 lower than Austin for the office setting.

  • Rest Of Georgia

    Georgia · 12016

    Office

    $254.17

    Facility

    $124.57

    $20.50 lower than Austin for the office setting.

  • Hawaii, Guam

    Hawaii · 12016

    Office

    $280.88

    Facility

    $115.68

    $6.21 higher than Austin for the office setting.

  • Iowa

    Iowa · 12016

    Office

    $241.66

    Facility

    $108.71

    $33.01 lower than Austin for the office setting.

  • Idaho

    Idaho · 12016

    Office

    $244.00

    Facility

    $110.33

    $30.67 lower than Austin for the office setting.

  • East St. Louis

    Illinois · 12016

    Office

    $275.40

    Facility

    $141.73

    $0.73 higher than Austin for the office setting.

  • Rest Of Illinois

    Illinois · 12016

    Office

    $265.09

    Facility

    $132.44

    $9.58 lower than Austin for the office setting.

  • Suburban Chicago

    Illinois · 12016

    Office

    $288.20

    Facility

    $138.98

    $13.53 higher than Austin for the office setting.

  • Indiana

    Indiana · 12016

    Office

    $245.39

    Facility

    $110.70

    $29.28 lower than Austin for the office setting.

  • Kansas

    Kansas · 12016

    Office

    $242.08

    Facility

    $110.73

    $32.59 lower than Austin for the office setting.

  • Kentucky

    Kentucky · 12016

    Office

    $248.05

    Facility

    $118.88

    $26.62 lower than Austin for the office setting.

  • New Orleans

    Louisiana · 12016

    Office

    $260.87

    Facility

    $124.15

    $13.80 lower than Austin for the office setting.

  • Rest Of Louisiana

    Louisiana · 12016

    Office

    $248.29

    Facility

    $119.70

    $26.38 lower than Austin for the office setting.

  • Metropolitan Boston

    Massachusetts · 12016

    Office

    $299.91

    Facility

    $126.43

    $25.24 higher than Austin for the office setting.

  • Rest Of Massachusetts

    Massachusetts · 12016

    Office

    $273.28

    Facility

    $120.28

    $1.39 lower than Austin for the office setting.

  • Baltimore/Surr. Cntys

    Maryland · 12016

    Office

    $285.44

    Facility

    $129.54

    $10.77 higher than Austin for the office setting.

  • Rest Of Maryland

    Maryland · 12016

    Office

    $268.66

    Facility

    $121.62

    $6.01 lower than Austin for the office setting.

  • Rest Of Maine

    Maine · 12016

    Office

    $247.04

    Facility

    $113.37

    $27.63 lower than Austin for the office setting.

  • Southern Maine

    Maine · 12016

    Office

    $258.58

    Facility

    $114.60

    $16.09 lower than Austin for the office setting.

  • Detroit

    Michigan · 12016

    Office

    $275.92

    Facility

    $135.71

    $1.25 higher than Austin for the office setting.

  • Rest Of Michigan

    Michigan · 12016

    Office

    $256.25

    Facility

    $123.60

    $18.42 lower than Austin for the office setting.

  • Minnesota

    Minnesota · 12016

    Office

    $257.84

    Facility

    $108.33

    $16.83 lower than Austin for the office setting.

  • Metropolitan Kansas City

    Missouri · 12016

    Office

    $257.31

    Facility

    $120.88

    $17.36 lower than Austin for the office setting.

  • Metropolitan St. Louis

    Missouri · 12016

    Office

    $259.90

    Facility

    $121.58

    $14.77 lower than Austin for the office setting.

  • Rest Of Missouri

    Missouri · 12016

    Office

    $244.93

    Facility

    $119.69

    $29.74 lower than Austin for the office setting.

  • Mississippi

    Mississippi · 12016

    Office

    $239.98

    Facility

    $114.89

    $34.69 lower than Austin for the office setting.

  • Montana**

    Montana · 12016

    Office

    $267.50

    Facility

    $122.21

    $7.17 lower than Austin for the office setting.

  • North Carolina

    North Carolina · 12016

    Office

    $249.47

    Facility

    $113.91

    $25.20 lower than Austin for the office setting.

  • North Dakota**

    North Dakota · 12016

    Office

    $255.44

    Facility

    $110.14

    $19.23 lower than Austin for the office setting.

  • Nebraska

    Nebraska · 12016

    Office

    $242.55

    Facility

    $108.44

    $32.12 lower than Austin for the office setting.

  • New Hampshire

    New Hampshire · 12016

    Office

    $271.55

    Facility

    $120.30

    $3.12 lower than Austin for the office setting.

  • Northern Nj

    New Jersey · 12016

    Office

    $300.02

    Facility

    $131.48

    $25.35 higher than Austin for the office setting.

  • Rest Of New Jersey

    New Jersey · 12016

    Office

    $287.72

    Facility

    $129.06

    $13.05 higher than Austin for the office setting.

  • New Mexico

    New Mexico · 12016

    Office

    $258.36

    Facility

    $125.12

    $16.31 lower than Austin for the office setting.

  • Nevada**

    Nevada · 12016

    Office

    $264.30

    Facility

    $118.86

    $10.37 lower than Austin for the office setting.

  • Nyc Suburbs/Long Island

    New York · 12016

    Office

    $320.82

    Facility

    $148.07

    $46.15 higher than Austin for the office setting.

  • Poughkpsie/N Nyc Suburbs

    New York · 12016

    Office

    $290.94

    Facility

    $131.85

    $16.27 higher than Austin for the office setting.

  • Queens

    New York · 12016

    Office

    $311.24

    Facility

    $139.51

    $36.57 higher than Austin for the office setting.

  • Rest Of New York

    New York · 12016

    Office

    $253.49

    Facility

    $115.46

    $21.18 lower than Austin for the office setting.

  • Ohio

    Ohio · 12016

    Office

    $253.79

    Facility

    $121.13

    $20.88 lower than Austin for the office setting.

  • Oklahoma

    Oklahoma · 12016

    Office

    $245.88

    Facility

    $116.13

    $28.79 lower than Austin for the office setting.

  • Portland

    Oregon · 12016

    Office

    $281.48

    Facility

    $120.06

    $6.81 higher than Austin for the office setting.

  • Rest Of Oregon

    Oregon · 12016

    Office

    $260.85

    Facility

    $116.14

    $13.82 lower than Austin for the office setting.

  • Metropolitan Philadelphia

    Pennsylvania · 12016

    Office

    $279.60

    Facility

    $128.35

    $4.93 higher than Austin for the office setting.

  • Rest Of Pennsylvania

    Pennsylvania · 12016

    Office

    $253.30

    Facility

    $119.92

    $21.37 lower than Austin for the office setting.

  • Puerto Rico

    Puerto Rico · 12016

    Office

    $269.00

    Facility

    $122.10

    $5.67 lower than Austin for the office setting.

  • Rhode Island

    Rhode Island · 12016

    Office

    $272.28

    Facility

    $122.19

    $2.39 lower than Austin for the office setting.

  • South Carolina

    South Carolina · 12016

    Office

    $252.33

    Facility

    $118.07

    $22.34 lower than Austin for the office setting.

  • South Dakota**

    South Dakota · 12016

    Office

    $254.01

    Facility

    $108.72

    $20.66 lower than Austin for the office setting.

  • Tennessee

    Tennessee · 12016

    Office

    $243.55

    Facility

    $111.48

    $31.12 lower than Austin for the office setting.

  • Utah

    Utah · 12016

    Office

    $255.86

    Facility

    $119.29

    $18.81 lower than Austin for the office setting.

  • Virginia

    Virginia · 12016

    Office

    $258.83

    Facility

    $116.01

    $15.84 lower than Austin for the office setting.

  • Virgin Islands

    United States Virgin Islands · 12016

    Office

    $269.00

    Facility

    $122.10

    $5.67 lower than Austin for the office setting.

  • Vermont

    Vermont · 12016

    Office

    $255.88

    Facility

    $112.04

    $18.79 lower than Austin for the office setting.

  • Rest Of Washington

    Washington · 12016

    Office

    $272.28

    Facility

    $119.29

    $2.39 lower than Austin for the office setting.

  • Seattle (King Cnty)

    Washington · 12016

    Office

    $304.49

    Facility

    $126.21

    $29.82 higher than Austin for the office setting.

  • Wisconsin

    Wisconsin · 12016

    Office

    $246.72

    Facility

    $107.53

    $27.95 lower than Austin for the office setting.

  • West Virginia

    West Virginia · 12016

    Office

    $255.36

    Facility

    $129.10

    $19.31 lower than Austin for the office setting.

  • Wyoming**

    Wyoming · 12016

    Office

    $262.24

    Facility

    $116.95

    $12.43 lower than Austin for the office setting.

See how rates vary across the country

12016 · Office / nonfacility · Non-QP. Choose a state to explore its payment localities. A range means the amount varies within that state.

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.

$235.10

$312.38

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

View all state and territory rates as a table
State / territoryRate rangeLocalities
AK$312.381
AL$238.701
AR$235.101
AZ$259.651
CA$274.93–$338.3929
CO$274.361
CT$285.881
DC$303.031
DE$264.001
FL$270.75–$305.253
GA$254.17–$274.462
GU$280.881
HI$280.881
IA$241.661
ID$244.001
IL$265.09–$295.344
IN$245.391
KS$242.081
KY$248.051
LA$248.29–$260.872
MA$273.28–$299.912
MD$268.66–$303.033
ME$247.04–$258.582
MI$256.25–$275.922
MN$257.841
MO$244.93–$259.903
MS$239.981
MT$267.501
NC$249.471
ND$255.441
NE$242.551
NH$271.551
NJ$287.72–$300.022
NM$258.361
NV$264.301
NY$253.49–$320.825
OH$253.791
OK$245.881
OR$260.85–$281.482
PA$253.30–$279.602
PR$269.001
RI$272.281
SC$252.331
SD$254.011
TN$243.551
TX$251.70–$274.788
UT$255.861
VA$258.83–$303.032
VI$269.001
VT$255.881
WA$272.28–$304.492
WI$246.721
WV$255.361
WY$262.241

Explore 12016 on the national rate map →

Where does this rate apply?

Austin is a Medicare payment area. Our Census mapping connects it to 31 cities and communities in Texas, including the examples shown here.

Some communities span more than one payment area. Follow a city link to compare all of its mapped areas, or check the service-location ZIP above for an address-level starting point.

Browse all communities in Texas →

Why are the office and facility amounts different?

For 12016 in Austin, the physician’s office rate is $274.67 and the facility-setting rate is $120.95: a difference of $153.72.

The calculation uses a different practice-expense RVU for each setting. Both amounts here are physician fee-schedule amounts. The facility figure does not include a hospital’s separate charges, so this comparison does not tell you the total cost of receiving care in each setting.

See the inputs behind this difference →

Use this rate

What is a percentage of Medicare worth?

Turn a percentage into dollars for 12016 in Austin. This uses the base rate on this page, so the locality and release stay consistent.

Reference amount per service

$302.14

$274.67 × 110% = $302.14

A contract may specify another Medicare year or additional adjustments. This is percentage arithmetic on the displayed base rate, not a claim adjudication.

Working with a whole code list?

Compare an offer across your annual code mix, including an older Medicare schedule or flat per-code rates.

Compare your contract offer →

How this local rate is calculated

Each RVU component is multiplied by its own geographic practice cost index (GPCI). The three adjusted components are added, then multiplied by the conversion factor. These are the inputs used for 12016 in Austin.

PPRRVU2026_Oct_nonQPP.csv

1,407

Code
12016
Physician work
2.61
Practice expense
4.79
Malpractice
0.61

GPCI2026.csv

96

Locality
Austin
Physician work
1.002
Practice expense
1.058
Malpractice
0.886
Office / nonfacility calculation for 12016 in Austin
ComponentRVULocality factorAdjusted
Physician work2.61× 1.0022.6152
Practice expense4.79× 1.0585.0678
Malpractice0.61× 0.8860.5405
Total RVUs8.2235
Conversion factor× 33.4009

Office / nonfacility rate, Austin$274.67

Values as parsed from CMS release RVU26D, effective 2026-10-01. The amount is rounded to the nearest cent only at the end.

Open 12016 in the RVU calculator →

Explore RVUs, geographic factors and the full formula

Office / nonfacility

Office / nonfacility calculation inputs
ComponentRVULocal GPCI
Work2.611.002
Practice expense4.791.058
Malpractice0.610.886

(2.61 × 1.002 + 4.79 × 1.058 + 0.61 × 0.886) × $33.4009 = $274.67

Facility

Facility calculation inputs
ComponentRVULocal GPCI
Work2.611.002
Practice expense0.441.058
Malpractice0.610.886

(2.61 × 1.002 + 0.44 × 1.058 + 0.61 × 0.886) × $33.4009 = $120.95

The office and facility calculations use their respective practice-expense RVUs. The facility amount here is the physician fee, not a separate hospital or facility bill.

How this rate has changed

12016 · Office / nonfacility

$274.67

Effective 2026-10-01

The base rate is $56.68 higher than on 2025-10-01, moving from $217.99 to $274.67 (26.0%).

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

    $217.99changed to$274.67

    • Conversion factor 32.3465 changed to 33.4009
    • Work RVU 2.68 changed to 2.61
    • Practice expense RVU 3.40 changed to 4.79
    • Malpractice RVU 0.55 changed to 0.61
    • Work GPCI 1.000 changed to 1.002
    • Practice expense GPCI 1.046 changed to 1.058
    • Malpractice GPCI 0.914 changed to 0.886

    Held through RVU26B, RVU26C, RVU26D.

  2. January 1, 2025

    RVU25A

    Earliest loaded release: $217.99

    Held through RVU25B, RVU25C, RVU25D.

Explore release dates and calculate this code in an earlier period →

Each row uses the accepted CMS release effective on that date and the same contractor and locality identifiers. Missing rates stay visible. Historical boundaries may differ; verify the service address for an older claim.

Inspect every release and its CMS source
Effective fromOffice / nonfacilityFacilityCMS release
2026-10-01$274.67$120.95RVU26D
2026-07-01$274.67$120.95RVU26C
2026-04-01$274.67$120.95RVU26B
2026-01-01$274.67$120.95RVU26A
2025-10-01$217.99$122.57RVU25D
2025-07-01$217.99$122.57RVU25C
2025-04-01$217.99$122.57RVU25B
2025-01-01$217.99$122.57RVU25A

12016 billing questions

How is the 12.6–20 cm length determined when there are several facial wounds?

Add the lengths of simple repairs in the same face-site group performed during the session. Report the code matching that combined length and retain measurements for each wound.

When should 12015 or 12017 be selected instead?

Use 12015 for a shorter total length in the same site group and 12017 for a longer total length. The repair type and anatomic group remain the same.

Can modifier 50 be used for wounds on both sides of the face?

No. The CMS bilateral adjustment does not apply to this code, and modifier 50 is inappropriate.

How does Medicare handle other procedures performed in the same session?

The highest-valued procedure is paid in full; other procedures in that session are subject to the standard 50% multiple-procedure reduction.

Does the code include same-day follow-up care, and can an assistant surgeon be reported?

The 0-day global period includes same-day preoperative and postoperative care. Medicare does not pay an assistant at surgery for this service.

What documentation supports reporting this code rather than an intermediate repair?

Record the wound sites, individual lengths, and that the closure was a simple, one-layer repair of superficial tissue. An intermediate repair involves a different repair classification.

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.

RVUs for 12016PPRRVU2026_Oct_nonQPP.csv, line 1,407 (RVU26D)
Geographic factors for AustinGPCI2026.csv, line 96 (RVU26D)
Open CMS sourceHow this rate is calculatedBuild a fee sheet