Billing code 12046: Intermediate repairMedicare rate & RVUs in Washington
Report this code for intermediate layered closure of wounds totaling 20.1–30 cm on the neck, hands, feet, or external genitalia.
Medicare pays $570.13–$643.49 for 12046 in the office in Washington, from Rest Of Washington to Seattle (King Cnty). 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 12046 covers
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.
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.
Where 12046 pays more and less in Washington
| Payment locality | Office | Facility |
|---|---|---|
| Rest Of Washington | $570.13 | $313.38 |
| Seattle (King Cnty) | $643.49 | $344.31 |
How the 12046 rate is calculated
Each of 12046’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 · 12046
RVUs × geographic indexes × conversion factor
Work4.19
4.19 RVUs× 1.000 GPCI
Practice expense11.37
11.37 RVUs× 1.000 GPCI
Malpractice1.12
1.12 RVUs× 1.000 GPCI
Adjusted RVUs
16.6800
Conversion factor
$33.4009
Medicare rate
$557.13
Every GPCI starts at 1.000, the national rate. Enter a ZIP or drag a slider.
Payment rules and modifiers for 12046
12046 has a 10-day global period: related visits in that window are included in the surgery payment.
CMS payment indicators · 12046
Intermediate repair
| Rule | CMS value | What it means |
|---|---|---|
| Global period | 010 | Minor procedure: the day of the procedure plus 10 days after are 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) | 0 | Not paid without supporting documentation. |
| Co-surgeons (62) | 0 | Not permitted. |
| Team surgery (66) | 0 | Not permitted. |
| Professional/technical | 0 | Physician service: no professional/technical split. |
| Split (54/55/56) | 0.10/0.80/0.10 | Share of the payment for pre-op, the procedure itself, and post-op care. |
Global surgery period · 12046
Intermediate repair
10-day global period ends
Oct 11, 2026
Covers Oct 1, 2026 through Oct 11, 2026 (11 days).
Visit on Oct 31, 2026
After the global period ends: visits and procedures are billed normally.
What modifiers do to the payment
Modifier 51 · payment effect
With and without the modifier
12046 without 51 · national office
$557.13
Intermediate repair
12046-51 · Second procedure: 50%
$278.57
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%).
12046 compared with similar codes
Compare codes · National
5 codes, side by side
How to choose
- 12045Intermediate wound repair
- 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.
- 12047Intermediate repair
- Use 12047 for the same anatomical grouping and repair type when total length exceeds 30 cm; 12046 is for 20.1–30 cm.
- 12036Wound repair
- Both represent intermediate repair in the 20.1–30 cm band, but 12036 applies to a different anatomical grouping.
- 12056Wound repair
- 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.
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 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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