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CPT 12001 Fee Schedule

Last Verified: July 2026

Healthcare providers use this code to document and receive reimbursement for visits that address moderate-level medical decision-making, often including multiple diagnoses or prescription management.

Rpr S N Ax Gen Trnk 2 5cm, Simple Repair Of Superficial Wounds Of Scalp Neck Axillae External Genitalia Trunk And Or Extremities Including Hands And Feet 2 5 Cm Or Less
Key FactDetail
Service Type

Repair-Simple Procedures on the Integumentary System

Surgical Repair (Closure) Procedures on the Integumentary System

Common Place of Service

23 - Emergency Room

20 - Urgent Care Facility

Common Modifiers

None

59 - Distinct Procedural Service

AG - Primary physician

Complexity LevelLow
Medicare Fee ScheduleView Medicare rates for 12001

National average reimbursement for CPT 12001 by major payers:

bcbs

$117.23

uhc

$132.25

aetna

$134.10

cigna

$159.97

Preview provider-level rates for...
For billing codeCPT 12001
PayerCodeRateNPITax IDStateSpecialty
United
12001$56.541083840516 - AARTI MANGLANI133971298 - NYU LANGONE HOSPITALSNYPediatrics Physician (208000000X)
United
12001$86.831558626309 - ALINA NAZAR141660131 - (NY) COMMUNITY CARE PHYSICIANS, PLLCNYFamily Medicine Physician (207Q00000X)
United
12001$109.471003851064 - MOSTAQUE AHMED113237480 - (NY) URBAN STRATEGIES-BROOKDALE FAMILY CARE CENTER INCNYInternal Medicine Physician (207R00000X)
United
12001$61.181598924904 - OMESH JHAGROO473923376NYInternal Medicine Physician (207R00000X)
United
12001$166.941194767079 - JOSEPH LURIO133273402 - (NY) THE INSTITUTE FOR FAMILY HEALTHNYFamily Medicine Physician (207Q00000X)
United
12001$149.331063460194 - LAURIE RICE383931355NYInternal Medicine Physician (207R00000X)
United
12001$94.411710931506 - SUSAN ROCKWELL160743024 - (NY) THE FREDERICK FERRIS THOMPSON HOSPI TALNYFamily Medicine Physician (207Q00000X)
United
12001$174.721275827826 - DANIEL MWANZA420698295 - (IA) MERCY MEDICAL CENTERNYSurgery Physician (208600000X)
United
12001$137.111467839035 - NATALIA RIMAREVA132655001 - NEW YORK CITY HEALTH AND HOSPITALS CORPORATIONNYPediatrics Physician (208000000X)
United
12001$525.461386106227 - REBECCA LICHTIN131740114 - MONTEFIORE MEDICAL CENTERNYInternal Medicine Physician (207R00000X)
United
12001$79.941962466813 - FERNANDO GINEBRA113437602 - (NY) WYCKOFF PROFESSIONAL MEDICAL SERVICES PCNYPediatrics Physician (208000000X)
United
12001$203.471689802498 - JASON STERNCHOS453023019 - (NY) NORTH SHORE-LIJ MEDICAL PCNYObstetrics & Gynecology Physician (207V00000X)
United
12001$121.791760876288 - ZOYA GAVRILMAN204985811NYObstetrics & Gynecology Physician (207V00000X)
United
12001$173.441154366474 - AMBROSE PIPIA274719998 - (NY) NEW YORK QUEENS MEDICINE AND SURGERY PCNYFamily Medicine Physician (207Q00000X)
United
12001$72.681942391347 - VINETTE TUMMINGS651166987NYObstetrics & Gynecology Physician (207V00000X)
United
99202$100.0012345678901234567890CACardiologist
United
99202$100.0012345678901234567890CACardiologist
United
99202$100.0012345678901234567890CACardiologist
United
99202$100.0012345678901234567890CACardiologist
United
99202$100.0012345678901234567890CACardiologist
United
99202$100.0012345678901234567890CACardiologist
United
99202$100.0012345678901234567890CACardiologist
United
99202$100.0012345678901234567890CACardiologist
United
99202$100.0012345678901234567890CACardiologist
United
99202$100.0012345678901234567890CACardiologist

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CPT 12001 vs. Other Surgical Repair (Closure) Procedures on the Integumentary System Codes

The CPT 12001 code is part of the Repair-Simple Procedures on the Integumentary System services used for Surgical Repair (Closure) Procedures on the Integumentary System. It represents a moderate-complexity encounter and is one of several codes that vary based on time spent, level of medical decision-making, and documentation requirements.

The CPT 12001 code involves more provider time and moderate medical decision-making, unlike lower-level codes that require less time and simpler assessments. It typically includes multiple diagnoses, medication management, or test interpretation, leading to higher reimbursement and more detailed documentation requirements.

CodeComplexityDescription
12001-CPTLowRpr S N Ax Gen Trnk 2 5cm, Simple Repair Of Superficial Wounds Of Scalp Neck Axillae External Genitalia Trunk And Or Extremities Including Hands And Feet 2 5 Cm Or Less
12002-CPTLowRpr S N Ax Gen Trnk2 6 7 5cm, Simple Repair Of Superficial Wounds Of Scalp Neck Axillae External Genitalia Trunk And Or Extremities Including Hands And Feet 2 6 Cm To 7 5 Cm
12004-CPTLowRpr S N Ax Gen Trk7 6 12 5cm, Simple Repair Of Superficial Wounds Of Scalp Neck Axillae External Genitalia Trunk And Or Extremities Including Hands And Feet 7 6 Cm To 12 5 Cm
12020-CPTModerateRe-Close Surgical Opening, Procedure To Close A Surgical Cut That Has Opened Up. Techniques That May Be Used Include Stitching The Wound Or Inserting A Packing Material For Drainage.

What is a fee schedule?

A fee schedule is a list of fixed prices that healthcare providers charge for specific services, including CPT 12001. These prices vary depending on payer type (Medicare, Medicaid, private insurance), geographic location, and provider contracts.

Understanding the 12001 fee schedule helps patients estimate costs and providers optimize billing for accurate reimbursements.

Factors that affect fee schedules


Medicare & Medicaid Rates

Government-set reimbursement amounts


Private Insurance Rates

Negotiated rates between providers and insurance companies


Geographic Location

Costs may be higher in urban areas.


Provider Type

Hospital providers may have different rates than private practice.

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Frequently Asked Questions