$441.48–$517.64
Use 12045 for the same anatomical grouping and repair type when the total length falls in its shorter band; 12046 requires 20.1–30 cm.
On this page
CMS RVU26D · Effective 2026-10-01
12046 Intermediate repair Medicare reimbursement rates in Virginia
Report this code for intermediate layered closure of wounds totaling 20.1–30 cm on the neck, hands, feet, or external genitalia. Compare 12046 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 12046 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
$539.67–$636.51
2 of 2 localities have a supported rate.
Facility setting
$299.99–$349.28
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 12046: Intermediate wound repair, neck, hands, feet, or genitalia
Report this code for intermediate layered closure of wounds totaling 20.1–30 cm on the neck, hands, feet, or external genitalia.
This code describes intermediate repair of one or more wounds on the neck, hands, feet, or external genitalia, when their reportable lengths total 20.1–30 cm. The closure includes repair of deeper tissue, such as subcutaneous tissue or superficial fascia, as well as skin. Physicians and other qualified practitioners may perform these repairs in settings such as an emergency department or operating room, often after trauma or excision leaves a wound requiring layered closure.
Select the code from the documented repair complexity, anatomical grouping, and total repaired length. Record each wound’s location and length and the layers closed; combine lengths only as permitted within the applicable repair group. This code has a 10-day global period, including related postoperative visits during that period. When multiple 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. Modifier 50 is inappropriate. Assistant-at-surgery payment requires documented medical necessity; co-surgeons and team surgery are not permitted.
CMS billing rules for 12046
- 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 not permitted.
- Team surgery
- Team surgery not permitted.
Where the value comes from
- Work RVU4.19 · 25%
- Practice expense (office) RVU11.37 · 68%
- Malpractice RVU1.12 · 7%
76
Medicare services in 2024 · #5093 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.
12046 compared with similar codes
Office rates for Virginia, from the same CMS release.
$590.67–$696.05
Use 12047 for the same anatomical grouping and repair type when total length exceeds 30 cm; 12046 is for 20.1–30 cm.
$465.82–$546.39
Both represent intermediate repair in the 20.1–30 cm band, but 12036 applies to a different anatomical grouping.
$607.05–$711.10
Use 12056 for intermediate repair of the face or mucous membranes in this length band; 12046 is for the neck, hands, feet, or external genitalia.
Compare 12046 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
$636.51
Facility
$349.28
Virginia →
Office / nonfacility
$539.67
Facility
$299.99
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12046 billing questions
How is the 20.1–30 cm length determined?
Use the documented total repaired length for wounds in this code’s anatomical grouping and repair category. The note should identify each wound’s site and length.
When should I choose this instead of 12045 or 12047?
Choose 12046 when the applicable total length is 20.1–30 cm. Code 12045 covers the immediately shorter length band, while 12047 is for lengths greater than 30 cm.
Can simple closure of the same wound be billed separately?
Do not separately report simple repair for the same wound when the intermediate layered repair includes closure of the skin. The documentation should support the deeper-layer work that makes the repair intermediate.
Should modifier 50 be added for wounds on both sides?
No. CMS identifies bilateral adjustment as inappropriate for this code; report the service based on the applicable wound grouping and documented total length.
What happens when another procedure is performed in the same session?
The highest-valued procedure is paid in full, and other procedures in the session are subject to the standard multiple-procedure reduction. Related postoperative visits during the 10-day global period are included.
Can an assistant or co-surgeon be reported?
Assistant-at-surgery payment is available only when medical necessity is documented. Co-surgeons and team surgery are not permitted for this code.
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.
1,41912042,,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
1,42112045,,Intmd rpr n-hf/genit12.6-20,A,,3.66,9.22,,3.68,,0.70,13.58,8.04,0,010,0.10,0.80,0.10,2,0,1,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
1,42212046,,Intmd rpr n-hf/genit20.1-30,A,,4.19,11.37,,4.07,,1.12,16.68,9.38,0,010,0.10,0.80,0.10,2,0,0,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
1,42312047,,Intmd rpr n-hf/genit >30.0cm,A,,4.83,12.15,,4.23,,1.29,18.27,10.35,0,010,0.10,0.80,0.10,2,0,2,1,0,9,,33.4009,09,0,99,0.00,0.00,0.00
1,42412051,,Intmd rpr face/mm 2.5 cm/<,A,,2.27,5.91,,1.91,,0.29,8.47,4.47,0,010,0.10,0.80,0.10,2,0,1,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
1,42512052,,Intmd rpr face/mm 2.6-5.0 cm,A,,2.80,6.20,,2.03,,0.34,9.34,5.17,0,010,0.10,0.80,0.10,2,0,1,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00