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See a sample rate comparisonCPT 12001 Fee Schedule
Last Verified: September 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 Fact | Detail |
|---|---|
| Service Type | Surgery Surgical 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 Level | Low |
| Medicare Fee Schedule | View Medicare rates for 12001 |
| Medicaid Fee Schedule | View Medicaid rates for 12001 |
National average reimbursement for CPT 12001 by major payers:
$117.23
$132.25
$134.10
$159.97
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CPT 12001
5 of 25 sample ratesHigher to lower in this preview
Rebecca Lichtin
Montefiore Medical Center
$525.46Published rateAkaraphan Sukanthanag
$149.33Published rateMostaque Ahmed
Urban Strategies-Brookdale Family Care Center Inc
$109.47Published rateFernando Ginebra
Wyckoff Professional Medical Services PC
$79.94Published rateAarti Manglani
NYU Langone Hospitals
$56.54Published rate
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See a sample payer proposalCPT 12001 vs. Other Surgical Procedures on the Integumentary System Codes
The CPT 12001 code is part of the Surgery services used for Surgical 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.
| Code | Complexity | Description |
|---|---|---|
| 12001-CPT | Low | 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 |
| 12002-CPT | Low | Rpr 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-CPT | Low | Rpr 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-CPT | Moderate | Re-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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