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CMS RVU26D · Effective 2026-10-01

12042 in Vallejo

Office / nonfacility

$370.15

Base rate per service

Facility setting

$190.10

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 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 rates for Vallejo, from the same CMS release.

12041

Intermediate repair

Neck, hands, feet, genitalia, 2.5 cm or less

$321.82

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.

12032

Intermediate repair

2.6–7.5 cm, scalp/trunk/extremities

$366.91

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.

12052

Wound repair

Face, 2.6–5 cm

$377.57

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.

12002

Wound repair

Simple, 2.6–7.5 cm

$167.23

12002 is a simple repair code for its specified sites and length range. Choose 12042 when the documented repair meets intermediate criteria.

The same code, a different location

How does Vallejo compare?

In Bakersfield, the office rate for 12042 is $322.35—$47.80 lower than the $370.15 rate in Vallejo. Both use the same code, release and participation basis.

12042 across payment areas

Same release and payment basis · bars start at $0

  1. Vallejo · This locality

    $370.15

  2. Bakersfield

    $322.35

    $47.80 lower than Vallejo

  3. Chico

    $321.44

    $48.71 lower than Vallejo

  4. El Centro

    $321.49

    $48.66 lower than Vallejo

  5. Fresno

    $321.44

    $48.71 lower than Vallejo

  6. Hanford-Corcoran

    $321.44

    $48.71 lower than Vallejo

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

    $342.65

    $27.50 lower than Vallejo

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, 12042 ranges from $271.32 in Arkansas to $400.50 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 · 12042

    Office

    $321.44

    Facility

    $171.71

    $48.71 lower than Vallejo for the office setting.

  • Merced

    California · 12042

    Office

    $321.44

    Facility

    $171.71

    $48.71 lower than Vallejo for the office setting.

  • Modesto

    California · 12042

    Office

    $321.44

    Facility

    $171.71

    $48.71 lower than Vallejo for the office setting.

  • Napa

    California · 12042

    Office

    $370.64

    Facility

    $190.59

    $0.49 higher than Vallejo for the office setting.

  • Oxnard-Thousand Oaks-Ventura

    California · 12042

    Office

    $340.86

    Facility

    $179.39

    $29.29 lower than Vallejo for the office setting.

  • Redding

    California · 12042

    Office

    $321.44

    Facility

    $171.71

    $48.71 lower than Vallejo for the office setting.

  • Rest Of California

    California · 12042

    Office

    $321.44

    Facility

    $171.71

    $48.71 lower than Vallejo for the office setting.

  • Riverside-San Bernardino-Ontario

    California · 12042

    Office

    $324.70

    Facility

    $174.98

    $45.45 lower than Vallejo for the office setting.

  • Sacramento-Roseville-Folsom

    California · 12042

    Office

    $336.84

    Facility

    $177.96

    $33.31 lower than Vallejo for the office setting.

  • Salinas

    California · 12042

    Office

    $335.57

    Facility

    $177.24

    $34.58 lower than Vallejo for the office setting.

  • San Diego-Chula Vista-Carlsbad

    California · 12042

    Office

    $343.09

    Facility

    $179.70

    $27.06 lower than Vallejo for the office setting.

  • San Francisco-Oakland-Berkeley (Marin Cnty)

    California · 12042

    Office

    $391.83

    Facility

    $199.21

    $21.68 higher than Vallejo for the office setting.

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

    California · 12042

    Office

    $391.49

    Facility

    $198.87

    $21.34 higher than Vallejo for the office setting.

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

    California · 12042

    Office

    $400.50

    Facility

    $203.51

    $30.35 higher than Vallejo for the office setting.

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

    California · 12042

    Office

    $399.10

    Facility

    $202.11

    $28.95 higher than Vallejo for the office setting.

  • San Luis Obispo-Paso Robles

    California · 12042

    Office

    $330.21

    Facility

    $174.61

    $39.94 lower than Vallejo for the office setting.

  • Santa Cruz-Watsonville

    California · 12042

    Office

    $346.09

    Facility

    $180.11

    $24.06 lower than Vallejo for the office setting.

  • Santa Maria-Santa Barbara

    California · 12042

    Office

    $336.72

    Facility

    $177.43

    $33.43 lower than Vallejo for the office setting.

  • Santa Rosa-Petaluma

    California · 12042

    Office

    $349.56

    Facility

    $181.80

    $20.59 lower than Vallejo for the office setting.

  • Stockton

    California · 12042

    Office

    $321.44

    Facility

    $171.71

    $48.71 lower than Vallejo for the office setting.

  • Visalia

    California · 12042

    Office

    $321.44

    Facility

    $171.71

    $48.71 lower than Vallejo for the office setting.

  • Yuba City

    California · 12042

    Office

    $321.44

    Facility

    $171.71

    $48.71 lower than Vallejo for the office setting.

  • Dc + Md/Va Suburbs

    District of Columbia · 12042

    Office

    $347.31

    Facility

    $186.39

    $22.84 lower than Vallejo for the office setting.

  • Miami

    Florida · 12042

    Office

    $328.64

    Facility

    $186.43

    $41.51 lower than Vallejo for the office setting.

  • Chicago

    Illinois · 12042

    Office

    $319.58

    Facility

    $182.29

    $50.57 lower than Vallejo for the office setting.

  • Manhattan

    New York · 12042

    Office

    $349.70

    Facility

    $190.96

    $20.45 lower than Vallejo for the office setting.

  • Alaska*

    Alaska · 12042

    Office

    $359.14

    Facility

    $213.65

    $11.01 lower than Vallejo for the office setting.

  • Alabama

    Alabama · 12042

    Office

    $275.09

    Facility

    $155.56

    $95.06 lower than Vallejo for the office setting.

  • Arkansas

    Arkansas · 12042

    Office

    $271.32

    Facility

    $153.97

    $98.83 lower than Vallejo for the office setting.

  • Arizona

    Arizona · 12042

    Office

    $297.18

    Facility

    $164.81

    $72.97 lower than Vallejo for the office setting.

  • Colorado

    Colorado · 12042

    Office

    $316.91

    Facility

    $171.55

    $53.24 lower than Vallejo for the office setting.

  • Connecticut

    Connecticut · 12042

    Office

    $324.59

    Facility

    $177.46

    $45.56 lower than Vallejo for the office setting.

  • Delaware

    Delaware · 12042

    Office

    $301.94

    Facility

    $166.97

    $68.21 lower than Vallejo for the office setting.

  • Fort Lauderdale

    Florida · 12042

    Office

    $315.70

    Facility

    $177.31

    $54.45 lower than Vallejo for the office setting.

  • Rest Of Florida

    Florida · 12042

    Office

    $301.01

    Facility

    $170.41

    $69.14 lower than Vallejo for the office setting.

  • Atlanta

    Georgia · 12042

    Office

    $310.50

    Facility

    $171.71

    $59.65 lower than Vallejo for the office setting.

  • Rest Of Georgia

    Georgia · 12042

    Office

    $284.83

    Facility

    $162.98

    $85.32 lower than Vallejo for the office setting.

  • Hawaii, Guam

    Hawaii · 12042

    Office

    $328.69

    Facility

    $173.37

    $41.46 lower than Vallejo for the office setting.

  • Iowa

    Iowa · 12042

    Office

    $281.56

    Facility

    $156.56

    $88.59 lower than Vallejo for the office setting.

  • Idaho

    Idaho · 12042

    Office

    $283.34

    Facility

    $157.66

    $86.81 lower than Vallejo for the office setting.

  • East St. Louis

    Illinois · 12042

    Office

    $298.78

    Facility

    $173.10

    $71.37 lower than Vallejo for the office setting.

  • Rest Of Illinois

    Illinois · 12042

    Office

    $292.84

    Facility

    $168.11

    $77.31 lower than Vallejo for the office setting.

  • Suburban Chicago

    Illinois · 12042

    Office

    $318.83

    Facility

    $178.53

    $51.32 lower than Vallejo for the office setting.

  • Indiana

    Indiana · 12042

    Office

    $284.90

    Facility

    $158.26

    $85.25 lower than Vallejo for the office setting.

  • Kansas

    Kansas · 12042

    Office

    $280.39

    Facility

    $156.89

    $89.76 lower than Vallejo for the office setting.

  • Kentucky

    Kentucky · 12042

    Office

    $281.45

    Facility

    $160.00

    $88.70 lower than Vallejo for the office setting.

  • New Orleans

    Louisiana · 12042

    Office

    $294.27

    Facility

    $165.72

    $75.88 lower than Vallejo for the office setting.

  • Rest Of Louisiana

    Louisiana · 12042

    Office

    $281.06

    Facility

    $160.16

    $89.09 lower than Vallejo for the office setting.

  • Metropolitan Boston

    Massachusetts · 12042

    Office

    $347.16

    Facility

    $184.05

    $22.99 lower than Vallejo for the office setting.

  • Rest Of Massachusetts

    Massachusetts · 12042

    Office

    $315.19

    Facility

    $171.34

    $54.96 lower than Vallejo for the office setting.

  • Baltimore/Surr. Cntys

    Maryland · 12042

    Office

    $323.68

    Facility

    $177.09

    $46.47 lower than Vallejo for the office setting.

  • Rest Of Maryland

    Maryland · 12042

    Office

    $307.49

    Facility

    $169.24

    $62.66 lower than Vallejo for the office setting.

  • Rest Of Maine

    Maine · 12042

    Office

    $284.84

    Facility

    $159.16

    $85.31 lower than Vallejo for the office setting.

  • Southern Maine

    Maine · 12042

    Office

    $299.42

    Facility

    $164.04

    $70.73 lower than Vallejo for the office setting.

  • Detroit

    Michigan · 12042

    Office

    $304.68

    Facility

    $172.85

    $65.47 lower than Vallejo for the office setting.

  • Rest Of Michigan

    Michigan · 12042

    Office

    $288.49

    Facility

    $163.76

    $81.66 lower than Vallejo for the office setting.

  • Minnesota

    Minnesota · 12042

    Office

    $303.81

    Facility

    $163.24

    $66.34 lower than Vallejo for the office setting.

  • Metropolitan Kansas City

    Missouri · 12042

    Office

    $292.27

    Facility

    $163.99

    $77.88 lower than Vallejo for the office setting.

  • Metropolitan St. Louis

    Missouri · 12042

    Office

    $295.17

    Facility

    $165.12

    $74.98 lower than Vallejo for the office setting.

  • Rest Of Missouri

    Missouri · 12042

    Office

    $276.53

    Facility

    $158.77

    $93.62 lower than Vallejo for the office setting.

  • Mississippi

    Mississippi · 12042

    Office

    $273.97

    Facility

    $156.35

    $96.18 lower than Vallejo for the office setting.

  • Montana**

    Montana · 12042

    Office

    $304.93

    Facility

    $168.32

    $65.22 lower than Vallejo for the office setting.

  • North Carolina

    North Carolina · 12042

    Office

    $287.66

    Facility

    $160.20

    $82.49 lower than Vallejo for the office setting.

  • North Dakota**

    North Dakota · 12042

    Office

    $299.00

    Facility

    $162.39

    $71.15 lower than Vallejo for the office setting.

  • Nebraska

    Nebraska · 12042

    Office

    $283.00

    Facility

    $156.91

    $87.15 lower than Vallejo for the office setting.

  • New Hampshire

    New Hampshire · 12042

    Office

    $312.06

    Facility

    $169.85

    $58.09 lower than Vallejo for the office setting.

  • Northern Nj

    New Jersey · 12042

    Office

    $344.01

    Facility

    $185.54

    $26.14 lower than Vallejo for the office setting.

  • Rest Of New Jersey

    New Jersey · 12042

    Office

    $328.33

    Facility

    $179.15

    $41.82 lower than Vallejo for the office setting.

  • New Mexico

    New Mexico · 12042

    Office

    $290.03

    Facility

    $164.75

    $80.12 lower than Vallejo for the office setting.

  • Nevada**

    Nevada · 12042

    Office

    $303.48

    Facility

    $166.73

    $66.67 lower than Vallejo for the office setting.

  • Nyc Suburbs/Long Island

    New York · 12042

    Office

    $357.92

    Facility

    $195.49

    $12.23 lower than Vallejo for the office setting.

  • Poughkpsie/N Nyc Suburbs

    New York · 12042

    Office

    $330.53

    Facility

    $180.94

    $39.62 lower than Vallejo for the office setting.

  • Queens

    New York · 12042

    Office

    $352.34

    Facility

    $190.86

    $17.81 lower than Vallejo for the office setting.

  • Rest Of New York

    New York · 12042

    Office

    $291.77

    Facility

    $161.99

    $78.38 lower than Vallejo for the office setting.

  • Ohio

    Ohio · 12042

    Office

    $287.28

    Facility

    $162.55

    $82.87 lower than Vallejo for the office setting.

  • Oklahoma

    Oklahoma · 12042

    Office

    $280.88

    Facility

    $158.89

    $89.27 lower than Vallejo for the office setting.

  • Portland

    Oregon · 12042

    Office

    $326.49

    Facility

    $174.72

    $43.66 lower than Vallejo for the office setting.

  • Rest Of Oregon

    Oregon · 12042

    Office

    $301.16

    Facility

    $165.09

    $68.99 lower than Vallejo for the office setting.

  • Metropolitan Philadelphia

    Pennsylvania · 12042

    Office

    $316.89

    Facility

    $174.68

    $53.26 lower than Vallejo for the office setting.

  • Rest Of Pennsylvania

    Pennsylvania · 12042

    Office

    $287.66

    Facility

    $162.26

    $82.49 lower than Vallejo for the office setting.

  • Puerto Rico

    Puerto Rico · 12042

    Office

    $307.04

    Facility

    $168.93

    $63.11 lower than Vallejo for the office setting.

  • Rhode Island

    Rhode Island · 12042

    Office

    $312.33

    Facility

    $171.21

    $57.82 lower than Vallejo for the office setting.

  • South Carolina

    South Carolina · 12042

    Office

    $287.94

    Facility

    $161.71

    $82.21 lower than Vallejo for the office setting.

  • South Dakota**

    South Dakota · 12042

    Office

    $298.30

    Facility

    $161.69

    $71.85 lower than Vallejo for the office setting.

  • Tennessee

    Tennessee · 12042

    Office

    $281.74

    Facility

    $157.56

    $88.41 lower than Vallejo for the office setting.

  • Austin

    Texas · 12042

    Office

    $315.83

    Facility

    $171.29

    $54.32 lower than Vallejo for the office setting.

  • Beaumont

    Texas · 12042

    Office

    $285.87

    Facility

    $161.56

    $84.28 lower than Vallejo for the office setting.

  • Brazoria

    Texas · 12042

    Office

    $301.64

    Facility

    $166.26

    $68.51 lower than Vallejo for the office setting.

  • Dallas

    Texas · 12042

    Office

    $303.53

    Facility

    $167.47

    $66.62 lower than Vallejo for the office setting.

  • Fort Worth

    Texas · 12042

    Office

    $301.62

    Facility

    $166.92

    $68.53 lower than Vallejo for the office setting.

  • Galveston

    Texas · 12042

    Office

    $302.52

    Facility

    $166.87

    $67.63 lower than Vallejo for the office setting.

  • Houston

    Texas · 12042

    Office

    $308.02

    Facility

    $172.36

    $62.13 lower than Vallejo for the office setting.

  • Rest Of Texas

    Texas · 12042

    Office

    $293.57

    Facility

    $163.93

    $76.58 lower than Vallejo for the office setting.

  • Utah

    Utah · 12042

    Office

    $291.68

    Facility

    $163.27

    $78.47 lower than Vallejo for the office setting.

  • Virginia

    Virginia · 12042

    Office

    $298.53

    Facility

    $164.25

    $71.62 lower than Vallejo for the office setting.

  • Virgin Islands

    United States Virgin Islands · 12042

    Office

    $307.04

    Facility

    $168.93

    $63.11 lower than Vallejo for the office setting.

  • Vermont

    Vermont · 12042

    Office

    $297.96

    Facility

    $162.72

    $72.19 lower than Vallejo for the office setting.

  • Rest Of Washington

    Washington · 12042

    Office

    $314.55

    Facility

    $170.70

    $55.60 lower than Vallejo for the office setting.

  • Seattle (King Cnty)

    Washington · 12042

    Office

    $353.99

    Facility

    $186.36

    $16.16 lower than Vallejo for the office setting.

  • Wisconsin

    Wisconsin · 12042

    Office

    $289.44

    Facility

    $158.57

    $80.71 lower than Vallejo for the office setting.

  • West Virginia

    West Virginia · 12042

    Office

    $282.53

    Facility

    $163.82

    $87.62 lower than Vallejo for the office setting.

  • Wyoming**

    Wyoming · 12042

    Office

    $302.34

    Facility

    $165.74

    $67.81 lower than Vallejo for the office setting.

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.

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.

$271.32

$360.97

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

View all state and territory rates as a table
State / territoryRate rangeLocalities
AK$359.141
AL$275.091
AR$271.321
AZ$297.181
CA$321.44–$400.5029
CO$316.911
CT$324.591
DC$347.311
DE$301.941
FL$301.01–$328.643
GA$284.83–$310.502
GU$328.691
HI$328.691
IA$281.561
ID$283.341
IL$292.84–$319.584
IN$284.901
KS$280.391
KY$281.451
LA$281.06–$294.272
MA$315.19–$347.162
MD$307.49–$347.313
ME$284.84–$299.422
MI$288.49–$304.682
MN$303.811
MO$276.53–$295.173
MS$273.971
MT$304.931
NC$287.661
ND$299.001
NE$283.001
NH$312.061
NJ$328.33–$344.012
NM$290.031
NV$303.481
NY$291.77–$357.925
OH$287.281
OK$280.881
OR$301.16–$326.492
PA$287.66–$316.892
PR$307.041
RI$312.331
SC$287.941
SD$298.301
TN$281.741
TX$285.87–$315.838
UT$291.681
VA$298.53–$347.312
VI$307.041
VT$297.961
WA$314.55–$353.992
WI$289.441
WV$282.531
WY$302.341

Explore 12042 on the national rate map →

Where does this rate apply?

Vallejo is a Medicare payment area. Our Census mapping connects it to 11 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 12042 in Vallejo, the physician’s office rate is $370.15 and the facility-setting rate is $190.10: a difference of $180.05.

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 12042 in Vallejo. This uses the base rate on this page, so the locality and release stay consistent.

Reference amount per service

$407.17

$370.15 × 110% = $407.17

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 12042 in Vallejo.

PPRRVU2026_Oct_nonQPP.csv

1,419

Code
12042
Physician work
2.72
Practice expense
6.11
Malpractice
0.30

GPCI2026.csv

33

Locality
Vallejo
Physician work
1.063
Practice expense
1.318
Malpractice
0.459
Office / nonfacility calculation for 12042 in Vallejo
ComponentRVULocality factorAdjusted
Physician work2.72× 1.0632.8914
Practice expense6.11× 1.3188.0530
Malpractice0.30× 0.4590.1377
Total RVUs11.0820
Conversion factor× 33.4009

Office / nonfacility rate, Vallejo$370.15

Open 12042 in the RVU calculator →

Explore RVUs, geographic factors and the full formula

Office / nonfacility

Office / nonfacility calculation inputs
ComponentRVULocal GPCI
Work2.721.063
Practice expense6.111.318
Malpractice0.30.459

(2.72 × 1.063 + 6.11 × 1.318 + 0.3 × 0.459) × $33.4009 = $370.15

Facility

Facility calculation inputs
ComponentRVULocal GPCI
Work2.721.063
Practice expense2.021.318
Malpractice0.30.459

(2.72 × 1.063 + 2.02 × 1.318 + 0.3 × 0.459) × $33.4009 = $190.10

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

12042 · Office / nonfacility

$370.15

Effective 2026-10-01

The base rate is $9.48 higher than on 2025-10-01, moving from $360.67 to $370.15 (2.6%).

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

    $360.67changed to$370.15

    • Conversion factor 32.3465 changed to 33.4009
    • Work RVU 2.79 changed to 2.72
    • Practice expense RVU 6.14 changed to 6.11
    • Malpractice RVU 0.33 changed to 0.30
    • Work GPCI 1.058 changed to 1.063
    • Practice expense GPCI 1.310 changed to 1.318
    • Malpractice GPCI 0.470 changed to 0.459

    Held through RVU26B, RVU26C, RVU26D.

  2. January 1, 2025

    RVU25A

    Earliest loaded release: $360.67

    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$370.15$190.10RVU26D
2026-07-01$370.15$190.10RVU26C
2026-04-01$370.15$190.10RVU26B
2026-01-01$370.15$190.10RVU26A
2025-10-01$360.67$218.72RVU25D
2025-07-01$360.67$218.72RVU25C
2025-04-01$360.67$218.72RVU25B
2025-01-01$360.67$218.72RVU25A

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.

RVUs for 12042PPRRVU2026_Oct_nonQPP.csv, line 1,419 (RVU26D)
Geographic factors for VallejoGPCI2026.csv, line 33 (RVU26D)
Open CMS sourceHow this rate is calculatedBuild a fee sheet