$465.82–$546.39
Use 12036 for intermediate repairs in the same anatomic group totaling 20.1–30 cm. This code is for a combined length greater than 30 cm.
On this page
CMS RVU26D · Effective 2026-10-01
12037 Intermediate repair Medicare reimbursement rates in Virginia
Reports intermediate layered closure of qualifying scalp, axillary, trunk, or extremity wounds when the combined repair length exceeds 30 cm. Compare 12037 office and facility rates across CMS payment localities in Virginia.
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 12037 in Virginia?
Virginia 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
$519.84–$608.97
2 of 2 localities have a supported rate.
Facility setting
$295.26–$339.84
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 12037: Intermediate repair of a large trunk or limb wound
Reports intermediate layered closure of qualifying scalp, axillary, trunk, or extremity wounds when the combined repair length exceeds 30 cm.
This service covers closure of qualifying wounds in the scalp, axillae, trunk, or extremities other than the hands and feet. Intermediate repair involves layered closure, such as closing deeper subcutaneous tissue and superficial fascia as well as the skin. It may also describe a single-layer closure when a heavily contaminated wound requires extensive cleaning. Physicians and other qualified practitioners commonly perform these repairs in emergency departments, clinics, and operating or procedure rooms.
Select the code when the combined length of intermediate repairs in this anatomic group is more than 30 cm. Document each wound’s location, length, and closure technique, including the deeper-layer work or extensive cleaning that supports intermediate complexity. Related postoperative visits are included in the 10-day global period. When multiple procedures occur in the same session, the highest-valued procedure is paid in full and other procedures are subject to the standard 50% multiple-procedure reduction. Modifier 50 is inappropriate for this code. Assistant-at-surgery and co-surgeon payment require supporting documentation; team surgery is not permitted.
CMS billing rules for 12037
- 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
- Assistant at surgery is paid only with documentation of medical necessity.
- Co-surgeons
- Co-surgeons paid only with supporting documentation.
- Team surgery
- Team surgery not permitted.
Where the value comes from
- Work RVU4.88 · 30%
- Practice expense (office) RVU10.10 · 63%
- Malpractice RVU1.07 · 7%
560
Medicare services in 2024 · #3456 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.
12037 compared with similar codes
Office rates for Virginia, from the same CMS release.
$590.67–$696.05
Both represent intermediate repair, but 12047 is for the neck, hands, feet, or external genitalia rather than this code’s anatomic group.
No office rate
12018 is a simple-repair code for specified facial and mucosal sites with a length over 30 cm. Choose repair complexity and anatomic group, not length alone.
$382.05–$444.97
13101 represents complex repair of a trunk wound in its applicable length range. Use it only when the documented repair meets complex-repair criteria, not merely because a wound is long.
Compare 12037 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
Dc + Md/Va Suburbs →
Office / nonfacility
$608.97
Facility
$339.84
Virginia →
Office / nonfacility
$519.84
Facility
$295.26
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12037 billing questions
How is the length threshold determined when there are several wounds?
Combine the lengths of qualifying intermediate repairs in this anatomic group. Report this code when that combined length is more than 30 cm, and retain each wound’s location and measurement in the record.
What distinguishes intermediate repair from simple repair?
Intermediate repair involves layered closure of deeper tissue along with skin closure, or single-layer closure of a heavily contaminated wound requiring extensive cleaning. A superficial wound closed without those features may support a simple repair code instead.
Can wounds on the hands or feet be included in this code?
No. The 12031–12037 group covers the scalp, axillae, trunk, and extremities other than the hands and feet; those sites are classified in another intermediate-repair group.
Does this code have a postoperative global period?
Yes. Related postoperative visits during the 10-day global period are included in the procedure payment.
Can modifier 50 be used for bilateral wounds?
No. The CMS bilateral adjustment does not apply to this code, and modifier 50 is inappropriate for its descriptor or anatomy.
When can an assistant or co-surgeon be paid?
Assistant-at-surgery payment requires documentation of medical necessity. Co-surgeon payment requires supporting documentation, and team surgery is 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.
1,41412034,,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
1,42012044,,Intmd rpr n-hf/genit7.6-12.5,A,,3.11,8.07,,2.16,,0.44,11.62,5.71,0,010,0.10,0.80,0.10,2,0,1,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00