Billing code 12031: Wound repairMedicare rate & RVUs in Guam
Reports intermediate layered repair of a scalp, axillary, trunk, or extremity wound, excluding hands and feet, when the repair length is 2.5 cm or less.
Medicare pays $282.25 for 12031 in the office in Guam (Hawaii, Guam). 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 12031 covers
This service is for a wound requiring more than a straightforward skin closure: the clinician closes one or more deeper tissue layers as well as the skin, or extensively cleans a heavily contaminated wound before closure. Typical settings include emergency departments, outpatient clinics, and surgical practices. The covered locations are the scalp, axillae, trunk, and extremities, but not the hands or feet. Intermediate repairs of the face and other separately classified sites use different codes.
Choose the code by the repair’s anatomic group, complexity, and documented length. For multiple intermediate wounds in the same anatomic group, add their lengths when selecting the code; report this level when the combined length is 2.5 cm or less. The note should describe the wound location and length, the layered closure or extensive cleaning, and the work performed. CMS assigns a 10-day global period, so related postoperative visits during that period are included. When multiple procedures are performed in one session, the highest-valued procedure is paid in full and other procedures are subject to the standard multiple-procedure reduction. Bilateral adjustment is not appropriate; assistant-at-surgery payment is statutorily restricted, and co-surgeons and team surgery 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.
12031 in Hawaii, Guam
| Payment locality | Office | Facility |
|---|---|---|
| Hawaii, Guam | $282.25 | $138.32 |
How the 12031 rate is calculated
Each of 12031’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 · 12031
RVUs × geographic indexes × conversion factor
Swap in your local Medicare rate.
Work 1.95Practice expense 5.60Malpractice 0.23
All indexes start at 1.000 (the national rate). Enter a ZIP or drag a slider.
Payment rules and modifiers for 12031
12031 has a 10-day global period: related visits in that window are included in the surgery payment.
CMS payment indicators · 12031
Wound 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 · 12031
Wound 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
12031 without 51 · national office
$259.86
Wound repair
12031-51 · Second procedure: 50%
$129.93
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%).
12031 compared with similar codes
Compare codes
12031 vs 12032 vs 12041 vs 12001 vs 12051: national Medicare rates
Swap in your local Medicare rate.
How to choose
- 12032Intermediate repair
- Both codes cover intermediate repairs in the same site group. Choose 12032 when the combined length is 2.6–7.5 cm rather than 2.5 cm or less.
- 12041Intermediate repair
- This code is for intermediate repair of the neck, hands, feet, or external genitalia. Use 12031 for the scalp, axillae, trunk, or extremities excluding hands and feet.
- 12001Simple wound repair
- 12001 describes a simple repair, generally a skin-only closure, in its applicable site group. 12031 is for intermediate repair involving layered closure or extensive cleaning of a heavily contaminated wound.
- 12051Facial repair
- 12051 is the intermediate-repair code for the face and specified facial sites. 12031 covers the scalp, axillae, trunk, and extremities excluding hands and feet.
12031 billing questions
When is 12031 appropriate instead of a simple repair code?
Use 12031 when the wound needs layered closure of deeper tissue and skin, or extensive cleaning because it is heavily contaminated. A straightforward skin-only closure is reported from the simple-repair family instead.
How do I select the length level for multiple wounds?
Add the lengths of intermediate repairs in the same anatomic group, then select the code for that combined length. This code covers a combined length of 2.5 cm or less.
Can I report 12031 for a hand or foot wound?
No. Hands and feet are assigned to the separate intermediate-repair site group represented by 12041 and its related length levels.
Are related postoperative visits separately reported?
Related postoperative visits during the 10-day global period are included in the procedure.
Can modifier 50 or an assistant-at-surgery modifier be used?
Bilateral adjustment does not apply to this code. CMS also identifies a statutory restriction on assistant-at-surgery payment.
What happens when another procedure is performed in the same session?
Under the standard multiple-procedure rule, the highest-valued procedure is paid in full and other procedures are subject to the 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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