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CMS RVU26D · Effective 2026-10-01

12004 in Wyoming**

Office / nonfacility

$159.13

Base rate per service

Facility setting

$69.28

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 12004: Simple repair of nonfacial wounds

Reports simple closure of a superficial wound at specified nonfacial sites when the combined repaired length is 7.6 to 12.5 cm.

This code covers closure of a superficial wound without layered repair of deeper tissue. The site group includes the scalp, neck, axillae, external genitalia, trunk, and extremities; wounds of the face have a separate code series. A clinician typically cleans and prepares the wound, uses local anesthesia as needed, and closes the skin with sutures, staples, or tissue adhesive. These repairs commonly occur in emergency departments, urgent care, and office settings, performed by emergency, primary care, or surgical clinicians.

Select the code by the eligible site group and the combined length of simple repairs in that group, not by the number of wounds or closure materials. Document each wound’s site, length, depth, and repair method. The 0-day global period includes same-day preoperative and postoperative care. 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; assistant-at-surgery services are not paid, and co-surgeon and team-surgery billing are not permitted.

CMS billing rules for 12004

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 RVU1.40 · 29%
  • Practice expense (office) RVU3.12 · 64%
  • Malpractice RVU0.33 · 7%

19.9K

Medicare services in 2024 · #1151 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.

12004 compared with similar codes

Office rates for Wyoming**, from the same CMS release.

12002

Wound repair

Simple, 2.6–7.5 cm

$137.20

Both codes cover simple repairs in the same site group; 12002 applies to a shorter combined length, while this code covers 7.6–12.5 cm.

12005

Simple wound repair

12.6–20.0 cm

$207.36

Both codes cover simple repairs in the same site group; 12005 applies when the combined length exceeds this code’s range.

12015

Simple wound repair

Face and related sites, 7.6-12.5 cm

$206.94

This code is for the scalp, neck, axillae, external genitalia, trunk, and extremities. Code 12015 is for the separate facial, ear, eyelid, nose, lip, and mucosal site group.

12034

Wound repair

Intermediate, 7.6–12.5 cm

$331.29

Both codes represent repairs in a similar length range, but 12034 is for intermediate repair, which involves layered closure or repair of deeper tissue.

The same code, a different location

How does Wyoming** compare?

12004 across payment areas

Same release and payment basis · bars start at $0

  1. Wyoming** · This locality

    $159.13

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

    $179.28

    $20.15 higher than Wyoming**

  3. Dc + Md/Va Suburbs

    $184.31

    $25.18 higher than Wyoming**

  4. Miami

    $183.12

    $23.99 higher than Wyoming**

  5. Chicago

    $177.12

    $17.99 higher than Wyoming**

  6. Manhattan

    $188.33

    $29.20 higher than Wyoming**

  7. Alaska*

    $187.20

    $28.07 higher than Wyoming**

Other payment areas listed in Wyoming 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, 12004 ranges from $141.95 in Arkansas to $208.08 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

  • Alabama

    Alabama · 12004

    Office

    $144.18

    Facility

    $65.57

    $14.95 lower than Wyoming** for the office setting.

  • Arkansas

    Arkansas · 12004

    Office

    $141.95

    Facility

    $64.78

    $17.18 lower than Wyoming** for the office setting.

  • Arizona

    Arizona · 12004

    Office

    $157.18

    Facility

    $70.11

    $1.95 lower than Wyoming** for the office setting.

  • Bakersfield

    California · 12004

    Office

    $168.58

    Facility

    $70.10

    $9.45 higher than Wyoming** for the office setting.

  • Chico

    California · 12004

    Office

    $167.68

    Facility

    $69.21

    $8.55 higher than Wyoming** for the office setting.

  • El Centro

    California · 12004

    Office

    $167.73

    Facility

    $69.26

    $8.60 higher than Wyoming** for the office setting.

  • Fresno

    California · 12004

    Office

    $167.68

    Facility

    $69.21

    $8.55 higher than Wyoming** for the office setting.

  • Hanford-Corcoran

    California · 12004

    Office

    $167.68

    Facility

    $69.21

    $8.55 higher than Wyoming** for the office setting.

  • Madera

    California · 12004

    Office

    $167.68

    Facility

    $69.21

    $8.55 higher than Wyoming** for the office setting.

  • Merced

    California · 12004

    Office

    $167.68

    Facility

    $69.21

    $8.55 higher than Wyoming** for the office setting.

  • Modesto

    California · 12004

    Office

    $167.68

    Facility

    $69.21

    $8.55 higher than Wyoming** for the office setting.

  • Napa

    California · 12004

    Office

    $192.66

    Facility

    $74.24

    $33.53 higher than Wyoming** for the office setting.

  • Oxnard-Thousand Oaks-Ventura

    California · 12004

    Office

    $178.11

    Facility

    $71.91

    $18.98 higher than Wyoming** for the office setting.

  • Redding

    California · 12004

    Office

    $167.68

    Facility

    $69.21

    $8.55 higher than Wyoming** for the office setting.

  • Rest Of California

    California · 12004

    Office

    $167.68

    Facility

    $69.21

    $8.55 higher than Wyoming** for the office setting.

  • Riverside-San Bernardino-Ontario

    California · 12004

    Office

    $171.22

    Facility

    $72.75

    $12.09 higher than Wyoming** for the office setting.

  • Sacramento-Roseville-Folsom

    California · 12004

    Office

    $175.55

    Facility

    $71.06

    $16.42 higher than Wyoming** for the office setting.

  • Salinas

    California · 12004

    Office

    $174.90

    Facility

    $70.76

    $15.77 higher than Wyoming** for the office setting.

  • San Diego-Chula Vista-Carlsbad

    California · 12004

    Office

    $178.77

    Facility

    $71.32

    $19.64 higher than Wyoming** for the office setting.

  • San Francisco-Oakland-Berkeley (Marin Cnty)

    California · 12004

    Office

    $203.20

    Facility

    $76.51

    $44.07 higher than Wyoming** for the office setting.

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

    California · 12004

    Office

    $202.83

    Facility

    $76.14

    $43.70 higher than Wyoming** for the office setting.

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

    California · 12004

    Office

    $208.08

    Facility

    $78.52

    $48.95 higher than Wyoming** for the office setting.

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

    California · 12004

    Office

    $206.55

    Facility

    $76.99

    $47.42 higher than Wyoming** for the office setting.

  • San Luis Obispo-Paso Robles

    California · 12004

    Office

    $172.16

    Facility

    $69.82

    $13.03 higher than Wyoming** for the office setting.

  • Santa Cruz-Watsonville

    California · 12004

    Office

    $180.27

    Facility

    $71.10

    $21.14 higher than Wyoming** for the office setting.

  • Santa Maria-Santa Barbara

    California · 12004

    Office

    $175.49

    Facility

    $70.73

    $16.36 higher than Wyoming** for the office setting.

  • Santa Rosa-Petaluma

    California · 12004

    Office

    $182.04

    Facility

    $71.71

    $22.91 higher than Wyoming** for the office setting.

  • Stockton

    California · 12004

    Office

    $167.68

    Facility

    $69.21

    $8.55 higher than Wyoming** for the office setting.

  • Vallejo

    California · 12004

    Office

    $192.12

    Facility

    $73.70

    $32.99 higher than Wyoming** for the office setting.

  • Visalia

    California · 12004

    Office

    $167.68

    Facility

    $69.21

    $8.55 higher than Wyoming** for the office setting.

  • Yuba City

    California · 12004

    Office

    $167.68

    Facility

    $69.21

    $8.55 higher than Wyoming** for the office setting.

  • Colorado

    Colorado · 12004

    Office

    $166.81

    Facility

    $71.21

    $7.68 higher than Wyoming** for the office setting.

  • Connecticut

    Connecticut · 12004

    Office

    $173.27

    Facility

    $76.50

    $14.14 higher than Wyoming** for the office setting.

  • Delaware

    Delaware · 12004

    Office

    $159.86

    Facility

    $71.09

    $0.73 higher than Wyoming** for the office setting.

  • Fort Lauderdale

    Florida · 12004

    Office

    $172.26

    Facility

    $81.24

    $13.13 higher than Wyoming** for the office setting.

  • Rest Of Florida

    Florida · 12004

    Office

    $162.95

    Facility

    $77.06

    $3.82 higher than Wyoming** for the office setting.

  • Atlanta

    Georgia · 12004

    Office

    $166.02

    Facility

    $74.73

    $6.89 higher than Wyoming** for the office setting.

  • Rest Of Georgia

    Georgia · 12004

    Office

    $152.86

    Facility

    $72.71

    $6.27 lower than Wyoming** for the office setting.

  • Hawaii, Guam

    Hawaii · 12004

    Office

    $171.63

    Facility

    $69.47

    $12.50 higher than Wyoming** for the office setting.

  • Iowa

    Iowa · 12004

    Office

    $146.49

    Facility

    $64.28

    $12.64 lower than Wyoming** for the office setting.

  • Idaho

    Idaho · 12004

    Office

    $147.85

    Facility

    $65.19

    $11.28 lower than Wyoming** for the office setting.

  • East St. Louis

    Illinois · 12004

    Office

    $164.83

    Facility

    $82.17

    $5.70 higher than Wyoming** for the office setting.

  • Rest Of Illinois

    Illinois · 12004

    Office

    $159.13

    Facility

    $77.10

    The same base rate than Wyoming** for the office setting.

  • Suburban Chicago

    Illinois · 12004

    Office

    $173.64

    Facility

    $81.37

    $14.51 higher than Wyoming** for the office setting.

  • Indiana

    Indiana · 12004

    Office

    $148.72

    Facility

    $65.43

    $10.41 lower than Wyoming** for the office setting.

  • Kansas

    Kansas · 12004

    Office

    $146.52

    Facility

    $65.30

    $12.61 lower than Wyoming** for the office setting.

  • Kentucky

    Kentucky · 12004

    Office

    $149.49

    Facility

    $69.61

    $9.64 lower than Wyoming** for the office setting.

  • New Orleans

    Louisiana · 12004

    Office

    $157.34

    Facility

    $72.80

    $1.79 lower than Wyoming** for the office setting.

  • Rest Of Louisiana

    Louisiana · 12004

    Office

    $149.55

    Facility

    $70.03

    $9.58 lower than Wyoming** for the office setting.

  • Metropolitan Boston

    Massachusetts · 12004

    Office

    $182.92

    Facility

    $75.64

    $23.79 higher than Wyoming** for the office setting.

  • Rest Of Massachusetts

    Massachusetts · 12004

    Office

    $166.03

    Facility

    $71.42

    $6.90 higher than Wyoming** for the office setting.

  • Baltimore/Surr. Cntys

    Maryland · 12004

    Office

    $172.96

    Facility

    $76.55

    $13.83 higher than Wyoming** for the office setting.

  • Rest Of Maryland

    Maryland · 12004

    Office

    $162.81

    Facility

    $71.88

    $3.68 higher than Wyoming** for the office setting.

  • Rest Of Maine

    Maine · 12004

    Office

    $149.49

    Facility

    $66.83

    $9.64 lower than Wyoming** for the office setting.

  • Southern Maine

    Maine · 12004

    Office

    $156.99

    Facility

    $67.95

    $2.14 lower than Wyoming** for the office setting.

  • Detroit

    Michigan · 12004

    Office

    $165.91

    Facility

    $79.20

    $6.78 higher than Wyoming** for the office setting.

  • Rest Of Michigan

    Michigan · 12004

    Office

    $154.35

    Facility

    $72.32

    $4.78 lower than Wyoming** for the office setting.

  • Minnesota

    Minnesota · 12004

    Office

    $157.26

    Facility

    $64.80

    $1.87 lower than Wyoming** for the office setting.

  • Metropolitan Kansas City

    Missouri · 12004

    Office

    $155.38

    Facility

    $71.02

    $3.75 lower than Wyoming** for the office setting.

  • Metropolitan St. Louis

    Missouri · 12004

    Office

    $157.01

    Facility

    $71.48

    $2.12 lower than Wyoming** for the office setting.

  • Rest Of Missouri

    Missouri · 12004

    Office

    $147.33

    Facility

    $69.88

    $11.80 lower than Wyoming** for the office setting.

  • Mississippi

    Mississippi · 12004

    Office

    $144.63

    Facility

    $67.27

    $14.50 lower than Wyoming** for the office setting.

  • Montana**

    Montana · 12004

    Office

    $161.97

    Facility

    $72.12

    $2.84 higher than Wyoming** for the office setting.

  • North Carolina

    North Carolina · 12004

    Office

    $151.03

    Facility

    $67.20

    $8.10 lower than Wyoming** for the office setting.

  • North Dakota**

    North Dakota · 12004

    Office

    $155.45

    Facility

    $65.60

    $3.68 lower than Wyoming** for the office setting.

  • Nebraska

    Nebraska · 12004

    Office

    $147.11

    Facility

    $64.18

    $12.02 lower than Wyoming** for the office setting.

  • New Hampshire

    New Hampshire · 12004

    Office

    $164.89

    Facility

    $71.36

    $5.76 higher than Wyoming** for the office setting.

  • Northern Nj

    New Jersey · 12004

    Office

    $182.36

    Facility

    $78.14

    $23.23 higher than Wyoming** for the office setting.

  • Rest Of New Jersey

    New Jersey · 12004

    Office

    $174.52

    Facility

    $76.41

    $15.39 higher than Wyoming** for the office setting.

  • New Mexico

    New Mexico · 12004

    Office

    $155.56

    Facility

    $73.17

    $3.57 lower than Wyoming** for the office setting.

  • Nevada**

    Nevada · 12004

    Office

    $160.26

    Facility

    $70.32

    $1.13 higher than Wyoming** for the office setting.

  • Nyc Suburbs/Long Island

    New York · 12004

    Office

    $194.13

    Facility

    $87.30

    $35.00 higher than Wyoming** for the office setting.

  • Poughkpsie/N Nyc Suburbs

    New York · 12004

    Office

    $176.31

    Facility

    $77.93

    $17.18 higher than Wyoming** for the office setting.

  • Queens

    New York · 12004

    Office

    $188.83

    Facility

    $82.62

    $29.70 higher than Wyoming** for the office setting.

  • Rest Of New York

    New York · 12004

    Office

    $153.51

    Facility

    $68.15

    $5.62 lower than Wyoming** for the office setting.

  • Ohio

    Ohio · 12004

    Office

    $153.02

    Facility

    $70.98

    $6.11 lower than Wyoming** for the office setting.

  • Oklahoma

    Oklahoma · 12004

    Office

    $148.39

    Facility

    $68.15

    $10.74 lower than Wyoming** for the office setting.

  • Portland

    Oregon · 12004

    Office

    $171.49

    Facility

    $71.67

    $12.36 higher than Wyoming** for the office setting.

  • Rest Of Oregon

    Oregon · 12004

    Office

    $158.30

    Facility

    $68.81

    $0.83 lower than Wyoming** for the office setting.

  • Metropolitan Philadelphia

    Pennsylvania · 12004

    Office

    $169.24

    Facility

    $75.70

    $10.11 higher than Wyoming** for the office setting.

  • Rest Of Pennsylvania

    Pennsylvania · 12004

    Office

    $152.84

    Facility

    $70.36

    $6.29 lower than Wyoming** for the office setting.

  • Puerto Rico

    Puerto Rico · 12004

    Office

    $162.98

    Facility

    $72.14

    $3.85 higher than Wyoming** for the office setting.

  • Rhode Island

    Rhode Island · 12004

    Office

    $165.13

    Facility

    $72.32

    $6.00 higher than Wyoming** for the office setting.

  • South Carolina

    South Carolina · 12004

    Office

    $152.42

    Facility

    $69.40

    $6.71 lower than Wyoming** for the office setting.

  • South Dakota**

    South Dakota · 12004

    Office

    $154.68

    Facility

    $64.83

    $4.45 lower than Wyoming** for the office setting.

  • Tennessee

    Tennessee · 12004

    Office

    $147.41

    Facility

    $65.74

    $11.72 lower than Wyoming** for the office setting.

  • Austin

    Texas · 12004

    Office

    $166.88

    Facility

    $71.82

    $7.75 higher than Wyoming** for the office setting.

  • Beaumont

    Texas · 12004

    Office

    $151.83

    Facility

    $70.07

    $7.30 lower than Wyoming** for the office setting.

  • Brazoria

    Texas · 12004

    Office

    $159.01

    Facility

    $69.97

    $0.12 lower than Wyoming** for the office setting.

  • Dallas

    Texas · 12004

    Office

    $160.43

    Facility

    $70.94

    $1.30 higher than Wyoming** for the office setting.

  • Fort Worth

    Texas · 12004

    Office

    $159.53

    Facility

    $70.94

    $0.40 higher than Wyoming** for the office setting.

  • Galveston

    Texas · 12004

    Office

    $159.74

    Facility

    $70.52

    $0.61 higher than Wyoming** for the office setting.

  • Houston

    Texas · 12004

    Office

    $165.78

    Facility

    $76.56

    $6.65 higher than Wyoming** for the office setting.

  • Rest Of Texas

    Texas · 12004

    Office

    $155.61

    Facility

    $70.34

    $3.52 lower than Wyoming** for the office setting.

  • Utah

    Utah · 12004

    Office

    $154.62

    Facility

    $70.16

    $4.51 lower than Wyoming** for the office setting.

  • Virginia

    Virginia · 12004

    Office

    $156.98

    Facility

    $68.66

    $2.15 lower than Wyoming** for the office setting.

  • Virgin Islands

    United States Virgin Islands · 12004

    Office

    $162.98

    Facility

    $72.14

    $3.85 higher than Wyoming** for the office setting.

  • Vermont

    Vermont · 12004

    Office

    $155.51

    Facility

    $66.56

    $3.62 lower than Wyoming** for the office setting.

  • Rest Of Washington

    Washington · 12004

    Office

    $165.49

    Facility

    $70.88

    $6.36 higher than Wyoming** for the office setting.

  • Seattle (King Cnty)

    Washington · 12004

    Office

    $185.97

    Facility

    $75.73

    $26.84 higher than Wyoming** for the office setting.

  • Wisconsin

    Wisconsin · 12004

    Office

    $149.99

    Facility

    $63.92

    $9.14 lower than Wyoming** for the office setting.

  • West Virginia

    West Virginia · 12004

    Office

    $153.09

    Facility

    $75.02

    $6.04 lower than Wyoming** for the office setting.

See how rates vary across the country

12004 · 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.

$141.95

$187.88

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

View all state and territory rates as a table
State / territoryRate rangeLocalities
AK$187.201
AL$144.181
AR$141.951
AZ$157.181
CA$167.68–$208.0829
CO$166.811
CT$173.271
DC$184.311
DE$159.861
FL$162.95–$183.123
GA$152.86–$166.022
GU$171.631
HI$171.631
IA$146.491
ID$147.851
IL$159.13–$177.124
IN$148.721
KS$146.521
KY$149.491
LA$149.55–$157.342
MA$166.03–$182.922
MD$162.81–$184.313
ME$149.49–$156.992
MI$154.35–$165.912
MN$157.261
MO$147.33–$157.013
MS$144.631
MT$161.971
NC$151.031
ND$155.451
NE$147.111
NH$164.891
NJ$174.52–$182.362
NM$155.561
NV$160.261
NY$153.51–$194.135
OH$153.021
OK$148.391
OR$158.30–$171.492
PA$152.84–$169.242
PR$162.981
RI$165.131
SC$152.421
SD$154.681
TN$147.411
TX$151.83–$166.888
UT$154.621
VA$156.98–$184.312
VI$162.981
VT$155.511
WA$165.49–$185.972
WI$149.991
WV$153.091
WY$159.131

Explore 12004 on the national rate map →

Where does this rate apply?

Wyoming** is a Medicare payment area. Our Census mapping connects it to 205 cities and communities in Wyoming, 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 Wyoming →

Why are the office and facility amounts different?

For 12004 in Wyoming**, the physician’s office rate is $159.13 and the facility-setting rate is $69.28: a difference of $89.85.

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 12004 in Wyoming**. This uses the base rate on this page, so the locality and release stay consistent.

Reference amount per service

$175.04

$159.13 × 110% = $175.04

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.

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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 12004 in Wyoming**.

PPRRVU2026_Oct_nonQPP.csv

1,398

Code
12004
Physician work
1.40
Practice expense
3.12
Malpractice
0.33

GPCI2026.csv

112

Locality
Wyoming**
Physician work
1.000
Practice expense
1.000
Malpractice
0.740
Office / nonfacility calculation for 12004 in Wyoming**
ComponentRVULocality factorAdjusted
Physician work1.40× 1.0001.4000
Practice expense3.12× 1.0003.1200
Malpractice0.33× 0.7400.2442
Total RVUs4.7642
Conversion factor× 33.4009

Office / nonfacility rate, Wyoming**$159.13

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

Open 12004 in the RVU calculator →

Explore RVUs, geographic factors and the full formula

Office / nonfacility

Office / nonfacility calculation inputs
ComponentRVULocal GPCI
Work1.41
Practice expense3.121
Malpractice0.330.74

(1.4 × 1 + 3.12 × 1 + 0.33 × 0.74) × $33.4009 = $159.13

Facility

Facility calculation inputs
ComponentRVULocal GPCI
Work1.41
Practice expense0.431
Malpractice0.330.74

(1.4 × 1 + 0.43 × 1 + 0.33 × 0.74) × $33.4009 = $69.28

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

12004 · Office / nonfacility

$159.13

Effective 2026-10-01

The base rate is $32.43 higher than on 2025-10-01, moving from $126.70 to $159.13 (25.6%).

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

    $126.70changed to$159.13

    • Conversion factor 32.3465 changed to 33.4009
    • Work RVU 1.44 changed to 1.40
    • Practice expense RVU 2.27 changed to 3.12
    • Malpractice RVU 0.28 changed to 0.33
    • Malpractice GPCI 0.739 changed to 0.740

    Held through RVU26B, RVU26C, RVU26D.

  2. January 1, 2025

    RVU25A

    Earliest loaded release: $126.70

    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$159.13$69.28RVU26D
2026-07-01$159.13$69.28RVU26C
2026-04-01$159.13$69.28RVU26B
2026-01-01$159.13$69.28RVU26A
2025-10-01$126.70$68.47RVU25D
2025-07-01$126.70$68.47RVU25C
2025-04-01$126.70$68.47RVU25B
2025-01-01$126.70$68.47RVU25A

12004 billing questions

How is the length selected when there are multiple wounds?

Add the lengths of simple repairs in the same anatomical grouping and select the applicable length range. Keep documentation of each wound’s location and length.

When should 12002 or 12005 be reported instead?

Use 12002 for a shorter combined repair length in this site group and 12005 for a longer one. The site group and simple-repair method remain the same.

Can this code be used for a layered closure?

No. This code describes simple closure; a repair requiring layered closure may fit an intermediate-repair code when its site and length criteria are met.

Is local anesthesia separately reported?

Local anesthesia used for the wound closure is part of the repair service, rather than a separate service under this code.

How does Medicare handle another procedure performed in the same session?

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

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 12004PPRRVU2026_Oct_nonQPP.csv, line 1,398 (RVU26D)
Geographic factors for Wyoming**GPCI2026.csv, line 112 (RVU26D)
Open CMS sourceHow this rate is calculatedBuild a fee sheet