$153.02
Use 12004 for simple repairs at the covered body sites when the applicable total length is 7.6–12.5 cm; this code begins at 12.6 cm.
On this page
CMS RVU26D · Effective 2026-10-01
12005 Simple wound repair Medicare reimbursement rates in Ohio
Reports simple, one-layer closure of superficial wounds on specified body sites when the combined repair length falls between 12.6 and 20.0 cm. Compare 12005 office and facility rates across CMS payment localities in Ohio.
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 12005 in Ohio?
Ohio 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
$199.67
1 of 1 localities have a supported rate.
Payment area: Ohio
One mapped payment locality.
Facility setting
$88.98
1 of 1 localities have a supported rate.
Payment area: Ohio
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 12005: Simple trunk and scalp wound repair
Reports simple, one-layer closure of superficial wounds on specified body sites when the combined repair length falls between 12.6 and 20.0 cm.
This code covers straightforward, one-layer closure of superficial wounds involving the epidermis, dermis, or superficial subcutaneous tissue, without deeper structural repair. The covered sites are the scalp, neck, axillae, external genitalia, and trunk. Emergency clinicians, surgeons, and other qualified practitioners may perform these repairs in an emergency department, office, or outpatient setting. A typical case is a long, uncomplicated laceration of the trunk closed in a single layer.
Select the code using the documented repair length and covered body site. When multiple wounds belong to the same repair category and anatomic grouping, combine their lengths for code selection; document each wound’s location, length, and closure technique. CMS assigns a 0-day global period, so same-day preoperative and postoperative care is included. When other procedures are performed in the same session, the highest-valued procedure is paid in full and other procedures are subject to the standard multiple-procedure reduction. Assistant-at-surgery services are not paid, and co-surgeons and team surgery are not permitted.
CMS billing rules for 12005
- Global period
- Minor procedure with a 0-day global period: same-day preoperative and postoperative care is 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 RVU1.92 · 30%
- Practice expense (office) RVU3.97 · 63%
- Malpractice RVU0.43 · 7%
5.3K
Medicare services in 2024 · #1830 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.
12005 compared with similar codes
Office rates for Ohio, from the same CMS release.
$227.65
Use 12006 for simple repairs at the covered body sites when the applicable total length is 20.1–30.0 cm; this code ends at 20.0 cm.
$390.01
12035 describes intermediate repair at its covered sites, requiring a different repair approach such as layered closure. This code is for simple one-layer repair.
$253.79
Both codes cover simple repair lengths of 12.6–20.0 cm, but 12016 is for specified facial and related sites; this code covers the scalp, neck, axillae, external genitalia, and trunk.
Compare 12005 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
Ohio →
Office / nonfacility
$199.67
Facility
$88.98
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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 12005 in Ohio.
PPRRVU2026_Oct_nonQPP.csv
1,399
- Code
- 12005
- Physician work
- 1.92
- Practice expense
- 3.97
- Malpractice
- 0.43
GPCI2026.csv
85
- Locality
- Ohio
- Physician work
- 1.000
- Practice expense
- 0.913
- Malpractice
- 1.008
| Component | RVU | Locality factor | Adjusted |
|---|---|---|---|
| Physician work | 1.92 | × 1.000 | 1.9200 |
| Practice expense | 3.97 | × 0.913 | 3.6246 |
| Malpractice | 0.43 | × 1.008 | 0.4334 |
| Total RVUs | 5.9781 | ||
| Conversion factor | × 33.4009 | ||
Office / nonfacility rate, Ohio$199.67
Explore RVUs, geographic factors and the full formula
Office / nonfacility
| Component | RVU | Local GPCI |
|---|---|---|
| Work | 1.92 | 1 |
| Practice expense | 3.97 | 0.913 |
| Malpractice | 0.43 | 1.008 |
(1.92 × 1 + 3.97 × 0.913 + 0.43 × 1.008) × $33.4009 = $199.67
Facility
| Component | RVU | Local GPCI |
|---|---|---|
| Work | 1.92 | 1 |
| Practice expense | 0.34 | 0.913 |
| Malpractice | 0.43 | 1.008 |
(1.92 × 1 + 0.34 × 0.913 + 0.43 × 1.008) × $33.4009 = $88.98
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.
12005 billing questions
How is this code distinguished from 12004 or 12006?
All three cover simple repairs at the same general body sites. Choose by the documented total repair length: 12004 covers 7.6–12.5 cm, this code covers 12.6–20.0 cm, and 12006 covers 20.1–30.0 cm.
Can the lengths of multiple wounds be combined?
Combine lengths when the wounds are in the same repair category and anatomic grouping. Record the location and length of each wound so the reported total can be supported.
When would 12035 be considered instead?
Consider 12035 for an intermediate repair in its covered sites, such as the scalp, axilla, or trunk, when the wound requires layered closure rather than a simple one-layer repair. The repair method and documented complexity, not length alone, distinguish the codes.
Is modifier 50 appropriate for repairs on both sides?
No. CMS identifies bilateral adjustment as inappropriate for this code; report the repair based on the applicable wound lengths and sites rather than applying modifier 50.
What same-day care is included, and how are other procedures handled?
The 0-day global period includes same-day preoperative and postoperative care. If other procedures are performed in the same session, the highest-valued procedure is paid in full and the others are subject to the standard multiple-procedure reduction.
Can an assistant or additional surgeon be reported for this repair?
Assistant-at-surgery services are not paid for this code. CMS also does not permit co-surgeons or team surgery.
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.
1,39612001,,Rpr s/n/ax/gen/trnk 2.5cm/<,A,,0.82,2.41,,0.32,,0.18,3.41,1.32,0,000,0.00,0.00,0.00,2,0,1,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
1,39712002,,Rpr s/n/ax/gen/trnk2.6-7.5cm,A,,1.11,2.82,,0.37,,0.24,4.17,1.72,0,000,0.00,0.00,0.00,2,0,1,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
1,39812004,,Rpr s/n/ax/gen/trk7.6-12.5cm,A,,1.40,3.12,,0.43,,0.33,4.85,2.16,0,000,0.00,0.00,0.00,2,0,1,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
1,39912005,,Rpr s/n/a/gen/trk12.6-20.0cm,A,,1.92,3.97,,0.34,,0.43,6.32,2.69,0,000,0.00,0.00,0.00,2,0,1,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
1,40012006,,Rpr s/n/a/gen/trk20.1-30.0cm,A,,2.33,4.35,,0.43,,0.51,7.19,3.27,0,000,0.00,0.00,0.00,2,0,1,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
1,40112007,,Rpr s/n/ax/gen/trnk >30.0 cm,A,,2.83,4.21,,0.56,,0.62,7.66,4.01,0,000,0.00,0.00,0.00,2,0,1,1,0,9,,33.4009,09,0,99,0.00,0.00,0.00
1,4021200F,,Seizure type& frequ docd,I,,0.00,0.00,,0.00,,0.00,0.00,0.00,9,XXX,0.00,0.00,0.00,9,9,9,9,9,9,,33.4009,09,0,99,0.00,0.00,0.00
8213282,NY,99,REST OF NEW YORK,1.000,0.950,0.703
8311502,NC,00,NORTH CAROLINA,1.000,0.933,0.639
8403302,ND,01,NORTH DAKOTA**,1.000,1.000,0.406
8515202,OH,00,OHIO,1.000,0.913,1.008
8604312,OK,00,OKLAHOMA,1.000,0.893,0.777
8702302,OR,01,PORTLAND,1.016,1.111,0.744
8802302,OR,99,REST OF OREGON,1.000,0.996,0.703