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CMS RVU26D · Effective 2026-10-01

12005 in Modesto

Office / nonfacility

$218.25

Base rate per service

Facility setting

$85.36

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 12005: Simple trunk and scalp wound repair

Reports simple, one-layer closure of superficial wounds on specified body sites when the combined repair length falls between 12.6 and 20.0 cm.

This code covers straightforward, one-layer closure of superficial wounds involving the epidermis, dermis, or superficial subcutaneous tissue, without deeper structural repair. The covered sites are the scalp, neck, axillae, external genitalia, and trunk. Emergency clinicians, surgeons, and other qualified practitioners may perform these repairs in an emergency department, office, or outpatient setting. A typical case is a long, uncomplicated laceration of the trunk closed in a single layer.

Select the code using the documented repair length and covered body site. When multiple wounds belong to the same repair category and anatomic grouping, combine their lengths for code selection; document each wound’s location, length, and closure technique. CMS assigns a 0-day global period, so same-day preoperative and postoperative care is included. When other 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. Assistant-at-surgery services are not paid, and co-surgeons and team surgery are not permitted.

CMS billing rules for 12005

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 RVU1.92 · 30%
  • Practice expense (office) RVU3.97 · 63%
  • Malpractice RVU0.43 · 7%

5.3K

Medicare services in 2024 · #1830 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.

12005 compared with similar codes

Office rates for Modesto, from the same CMS release.

12004

Simple wound repair

Nonfacial sites, 7.6–12.5 cm

$167.68

Use 12004 for simple repairs at the covered body sites when the applicable total length is 7.6–12.5 cm; this code begins at 12.6 cm.

12006

Simple wound repair

20.1–30 cm, specified sites

$247.52

Use 12006 for simple repairs at the covered body sites when the applicable total length is 20.1–30.0 cm; this code ends at 20.0 cm.

12035

Wound repair

Intermediate, 12.6–20 cm

$433.34

12035 describes intermediate repair at its covered sites, requiring a different repair approach such as layered closure. This code is for simple one-layer repair.

12016

Simple wound repair

Face group, 12.6–20 cm

$274.93

Both codes cover simple repair lengths of 12.6–20.0 cm, but 12016 is for specified facial and related sites; this code covers the scalp, neck, axillae, external genitalia, and trunk.

The same code, a different location

How does Modesto compare?

In Bakersfield, the office rate for 12005 is $219.43—$1.18 higher than the $218.25 rate in Modesto. Both use the same code, release and participation basis.

12005 across payment areas

Same release and payment basis · bars start at $0

  1. Modesto · This locality

    $218.25

  2. Bakersfield

    $219.43

    $1.18 higher than Modesto

  3. Chico

    $218.25

    The same base rate than Modesto

  4. El Centro

    $218.32

    $0.07 higher than Modesto

  5. Fresno

    $218.25

    The same base rate than Modesto

  6. Hanford-Corcoran

    $218.25

    The same base rate than Modesto

  7. Los Angeles-Long Beach-Anaheim (Los Angeles/Orange Cnty)

    $233.16

    $14.91 higher than Modesto

Other payment areas listed in California 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, 12005 ranges from $185.43 in Arkansas to $270.09 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

  • Madera

    California · 12005

    Office

    $218.25

    Facility

    $85.36

    The same base rate than Modesto for the office setting.

  • Merced

    California · 12005

    Office

    $218.25

    Facility

    $85.36

    The same base rate than Modesto for the office setting.

  • Napa

    California · 12005

    Office

    $250.23

    Facility

    $90.43

    $31.98 higher than Modesto for the office setting.

  • Oxnard-Thousand Oaks-Ventura

    California · 12005

    Office

    $231.61

    Facility

    $88.30

    $13.36 higher than Modesto for the office setting.

  • Redding

    California · 12005

    Office

    $218.25

    Facility

    $85.36

    The same base rate than Modesto for the office setting.

  • Rest Of California

    California · 12005

    Office

    $218.25

    Facility

    $85.36

    The same base rate than Modesto for the office setting.

  • Riverside-San Bernardino-Ontario

    California · 12005

    Office

    $222.87

    Facility

    $89.98

    $4.62 higher than Modesto for the office setting.

  • Sacramento-Roseville-Folsom

    California · 12005

    Office

    $228.35

    Facility

    $87.34

    $10.10 higher than Modesto for the office setting.

  • Salinas

    California · 12005

    Office

    $227.50

    Facility

    $86.98

    $9.25 higher than Modesto for the office setting.

  • San Diego-Chula Vista-Carlsbad

    California · 12005

    Office

    $232.43

    Facility

    $87.42

    $14.18 higher than Modesto for the office setting.

  • San Francisco-Oakland-Berkeley (Marin Cnty)

    California · 12005

    Office

    $263.78

    Facility

    $92.83

    $45.53 higher than Modesto for the office setting.

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

    California · 12005

    Office

    $263.29

    Facility

    $92.34

    $45.04 higher than Modesto for the office setting.

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

    California · 12005

    Office

    $270.09

    Facility

    $95.26

    $51.84 higher than Modesto for the office setting.

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

    California · 12005

    Office

    $268.10

    Facility

    $93.26

    $49.85 higher than Modesto for the office setting.

  • San Luis Obispo-Paso Robles

    California · 12005

    Office

    $223.95

    Facility

    $85.85

    $5.70 higher than Modesto for the office setting.

  • Santa Cruz-Watsonville

    California · 12005

    Office

    $234.29

    Facility

    $86.97

    $16.04 higher than Modesto for the office setting.

  • Santa Maria-Santa Barbara

    California · 12005

    Office

    $228.24

    Facility

    $86.87

    $9.99 higher than Modesto for the office setting.

  • Santa Rosa-Petaluma

    California · 12005

    Office

    $236.59

    Facility

    $87.70

    $18.34 higher than Modesto for the office setting.

  • Stockton

    California · 12005

    Office

    $218.25

    Facility

    $85.36

    The same base rate than Modesto for the office setting.

  • Vallejo

    California · 12005

    Office

    $249.53

    Facility

    $89.73

    $31.28 higher than Modesto for the office setting.

  • Visalia

    California · 12005

    Office

    $218.25

    Facility

    $85.36

    The same base rate than Modesto for the office setting.

  • Yuba City

    California · 12005

    Office

    $218.25

    Facility

    $85.36

    The same base rate than Modesto for the office setting.

  • Dc + Md/Va Suburbs

    District of Columbia · 12005

    Office

    $239.78

    Facility

    $96.96

    $21.53 higher than Modesto for the office setting.

  • Miami

    Florida · 12005

    Office

    $238.49

    Facility

    $112.27

    $20.24 higher than Modesto for the office setting.

  • Chicago

    Illinois · 12005

    Office

    $230.80

    Facility

    $108.95

    $12.55 higher than Modesto for the office setting.

  • Manhattan

    New York · 12005

    Office

    $245.10

    Facility

    $104.21

    $26.85 higher than Modesto for the office setting.

  • Alaska*

    Alaska · 12005

    Office

    $245.33

    Facility

    $116.20

    $27.08 higher than Modesto for the office setting.

  • Alabama

    Alabama · 12005

    Office

    $188.29

    Facility

    $82.20

    $29.96 lower than Modesto for the office setting.

  • Arkansas

    Arkansas · 12005

    Office

    $185.43

    Facility

    $81.28

    $32.82 lower than Modesto for the office setting.

  • Arizona

    Arizona · 12005

    Office

    $204.91

    Facility

    $87.43

    $13.34 lower than Modesto for the office setting.

  • Colorado

    Colorado · 12005

    Office

    $217.20

    Facility

    $88.20

    $1.05 lower than Modesto for the office setting.

  • Connecticut

    Connecticut · 12005

    Office

    $225.60

    Facility

    $95.02

    $7.35 higher than Modesto for the office setting.

  • Delaware

    Delaware · 12005

    Office

    $208.37

    Facility

    $88.58

    $9.88 lower than Modesto for the office setting.

  • Fort Lauderdale

    Florida · 12005

    Office

    $224.42

    Facility

    $101.60

    $6.17 higher than Modesto for the office setting.

  • Rest Of Florida

    Florida · 12005

    Office

    $212.48

    Facility

    $96.57

    $5.77 lower than Modesto for the office setting.

  • Atlanta

    Georgia · 12005

    Office

    $216.29

    Facility

    $93.11

    $1.96 lower than Modesto for the office setting.

  • Rest Of Georgia

    Georgia · 12005

    Office

    $199.53

    Facility

    $91.38

    $18.72 lower than Modesto for the office setting.

  • Hawaii, Guam

    Hawaii · 12005

    Office

    $223.21

    Facility

    $85.36

    $4.96 higher than Modesto for the office setting.

  • Iowa

    Iowa · 12005

    Office

    $191.16

    Facility

    $80.22

    $27.09 lower than Modesto for the office setting.

  • Idaho

    Idaho · 12005

    Office

    $192.92

    Facility

    $81.37

    $25.33 lower than Modesto for the office setting.

  • East St. Louis

    Illinois · 12005

    Office

    $215.05

    Facility

    $103.50

    $3.20 lower than Modesto for the office setting.

  • Rest Of Illinois

    Illinois · 12005

    Office

    $207.64

    Facility

    $96.95

    $10.61 lower than Modesto for the office setting.

  • Suburban Chicago

    Illinois · 12005

    Office

    $226.21

    Facility

    $101.69

    $7.96 higher than Modesto for the office setting.

  • Indiana

    Indiana · 12005

    Office

    $194.03

    Facility

    $81.64

    $24.22 lower than Modesto for the office setting.

  • Kansas

    Kansas · 12005

    Office

    $191.24

    Facility

    $81.63

    $27.01 lower than Modesto for the office setting.

  • Kentucky

    Kentucky · 12005

    Office

    $195.15

    Facility

    $87.37

    $23.10 lower than Modesto for the office setting.

  • New Orleans

    Louisiana · 12005

    Office

    $205.22

    Facility

    $91.13

    $13.03 lower than Modesto for the office setting.

  • Rest Of Louisiana

    Louisiana · 12005

    Office

    $195.24

    Facility

    $87.94

    $23.01 lower than Modesto for the office setting.

  • Metropolitan Boston

    Massachusetts · 12005

    Office

    $237.87

    Facility

    $93.10

    $19.62 higher than Modesto for the office setting.

  • Rest Of Massachusetts

    Massachusetts · 12005

    Office

    $216.23

    Facility

    $88.56

    $2.02 lower than Modesto for the office setting.

  • Baltimore/Surr. Cntys

    Maryland · 12005

    Office

    $225.20

    Facility

    $95.11

    $6.95 higher than Modesto for the office setting.

  • Rest Of Maryland

    Maryland · 12005

    Office

    $212.15

    Facility

    $89.45

    $6.10 lower than Modesto for the office setting.

  • Rest Of Maine

    Maine · 12005

    Office

    $195.06

    Facility

    $83.51

    $23.19 lower than Modesto for the office setting.

  • Southern Maine

    Maine · 12005

    Office

    $204.60

    Facility

    $84.45

    $13.65 lower than Modesto for the office setting.

  • Detroit

    Michigan · 12005

    Office

    $216.31

    Facility

    $99.30

    $1.94 lower than Modesto for the office setting.

  • Rest Of Michigan

    Michigan · 12005

    Office

    $201.41

    Facility

    $90.71

    $16.84 lower than Modesto for the office setting.

  • Minnesota

    Minnesota · 12005

    Office

    $204.83

    Facility

    $80.07

    $13.42 lower than Modesto for the office setting.

  • Metropolitan Kansas City

    Missouri · 12005

    Office

    $202.67

    Facility

    $88.83

    $15.58 lower than Modesto for the office setting.

  • Metropolitan St. Louis

    Missouri · 12005

    Office

    $204.76

    Facility

    $89.33

    $13.49 lower than Modesto for the office setting.

  • Rest Of Missouri

    Missouri · 12005

    Office

    $192.42

    Facility

    $87.91

    $25.83 lower than Modesto for the office setting.

  • Mississippi

    Mississippi · 12005

    Office

    $188.91

    Facility

    $84.52

    $29.34 lower than Modesto for the office setting.

  • Montana**

    Montana · 12005

    Office

    $211.06

    Facility

    $89.82

    $7.19 lower than Modesto for the office setting.

  • North Carolina

    North Carolina · 12005

    Office

    $197.02

    Facility

    $83.90

    $21.23 lower than Modesto for the office setting.

  • North Dakota**

    North Dakota · 12005

    Office

    $202.56

    Facility

    $81.32

    $15.69 lower than Modesto for the office setting.

  • Nebraska

    Nebraska · 12005

    Office

    $191.95

    Facility

    $80.04

    $26.30 lower than Modesto for the office setting.

  • New Hampshire

    New Hampshire · 12005

    Office

    $214.74

    Facility

    $88.52

    $3.51 lower than Modesto for the office setting.

  • Northern Nj

    New Jersey · 12005

    Office

    $237.33

    Facility

    $96.68

    $19.08 higher than Modesto for the office setting.

  • Rest Of New Jersey

    New Jersey · 12005

    Office

    $227.25

    Facility

    $94.85

    $9.00 higher than Modesto for the office setting.

  • New Mexico

    New Mexico · 12005

    Office

    $202.97

    Facility

    $91.79

    $15.28 lower than Modesto for the office setting.

  • Nevada**

    Nevada · 12005

    Office

    $208.83

    Facility

    $87.46

    $9.42 lower than Modesto for the office setting.

  • Nyc Suburbs/Long Island

    New York · 12005

    Office

    $252.57

    Facility

    $108.41

    $34.32 higher than Modesto for the office setting.

  • Poughkpsie/N Nyc Suburbs

    New York · 12005

    Office

    $229.59

    Facility

    $96.83

    $11.34 higher than Modesto for the office setting.

  • Queens

    New York · 12005

    Office

    $245.68

    Facility

    $102.37

    $27.43 higher than Modesto for the office setting.

  • Rest Of New York

    New York · 12005

    Office

    $200.20

    Facility

    $85.01

    $18.05 lower than Modesto for the office setting.

  • Ohio

    Ohio · 12005

    Office

    $199.67

    Facility

    $88.98

    $18.58 lower than Modesto for the office setting.

  • Oklahoma

    Oklahoma · 12005

    Office

    $193.70

    Facility

    $85.43

    $24.55 lower than Modesto for the office setting.

  • Portland

    Oregon · 12005

    Office

    $223.16

    Facility

    $88.46

    $4.91 higher than Modesto for the office setting.

  • Rest Of Oregon

    Oregon · 12005

    Office

    $206.30

    Facility

    $85.54

    $11.95 lower than Modesto for the office setting.

  • Metropolitan Philadelphia

    Pennsylvania · 12005

    Office

    $220.46

    Facility

    $94.24

    $2.21 higher than Modesto for the office setting.

  • Rest Of Pennsylvania

    Pennsylvania · 12005

    Office

    $199.43

    Facility

    $88.13

    $18.82 lower than Modesto for the office setting.

  • Puerto Rico

    Puerto Rico · 12005

    Office

    $212.34

    Facility

    $89.76

    $5.91 lower than Modesto for the office setting.

  • Rhode Island

    Rhode Island · 12005

    Office

    $215.14

    Facility

    $89.89

    $3.11 lower than Modesto for the office setting.

  • South Carolina

    South Carolina · 12005

    Office

    $198.86

    Facility

    $86.83

    $19.39 lower than Modesto for the office setting.

  • South Dakota**

    South Dakota · 12005

    Office

    $201.56

    Facility

    $80.31

    $16.69 lower than Modesto for the office setting.

  • Tennessee

    Tennessee · 12005

    Office

    $192.38

    Facility

    $82.17

    $25.87 lower than Modesto for the office setting.

  • Austin

    Texas · 12005

    Office

    $217.28

    Facility

    $89.00

    $0.97 lower than Modesto for the office setting.

  • Beaumont

    Texas · 12005

    Office

    $198.14

    Facility

    $87.81

    $20.11 lower than Modesto for the office setting.

  • Brazoria

    Texas · 12005

    Office

    $207.25

    Facility

    $87.10

    $11.00 lower than Modesto for the office setting.

  • Dallas

    Texas · 12005

    Office

    $209.10

    Facility

    $88.34

    $9.15 lower than Modesto for the office setting.

  • Fort Worth

    Texas · 12005

    Office

    $207.96

    Facility

    $88.41

    $10.29 lower than Modesto for the office setting.

  • Galveston

    Texas · 12005

    Office

    $208.21

    Facility

    $87.81

    $10.04 lower than Modesto for the office setting.

  • Houston

    Texas · 12005

    Office

    $216.08

    Facility

    $95.68

    $2.17 lower than Modesto for the office setting.

  • Rest Of Texas

    Texas · 12005

    Office

    $202.94

    Facility

    $87.88

    $15.31 lower than Modesto for the office setting.

  • Utah

    Utah · 12005

    Office

    $201.67

    Facility

    $87.70

    $16.58 lower than Modesto for the office setting.

  • Virginia

    Virginia · 12005

    Office

    $204.62

    Facility

    $85.43

    $13.63 lower than Modesto for the office setting.

  • Virgin Islands

    United States Virgin Islands · 12005

    Office

    $212.34

    Facility

    $89.76

    $5.91 lower than Modesto for the office setting.

  • Vermont

    Vermont · 12005

    Office

    $202.67

    Facility

    $82.64

    $15.58 lower than Modesto for the office setting.

  • Rest Of Washington

    Washington · 12005

    Office

    $215.52

    Facility

    $87.85

    $2.73 lower than Modesto for the office setting.

  • Seattle (King Cnty)

    Washington · 12005

    Office

    $241.77

    Facility

    $93.00

    $23.52 higher than Modesto for the office setting.

  • Wisconsin

    Wisconsin · 12005

    Office

    $195.59

    Facility

    $79.43

    $22.66 lower than Modesto for the office setting.

  • West Virginia

    West Virginia · 12005

    Office

    $199.91

    Facility

    $94.55

    $18.34 lower than Modesto for the office setting.

  • Wyoming**

    Wyoming · 12005

    Office

    $207.36

    Facility

    $86.11

    $10.89 lower than Modesto for the office setting.

See how rates vary across the country

12005 · 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.

$185.43

$245.33

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

View all state and territory rates as a table
State / territoryRate rangeLocalities
AK$245.331
AL$188.291
AR$185.431
AZ$204.911
CA$218.25–$270.0929
CO$217.201
CT$225.601
DC$239.781
DE$208.371
FL$212.48–$238.493
GA$199.53–$216.292
GU$223.211
HI$223.211
IA$191.161
ID$192.921
IL$207.64–$230.804
IN$194.031
KS$191.241
KY$195.151
LA$195.24–$205.222
MA$216.23–$237.872
MD$212.15–$239.783
ME$195.06–$204.602
MI$201.41–$216.312
MN$204.831
MO$192.42–$204.763
MS$188.911
MT$211.061
NC$197.021
ND$202.561
NE$191.951
NH$214.741
NJ$227.25–$237.332
NM$202.971
NV$208.831
NY$200.20–$252.575
OH$199.671
OK$193.701
OR$206.30–$223.162
PA$199.43–$220.462
PR$212.341
RI$215.141
SC$198.861
SD$201.561
TN$192.381
TX$198.14–$217.288
UT$201.671
VA$204.62–$239.782
VI$212.341
VT$202.671
WA$215.52–$241.772
WI$195.591
WV$199.911
WY$207.361

Explore 12005 on the national rate map →

Where does this rate apply?

Modesto is a Medicare payment area. Our Census mapping connects it to 33 cities and communities in California, 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 California →

Why are the office and facility amounts different?

For 12005 in Modesto, the physician’s office rate is $218.25 and the facility-setting rate is $85.36: a difference of $132.89.

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 12005 in Modesto. This uses the base rate on this page, so the locality and release stay consistent.

Reference amount per service

$240.08

$218.25 × 110% = $240.08

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 12005 in Modesto.

PPRRVU2026_Oct_nonQPP.csv

1,399

Code
12005
Physician work
1.92
Practice expense
3.97
Malpractice
0.43

GPCI2026.csv

16

Locality
Modesto
Physician work
1.017
Practice expense
1.096
Malpractice
0.536
Office / nonfacility calculation for 12005 in Modesto
ComponentRVULocality factorAdjusted
Physician work1.92× 1.0171.9526
Practice expense3.97× 1.0964.3511
Malpractice0.43× 0.5360.2305
Total RVUs6.5342
Conversion factor× 33.4009

Office / nonfacility rate, Modesto$218.25

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

Open 12005 in the RVU calculator →

Explore RVUs, geographic factors and the full formula

Office / nonfacility

Office / nonfacility calculation inputs
ComponentRVULocal GPCI
Work1.921.017
Practice expense3.971.096
Malpractice0.430.536

(1.92 × 1.017 + 3.97 × 1.096 + 0.43 × 0.536) × $33.4009 = $218.25

Facility

Facility calculation inputs
ComponentRVULocal GPCI
Work1.921.017
Practice expense0.341.096
Malpractice0.430.536

(1.92 × 1.017 + 0.34 × 1.096 + 0.43 × 0.536) × $33.4009 = $85.36

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

12005 · Office / nonfacility

$218.25

Effective 2026-10-01

The base rate is $42.27 higher than on 2025-10-01, moving from $175.98 to $218.25 (24.0%).

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

    $175.98changed to$218.25

    • Conversion factor 32.3465 changed to 33.4009
    • Work RVU 1.97 changed to 1.92
    • Practice expense RVU 2.95 changed to 3.97
    • Malpractice RVU 0.39 changed to 0.43
    • Work GPCI 1.014 changed to 1.017
    • Practice expense GPCI 1.093 changed to 1.096
    • Malpractice GPCI 0.560 changed to 0.536

    Held through RVU26B, RVU26C, RVU26D.

  2. January 1, 2025

    RVU25A

    Earliest loaded release: $175.98

    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$218.25$85.36RVU26D
2026-07-01$218.25$85.36RVU26C
2026-04-01$218.25$85.36RVU26B
2026-01-01$218.25$85.36RVU26A
2025-10-01$175.98$87.94RVU25D
2025-07-01$175.98$87.94RVU25C
2025-04-01$175.98$87.94RVU25B
2025-01-01$175.98$87.94RVU25A

12005 billing questions

How is this code distinguished from 12004 or 12006?

All three cover simple repairs at the same general body sites. Choose by the documented total repair length: 12004 covers 7.6–12.5 cm, this code covers 12.6–20.0 cm, and 12006 covers 20.1–30.0 cm.

Can the lengths of multiple wounds be combined?

Combine lengths when the wounds are in the same repair category and anatomic grouping. Record the location and length of each wound so the reported total can be supported.

When would 12035 be considered instead?

Consider 12035 for an intermediate repair in its covered sites, such as the scalp, axilla, or trunk, when the wound requires layered closure rather than a simple one-layer repair. The repair method and documented complexity, not length alone, distinguish the codes.

Is modifier 50 appropriate for repairs on both sides?

No. CMS identifies bilateral adjustment as inappropriate for this code; report the repair based on the applicable wound lengths and sites rather than applying modifier 50.

What same-day care is included, and how are other procedures handled?

The 0-day global period includes same-day preoperative and postoperative care. If other procedures are performed in the same session, the highest-valued procedure is paid in full and the others are subject to the standard multiple-procedure reduction.

Can an assistant or additional surgeon be reported for this repair?

Assistant-at-surgery services are not paid for this code. CMS also does not permit co-surgeons or team surgery.

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 12005PPRRVU2026_Oct_nonQPP.csv, line 1,399 (RVU26D)
Geographic factors for ModestoGPCI2026.csv, line 16 (RVU26D)
Open CMS sourceHow this rate is calculatedBuild a fee sheet