$379.76
Use 12035 for the same general site grouping and intermediate repair method when the total length is 12.6–20 cm. This code covers 20.1–30 cm.
On this page
CMS RVU26D · Effective 2026-10-01
12036 Wound repair Medicare reimbursement rates in Nebraska
Reports intermediate wound closure with layered technique or extensive cleaning for scalp, axilla, trunk, or extremity wounds totaling 20.1 to 30 cm. Compare 12036 office and facility rates across CMS payment localities in Nebraska.
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 12036 in Nebraska?
Nebraska has 1 payment locality in this comparison. Use the service location to choose the applicable amount. These are the supported base rates for the payment area shown below, using the same CMS release.
Office / nonfacility
$437.23
1 of 1 localities have a supported rate.
Payment area: Nebraska
One mapped payment locality.
Facility setting
$243.62
1 of 1 localities have a supported rate.
Payment area: Nebraska
One mapped payment locality.
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 12036: Intermediate Repair of Scalp, Trunk, or Extremities
Reports intermediate wound closure with layered technique or extensive cleaning for scalp, axilla, trunk, or extremity wounds totaling 20.1 to 30 cm.
This code covers intermediate repair of wounds in the scalp, axillae, trunk, or extremities when the total repaired length is 20.1 to 30 cm. A clinician closes the skin and also repairs one or more deeper layers, such as subcutaneous tissue or superficial fascia. It can also describe a single-layer closure of a heavily contaminated wound that requires extensive cleaning or removal of embedded material. Physicians and other qualified clinicians commonly perform these repairs in emergency departments, operating rooms, and office procedure settings.
Choose the code based on the repair method, anatomical grouping, and documented total length—not wound depth alone. For wounds in the same repair class and anatomical grouping, combine their lengths; document each wound’s site, length, tissue layers repaired, and any extensive cleaning. Medicare includes related postoperative visits during the 10-day global 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 descriptor. Medicare does not pay assistant-at-surgery services for this code; co-surgeon and team-surgery billing are not permitted.
CMS billing rules for 12036
- 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 RVU4.12 · 29%
- Practice expense (office) RVU9.35 · 65%
- Malpractice RVU0.90 · 6%
1.2K
Medicare services in 2024 · #2865 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.
12036 compared with similar codes
Office rates for Nebraska, from the same CMS release.
$487.88
Use 12037 for the same general site grouping and intermediate repair method when the total length exceeds 30 cm. This code ends at 30 cm.
$504.62
Both codes represent intermediate repair in the 20.1–30 cm range, but 12046 applies to a different anatomical grouping, including the neck or external genitalia.
No office rate
Code 12017 describes simple repair in a different site grouping. Choose this code when the repair is intermediate and the wound sites and total length fit its descriptor.
Compare 12036 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.
1 of 1 payment localities
Nebraska →
Office / nonfacility
$437.23
Facility
$243.62
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How this local rate is calculated
Each RVU component is multiplied by its own geographic practice cost index (GPCI). The three adjusted components are added, then multiplied by the conversion factor. These are the inputs used for 12036 in Nebraska.
PPRRVU2026_Oct_nonQPP.csv
1,416
- Code
- 12036
- Physician work
- 4.12
- Practice expense
- 9.35
- Malpractice
- 0.90
GPCI2026.csv
72
- Locality
- Nebraska
- Physician work
- 1.000
- Practice expense
- 0.923
- Malpractice
- 0.378
| Component | RVU | Locality factor | Adjusted |
|---|---|---|---|
| Physician work | 4.12 | × 1.000 | 4.1200 |
| Practice expense | 9.35 | × 0.923 | 8.6301 |
| Malpractice | 0.90 | × 0.378 | 0.3402 |
| Total RVUs | 13.0903 | ||
| Conversion factor | × 33.4009 | ||
Office / nonfacility rate, Nebraska$437.23
Explore RVUs, geographic factors and the full formula
Office / nonfacility
| Component | RVU | Local GPCI |
|---|---|---|
| Work | 4.12 | 1 |
| Practice expense | 9.35 | 0.923 |
| Malpractice | 0.9 | 0.378 |
(4.12 × 1 + 9.35 × 0.923 + 0.9 × 0.378) × $33.4009 = $437.23
Facility
| Component | RVU | Local GPCI |
|---|---|---|
| Work | 4.12 | 1 |
| Practice expense | 3.07 | 0.923 |
| Malpractice | 0.9 | 0.378 |
(4.12 × 1 + 3.07 × 0.923 + 0.9 × 0.378) × $33.4009 = $243.62
The office and facility calculations use their respective practice-expense RVUs. The facility amount here is the physician fee, not a separate hospital or facility bill.
12036 billing questions
How is the 20.1–30 cm length determined when there are multiple wounds?
Combine lengths for wounds in the same repair class and anatomical grouping. Keep the documented lengths and sites clear enough to support the total reported.
When is this intermediate repair code appropriate instead of a simple repair code?
Use this code when the repair involves closure of one or more deeper tissue layers in addition to skin, or extensive cleaning of a heavily contaminated wound. A straightforward skin-only closure is a simple repair.
Are related wound checks separately payable during the global period?
Related postoperative visits during the 10-day global period are included in the procedure payment.
Can modifier 50 be used for wounds on both sides of the body?
No. Modifier 50 is inappropriate for this descriptor; report the repair based on the applicable wound group and total length.
How does Medicare handle this repair when other procedures are performed in the same session?
The highest-valued procedure is paid in full, and other procedures subject to the multiple procedure reduction are paid at 50%. Assistant-at-surgery payment is unavailable, and co-surgeon and team-surgery billing are 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 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.
1,41312032,,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
1,41912042,,Intmd rpr n-hf/genit2.6-7.5,A,,2.72,6.11,,2.02,,0.30,9.13,5.04,0,010,0.10,0.80,0.10,2,0,1,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
6905302,MO,01,METROPOLITAN ST. LOUIS,1.000,0.952,1.002
7005302,MO,99,REST OF MISSOURI,1.000,0.862,0.974
7103202,MT,01,MONTANA**,1.000,1.000,0.998
7205402,NE,00,NEBRASKA,1.000,0.923,0.378
7301312,NV,00,NEVADA**,1.000,1.001,0.833
7414312,NH,40,NEW HAMPSHIRE,1.000,1.041,0.875
7512402,NJ,01,NORTHERN NJ,1.063,1.160,1.068