$190.46–$208.98
Both address superficial wound dehiscence; 12021 is the related service when packing is used, while 12020 represents simple closure.
On this page
CMS RVU26D · Effective 2026-10-01
12020 Wound dehiscence Medicare reimbursement rates in Massachusetts
Use this code when a separated superficial surgical wound is treated with simple closure, such as reapproximating the skin of an incision. Compare 12020 office and facility rates across CMS payment localities in Massachusetts.
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.
What does Medicare pay for 12020 in Massachusetts?
Massachusetts has 2 payment localities in this comparison. Use the service location to choose the applicable amount. These are the supported base rates for the 2 payment areas shown below, using the same CMS release.
Office / nonfacility
$326.53–$360.42
2 of 2 localities have a supported rate.
Facility setting
$181.28–$195.71
2 of 2 localities have a supported rate.
These are locality ranges, not averages or address-specific quotes. A facility-setting amount covers the physician service; it does not include a hospital’s separate bill. Choose a locality below to inspect its calculation, compare other payment areas, or price a percentage of Medicare.
Wound repair
About 12020: Superficial surgical wound dehiscence closure
Use this code when a separated superficial surgical wound is treated with simple closure, such as reapproximating the skin of an incision.
This service treats a superficial surgical wound that has separated after the original closure. A physician or other qualified clinician managing the wound may cleanse and assess the site, then reapproximate the separated edges with a simple closure. Typical cases involve separation limited to the skin or superficial tissue of an incision; a deeper disruption is not the service described by this code. The code is for treating dehiscence, not for closing a new traumatic laceration.
Report the service when the record identifies the prior surgical wound, documents the separation and its superficial extent, and supports simple closure. Packing distinguishes the related 12021 service. Medicare assigns a 10-day global period, so related postoperative visits during those 10 days 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 50% reduction. Modifier 50 is inappropriate; assistant-at-surgery payment is statutorily restricted, and co-surgeon and team-surgery billing are not permitted.
CMS billing rules for 12020
- 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 RVU2.60 · 27%
- Practice expense (office) RVU6.45 · 68%
- Malpractice RVU0.43 · 5%
3.5K
Medicare services in 2024 · #2082 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.
12020 compared with similar codes
Office rates for Massachusetts, from the same CMS release.
No office rate
Use 13160 for extensive or complicated secondary closure of a surgical wound; 12020 is for superficial dehiscence treated with simple closure.
$117.38–$129.97
12001 repairs a new simple laceration by applicable site and length. 12020 treats separation of a previously closed superficial surgical wound.
Compare 12020 by payment locality
Find the payment area for your service address, then open its rate page for calculation inputs, release history and the percentage-of-Medicare tool. A city may cross payment-area boundaries; the ZIP lookup above helps resolve the location.
2 of 2 payment localities
Metropolitan Boston →
Office / nonfacility
$360.42
Facility
$195.71
Rest Of Massachusetts →
Office / nonfacility
$326.53
Facility
$181.28
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12020 billing questions
When should 12020 be selected instead of 12021?
Use 12020 for treatment of superficial wound dehiscence with simple closure. When packing is used, the related code is 12021.
Can 12020 be used for a new laceration?
No. It addresses separation of a previously closed superficial surgical wound; a new laceration is selected from the repair codes according to its site and other coding criteria.
What documentation supports reporting 12020?
Document the prior surgical wound, the dehiscence and its superficial extent, and the simple closure performed. The record should make clear that this was treatment of wound separation rather than repair of a new injury.
Are related postoperative visits separately payable during the global period?
Related postoperative visits during the 10-day global period are included in the procedure payment.
Can modifier 50 or an assistant-at-surgery claim be reported?
Modifier 50 is inappropriate for this code. Medicare does not pay an assistant at surgery for this service.
How are other procedures in the same session handled?
Under the standard multiple procedure reduction, the highest-valued procedure is paid in full and other procedures performed in the same session are paid at 50%.
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.
1,40712016,,Rpr fe/e/en/l/m 12.6-20.0 cm,A,,2.61,4.79,,0.44,,0.61,8.01,3.66,0,000,0.00,0.00,0.00,2,0,1,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
1,40812017,,Rpr fe/e/en/l/m 20.1-30.0 cm,A,,3.10,0.74,NA,0.74,,0.78,4.62,4.62,0,000,0.00,0.00,0.00,2,0,0,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
1,40912018,,Rpr f/e/e/n/l/m >30.0 cm,A,,3.52,0.81,NA,0.81,,0.88,5.21,5.21,0,000,0.00,0.00,0.00,2,0,2,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
1,41012020,,Tx supfc wnd dehsn smpl clsr,A,,2.60,6.45,,2.32,,0.43,9.48,5.35,0,010,0.10,0.80,0.10,2,0,1,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
1,41112021,,Tx supfc wnd dehsn w/packing,A,,1.84,3.39,,1.86,,0.33,5.56,4.03,0,010,0.10,0.80,0.10,2,0,1,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
1,41212031,,Intmd rpr s/a/t/ext 2.5 cm/<,A,,1.95,5.60,,1.81,,0.23,7.78,3.99,0,010,0.10,0.80,0.10,2,0,1,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
1,41312032,,Intmd rpr s/a/t/ext 2.6-7.5,A,,2.46,6.26,,2.22,,0.26,8.98,4.94,0,010,0.10,0.80,0.10,2,0,1,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00