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CPT 12001 Fee Schedule

Last Verified: January 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.

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

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 LevelLow

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

Select a payer to view fee schedule data

Choose a payer from the options above to see rates for CPT 12001

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 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.

CodeComplexityDescription
12001-CPTLowSimple Repair Of Superficial Wounds Of Scalp, Neck, Axillae, External Genitalia, Trunk And/Or Extremities (Including Hands And Feet); 2.5 Cm Or Less
12002-CPTLowSimple 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-CPTLowSimple 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-CPTModerateClosure Superfic Wound Dehiscence

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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