Billing code 12041: Intermediate repairMedicare rate & RVUs in Delaware
Reports intermediate closure of a wound 2.5 cm or shorter on the neck, hand, foot, or external genitalia, including layered closure or qualifying contaminated-wound repair.
Medicare pays $260.13 for 12041 in the office in Delaware (Delaware). Which amount applies depends on the service address.
Medicare allowed amount for participating (non-QP) physicians, before deductible, coinsurance and claim adjustments. Not a patient’s bill or a hospital charge.
On this page 9 sections
What 12041 covers
This service covers closure of a wound in the code’s site group when the repair requires more than a simple skin closure. Typically, the clinician closes deeper subcutaneous tissue and superficial fascia as well as the skin. It can also cover a single-layer closure of a heavily contaminated wound that needs extensive cleaning or removal of embedded material. Emergency physicians, surgeons, and other clinicians who repair traumatic lacerations may perform it in an emergency department, clinic, or operating setting.
Select the code by the documented wound site, repair complexity, and total length repaired; combine lengths for wounds of the same complexity in the same anatomic grouping. Documentation should identify each site and length and describe the layered closure or qualifying extensive cleaning. CMS assigns a 10-day global period, including related postoperative visits during that period. When multiple procedures occur in one session, the highest-valued procedure is paid in full and the others at 50%. Modifier 50 is inappropriate for this code. Assistant-at-surgery services are not paid, and co-surgeon and team-surgery reporting are not permitted.
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.
12041 in Delaware
| Payment locality | Office | Facility |
|---|---|---|
| Delaware | $260.13 | $128.13 |
How the 12041 rate is calculated
Each of 12041’s three RVUs is multiplied by a geographic index (GPCI) for the payment locality, added up, and multiplied by the conversion factor. Drag the indexes or enter a ZIP to see what moves the rate.
How the rate is built · 12041
RVUs × geographic indexes × conversion factor
Swap in your local Medicare rate.
Work 2.05Practice expense 5.57Malpractice 0.25
All indexes start at 1.000 (the national rate). Enter a ZIP or drag a slider.
Payment rules and modifiers for 12041
12041 has a 10-day global period: related visits in that window are included in the surgery payment.
CMS payment indicators · 12041
Intermediate repair
| Rule | CMS value | What it means |
|---|---|---|
| Global period | 010 | Minor procedure: the day of the procedure plus 10 days after are included. |
| Multiple procedures | 2 | Standard reduction: highest-valued procedure at 100%, others at 50%. |
| Bilateral (modifier 50) | 0 | The 150% bilateral adjustment doesn’t apply. |
| Assistant at surgery (80/81/82/AS) | 1 | Not paid (statutory restriction). |
| Co-surgeons (62) | 0 | Not permitted. |
| Team surgery (66) | 0 | Not permitted. |
| Professional/technical | 0 | Physician service: no professional/technical split. |
| Split (54/55/56) | 0.10/0.80/0.10 | Share of the payment for pre-op, the procedure itself, and post-op care. |
Global surgery period · 12041
Intermediate repair
10-day global period ends
Oct 11, 2026
Covers Oct 1, 2026 through Oct 11, 2026 (11 days).
Visit on Oct 31, 2026
After the global period ends: visits and procedures are billed normally.
What modifiers do to the payment
Modifier 51 · payment effect
With and without the modifier
12041 without 51 · national office
$262.87
Intermediate repair
12041-51 · Second procedure: 50%
$131.44
When this isn’t the highest-valued procedure in the session, Medicare pays 50% of its fee schedule amount (the highest is paid at 100%).
12041 compared with similar codes
Compare codes
12041 vs 12042 vs 12031 vs 12051 vs 12001: national Medicare rates
Swap in your local Medicare rate.
How to choose
- 12042Intermediate wound repair
- Both cover intermediate repair in the same site grouping; choose 12042 when the total repaired length is 2.6–7.5 cm rather than 2.5 cm or less.
- 12031Wound repair
- This is also an intermediate repair code, but it covers a different anatomic site grouping. Choose by the wound’s actual site, not by length alone.
- 12051Facial repair
- Use 12051 for intermediate repairs of the face or mucous membranes; this code is for the neck, hands, feet, or external genitalia.
- 12001Simple wound repair
- 12001 is for a simple repair of a superficial wound in overlapping site groupings. Use this code when the wound meets intermediate-repair criteria instead.
12041 billing questions
What wound length qualifies for this code?
Use it for a qualifying intermediate repair with a total repaired length of 2.5 cm or less in the neck, hands, feet, or external genitalia. A longer repair in the same site group falls into a higher length level.
What makes the repair intermediate rather than simple?
The repair generally includes closure of deeper subcutaneous tissue and superficial fascia in addition to skin. A single-layer closure may also qualify when the wound is heavily contaminated and requires extensive cleaning or removal of embedded material.
Can lengths from multiple wounds be added together?
Yes, combine lengths for wounds of the same complexity within the same anatomic grouping. Document each wound’s location and length so the combined measurement is supported.
Are related postoperative visits separately reported during the global period?
Related postoperative visits for 10 days are included in the minor-procedure global period.
Can modifier 50 or an assistant-at-surgery modifier be reported?
Modifier 50 is inappropriate for this code. Medicare does not pay an assistant at surgery for this service; co-surgeon and team-surgery reporting are also not permitted.
Where these rates come from
FeeBase calculates base physician payments from CMS work, practice-expense and malpractice RVUs, adjusted by each locality’s geographic indexes and the conversion factor. Services without a published rate are labeled, never given a made-up amount. Amounts are Medicare allowed amounts before claim adjustments: not a patient’s bill or a commercial rate.
CMS RVU26D · effective Oct 1, 2026 through the day before Jan 1, 2027
Show the CMS file lines behind this rate
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