Billing code 12007: Wound repairMedicare rate & RVUs in Florida
Reports simple closure of superficial wounds totaling more than 30 cm across the scalp, neck, axillae, external genitalia, or trunk.
Medicare pays $260.08–$293.28 for 12007 in the office in Florida, from Rest Of Florida to Miami. 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 12007 covers
This code describes simple closure of superficial wounds in the scalp, neck, axillae, external genitalia, or trunk when the qualifying repaired length exceeds 30 cm. Simple repair involves closure of the superficial wound layers without the layered work that characterizes an intermediate repair. Emergency department and urgent care clinicians commonly report it for extensive lacerations; surgeons and other clinicians may perform the repair in office or facility settings.
Select the code based on repair complexity, listed body-site group, and total repaired length. Add lengths of wounds in the same complexity and anatomic grouping; the documentation should identify each site, wound length, and the simple closure performed. This is a minor procedure with a 0-day global period, so same-day preoperative and postoperative care is included. When multiple procedures occur in one session, the highest-valued is paid in full and others are subject to the standard 50% reduction. Modifier 50 is inappropriate. Assistant-at-surgery payment is restricted; co-surgeon payment requires supporting documentation, and team surgery is 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.
Where 12007 pays more and less in Florida
The same RVUs, adjusted for each area’s costs. Open a locality for its calculation, history and nearby areas.
3 payment localities
$260.08 to $293.28
| Payment locality | Office | Facility |
|---|---|---|
| Fort Lauderdale | $274.41 | $150.91 |
| Miami | $293.28 | $166.37 |
| Rest Of Florida | $260.08 | $143.53 |
How the 12007 rate is calculated
Each of 12007’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 · 12007
RVUs × geographic indexes × conversion factor
Work2.83
2.83 RVUs× 1.000 GPCI
Practice expense4.21
4.21 RVUs× 1.000 GPCI
Malpractice0.62
0.62 RVUs× 1.000 GPCI
Adjusted RVUs
7.6600
Conversion factor
$33.4009
Medicare rate
$255.85
Every GPCI starts at 1.000, the national rate. Enter a ZIP or drag a slider.
Payment rules and modifiers for 12007
The CMS indicators that decide how 12007 is paid alongside other services.
CMS payment indicators · 12007
Wound repair
| Rule | CMS value | What it means |
|---|---|---|
| Global period | 000 | Same-day global: pre- and post-op care on the day of the procedure is 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) | 1 | Permitted with supporting documentation. |
| Team surgery (66) | 0 | Not permitted. |
| Professional/technical | 0 | Physician service: no professional/technical split. |
What modifiers do to the payment
Modifier 51 · payment effect
With and without the modifier
12007 without 51 · national office
$255.85
Wound repair
12007-51 · Second procedure: 50%
$127.93
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%).
12007 compared with similar codes
Compare codes · National
5 codes, side by side
How to choose
- 12006Simple wound repair
- Both codes cover simple repair in the same site group. Choose 12007 only when the qualifying total repaired length exceeds 30 cm; 12006 applies through 30.0 cm.
- 12018Wound repair
- This is the corresponding long-length simple-repair code for the face, ears, eyelids, nose, lips, and mucous membranes, rather than the site group covered by 12007.
- 12037Intermediate repair
- 12037 represents intermediate repair, not simple closure, for its scalp, axilla, trunk, and extremity site group. Choose by the documented repair complexity and applicable site group.
- 12047Intermediate repair
- 12047 is for intermediate repair over 30 cm in its site group, which includes the neck and external genitalia. Use it when the repair requires intermediate-level work rather than simple closure.
12007 billing questions
How is this code distinguished from 12006?
Both cover simple repair in the same site group. Use 12007 when the qualifying total repaired length is more than 30 cm; 12006 covers 20.1–30.0 cm.
Can lengths from multiple wounds be combined?
Yes, combine lengths of wounds repaired with the same complexity in the same anatomic grouping. Document the individual sites and lengths supporting the total.
What documentation supports simple rather than intermediate repair?
Describe the wound depth and closure technique. A superficial closure supports simple repair; layered closure requiring intermediate repair is not reported with this code.
Should modifier 50 be used for wounds on both sides of the body?
No. CMS identifies bilateral adjustment as inappropriate for this code; select it from the total qualifying length and listed body sites.
How does the multiple-procedure payment rule affect this service?
When multiple procedures are performed in the same session, the highest-valued procedure is paid in full and the other procedures are subject to the standard 50% 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 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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