$106.36
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.
On this page
CMS RVU26D · Effective 2026-10-01
12002 Wound repair Medicare reimbursement rates in Wisconsin
Reports simple, one-layer closure of a 2.6–7.5 cm superficial wound on the scalp, neck, trunk, axilla, external genitalia, or extremities. Compare 12002 office and facility rates across CMS payment localities in Wisconsin.
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 12002 in Wisconsin?
Wisconsin 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
$129.78
1 of 1 localities have a supported rate.
Payment area: Wisconsin
One mapped payment locality.
Facility setting
$51.38
1 of 1 localities have a supported rate.
Payment area: Wisconsin
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 12002: Simple wound repair, 2.6–7.5 cm
Reports simple, one-layer closure of a 2.6–7.5 cm superficial wound on the scalp, neck, trunk, axilla, external genitalia, or extremities.
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.
CMS billing rules for 12002
- 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 RVU1.11 · 27%
- Practice expense (office) RVU2.82 · 68%
- Malpractice RVU0.24 · 6%
122.5K
Medicare services in 2024 · #508 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.
12002 compared with similar codes
Office rates for Wisconsin, from the same CMS release.
$149.99
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.
$130.22
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.
$285.15
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.
Compare 12002 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
Wisconsin →
Office / nonfacility
$129.78
Facility
$51.38
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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 12002 in Wisconsin.
PPRRVU2026_Oct_nonQPP.csv
1,397
- Code
- 12002
- Physician work
- 1.11
- Practice expense
- 2.82
- Malpractice
- 0.24
GPCI2026.csv
111
- Locality
- Wisconsin
- Physician work
- 1.000
- Practice expense
- 0.958
- Malpractice
- 0.308
| Component | RVU | Locality factor | Adjusted |
|---|---|---|---|
| Physician work | 1.11 | × 1.000 | 1.1100 |
| Practice expense | 2.82 | × 0.958 | 2.7016 |
| Malpractice | 0.24 | × 0.308 | 0.0739 |
| Total RVUs | 3.8855 | ||
| Conversion factor | × 33.4009 | ||
Office / nonfacility rate, Wisconsin$129.78
Explore RVUs, geographic factors and the full formula
Office / nonfacility
| Component | RVU | Local GPCI |
|---|---|---|
| Work | 1.11 | 1 |
| Practice expense | 2.82 | 0.958 |
| Malpractice | 0.24 | 0.308 |
(1.11 × 1 + 2.82 × 0.958 + 0.24 × 0.308) × $33.4009 = $129.78
Facility
| Component | RVU | Local GPCI |
|---|---|---|
| Work | 1.11 | 1 |
| Practice expense | 0.37 | 0.958 |
| Malpractice | 0.24 | 0.308 |
(1.11 × 1 + 0.37 × 0.958 + 0.24 × 0.308) × $33.4009 = $51.38
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.
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 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.
1,39411982,,Remove drug implant device,A,,1.31,1.89,,0.35,,0.23,3.43,1.89,0,000,0.00,0.00,0.00,2,0,0,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
1,39511983,,Remove/insert drug implant,A,,1.86,2.13,,0.46,,0.34,4.33,2.66,0,000,0.00,0.00,0.00,2,0,0,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
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
10802402,WA,02,SEATTLE (KING CNTY),1.050,1.227,0.817
10902402,WA,99,REST OF WASHINGTON,1.013,1.053,0.761
11011402,WV,16,WEST VIRGINIA,1.000,0.869,1.431
11106302,WI,00,WISCONSIN,1.000,0.958,0.308
11203602,WY,21,WYOMING**,1.000,1.000,0.740
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