Billing code 12002: Wound repairMedicare rate & RVUs in Utah
Reports simple, one-layer closure of a 2.6–7.5 cm superficial wound on the scalp, neck, trunk, axilla, external genitalia, or extremities.
Medicare pays $132.81 for 12002 in the office in Utah (Utah). 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 12002 covers
12002 covers simple closure of a superficial wound with a single layer of sutures, staples, or another closure method. The repair is appropriate when the wound involves skin and superficial tissue without the layered closure or other features that call for an intermediate repair. Common settings include an emergency department, urgent care clinic, or office, with the closure performed by a physician or other treating clinician. Eligible sites include the scalp, neck, axilla, external genitalia, trunk, and extremities, including hands and feet.
Select the code using the combined length of qualifying simple wounds in the same anatomic grouping; document each wound’s site, length, and repair method. The total must fall from 2.6 through 7.5 cm. Medicare assigns a 0-day global period, so same-day preoperative and postoperative care is included. For multiple procedures in one session, the highest-valued procedure is paid in full and other procedures are subject to a 50% reduction. Modifier 50 is inappropriate for this code. Medicare does not pay an assistant at surgery; 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.
12002 in Utah
| Payment locality | Office | Facility |
|---|---|---|
| Utah | $132.81 | $55.89 |
How the 12002 rate is calculated
Each of 12002’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 · 12002
RVUs × geographic indexes × conversion factor
Swap in your local Medicare rate.
Work 1.11Practice expense 2.82Malpractice 0.24
All indexes start at 1.000 (the national rate). Enter a ZIP or drag a slider.
Payment rules and modifiers for 12002
The CMS indicators that decide how 12002 is paid alongside other services.
CMS payment indicators · 12002
Wound repair
| Rule | CMS value | What it means |
|---|---|---|
| Global period | 000 | Same-day global: pre- and post-op care on the day of the procedure is 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. |
What modifiers do to the payment
Modifier 51 · payment effect
With and without the modifier
12002 without 51 · national office
$139.28
Wound repair
12002-51 · Second procedure: 50%
$69.64
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%).
12002 compared with similar codes
Compare codes
12002 vs 12001 vs 12004 vs 12011 vs 12032: national Medicare rates
Swap in your local Medicare rate.
How to choose
- 12001Simple wound repair
- Both describe simple repair in the same site grouping. Choose 12001 when the combined length is 2.5 cm or less; 12002 starts at 2.6 cm.
- 12004Simple wound repair
- Both describe simple repair in the same site grouping. Choose 12004 when the combined length is 7.6–12.5 cm, rather than the 2.6–7.5 cm range for 12002.
- 12011Wound repair
- 12011 is for simple repairs of the face, ears, eyelids, nose, lips, or mucous membranes. 12002 is for its separate scalp, neck, axilla, external genitalia, trunk, and extremity grouping.
- 12032Intermediate repair
- 12032 is an intermediate repair code for a 2.6–7.5 cm wound in the corresponding site grouping. Use 12002 for a simple, single-layer repair.
12002 billing questions
How is 12002 distinguished from 12001 or 12004?
Use the combined length of the qualifying simple repairs in the same anatomic grouping: 12001 covers 2.5 cm or less, 12002 covers 2.6–7.5 cm, and 12004 covers 7.6–12.5 cm.
Can lengths of multiple wounds be added together?
Yes, when the wounds are simple repairs in the same anatomic grouping. Document each wound’s location and length; do not combine wounds from different groupings to reach this code’s range.
When should an intermediate repair be reported instead?
Use an intermediate repair code when the closure involves qualifying layered repair or other features that make the repair more than simple. For the same 2.6–7.5 cm length range and relevant site grouping, compare 12032.
Should modifier 50 be appended for wounds on both sides?
No. CMS identifies bilateral adjustment as inappropriate for 12002; do not report modifier 50 for this code.
How does Medicare handle 12002 with another procedure in the same session?
The highest-valued procedure is paid in full, and other procedures in the same session are subject to the standard 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 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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