$316.80–$335.75
Both cover intermediate repair in the same general site group. Choose 12034 for a summed length of 7.6 to 12.5 cm; choose 12035 for 12.6 to 20.0 cm.
On this page
CMS RVU26D · Effective 2026-10-01
12035 Wound repair Medicare reimbursement rates in Michigan
Reports intermediate repair of qualifying scalp, axillary, trunk, or extremity wounds when the summed repair length is 12.6 to 20.0 cm. Compare 12035 office and facility rates across CMS payment localities in Michigan.
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 12035 in Michigan?
Michigan 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
$392.52–$418.59
2 of 2 localities have a supported rate.
Facility setting
$219.31–$235.52
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 12035: Intermediate wound repair, 12.6 to 20 cm
Reports intermediate repair of qualifying scalp, axillary, trunk, or extremity wounds when the summed repair length is 12.6 to 20.0 cm.
This code covers intermediate repair of wounds on the scalp, axillae, trunk, or extremities, excluding the hands and feet. The repair generally closes deeper subcutaneous tissue or superficial fascia as well as the skin. A heavily contaminated wound may qualify when extensive cleaning is needed, even if closure is in one layer. Emergency physicians, surgeons, and other clinicians who repair traumatic or surgical wounds may perform this service in an office, emergency department, or operating room.
Select the code by the qualifying wound site, repair complexity, and summed length of wounds in the same anatomic grouping and repair classification; the total must be 12.6 to 20.0 cm. Document each wound’s location and length, the closure technique and layers repaired, and extensive cleaning when that is the basis for intermediate repair. Related postoperative visits during the 10-day global period are included. When multiple procedures occur in the same session, the highest-valued procedure is paid in full and other procedures are subject to a 50% reduction. Modifier 50 is not appropriate for this code. Assistant-at-surgery payment is restricted, and co-surgeons and team surgery are not permitted.
CMS billing rules for 12035
- 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 RVU3.41 · 28%
- Practice expense (office) RVU8.37 · 68%
- Malpractice RVU0.62 · 5%
5.7K
Medicare services in 2024 · #1792 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.
12035 compared with similar codes
Office rates for Michigan, from the same CMS release.
$456.68–$489.66
Both cover intermediate repair in the same general site group. Choose 12036 when the summed length is 20.1 to 30.0 cm.
$429.81–$458.84
This is the corresponding intermediate-repair length range for neck, hands, feet, or external genitalia; 12035 covers the scalp, axillae, trunk, and other extremities.
$256.25–$275.92
This code describes simple repair at specified face sites in the 12.6-to-20.0-cm range. Use 12035 only for its site group when intermediate-repair criteria are met.
Compare 12035 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
Detroit →
Office / nonfacility
$418.59
Facility
$235.52
Rest Of Michigan →
Office / nonfacility
$392.52
Facility
$219.31
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12035 billing questions
How is 12035 distinguished from 12034 or 12036?
Use 12035 when the qualifying intermediate repairs total 12.6 to 20.0 cm. Code 12034 covers the shorter 7.6-to-12.5-cm range, while 12036 covers 20.1 to 30.0 cm.
Which wound sites belong under 12035?
This code is for qualifying wounds of the scalp, axillae, trunk, or extremities, excluding hands and feet. Neck, hand, foot, and external genitalia repairs are represented in a different intermediate-repair series.
Does a single-layer closure ever qualify as intermediate repair?
Yes. A heavily contaminated wound can qualify when extensive cleaning is required, even if it is closed in one layer. Document the contamination and cleaning performed.
What length should be documented when several wounds are repaired?
Record each wound’s length and site. Lengths may be combined when the wounds share the same repair classification and anatomic grouping; the qualifying total for 12035 is 12.6 to 20.0 cm.
Can modifier 50 be reported for bilateral wounds?
Modifier 50 is not appropriate for 12035. Select and report the repair based on the applicable site, complexity, and length.
Are follow-up visits included after the repair?
Related postoperative visits for 10 days are included in the global period. When other procedures are performed in the same session, the highest-valued procedure is paid in full and others are subject to the standard 50% multiple-procedure 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 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.
1,41212031,,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
1,41412034,,Intmd rpr s/tr/ext 7.6-12.5,A,,2.90,6.73,,2.10,,0.39,10.02,5.39,0,010,0.10,0.80,0.10,2,0,1,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
1,41512035,,Intmd rpr s/a/t/ext 12.6-20,A,,3.41,8.37,,2.69,,0.62,12.40,6.72,0,010,0.10,0.80,0.10,2,0,1,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
1,41612036,,Intmd rpr s/a/t/ext 20.1-30,A,,4.12,9.35,,3.07,,0.90,14.37,8.09,0,010,0.10,0.80,0.10,2,0,1,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
1,41712037,,Intmd rpr s/tr/ext >30.0 cm,A,,4.88,10.10,,3.26,,1.07,16.05,9.21,0,010,0.10,0.80,0.10,2,0,0,1,0,9,,33.4009,09,0,99,0.00,0.00,0.00
1,41812041,,Intmd rpr n-hf/genit 2.5cm/<,A,,2.05,5.57,,1.57,,0.25,7.87,3.87,0,010,0.10,0.80,0.10,2,0,1,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00