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See a sample rate comparisonCPT 12001 Fee Schedule
Medicare rates as of October 2026
CPT 12001 is classified under Surgery, in the Surgical Procedures on the Integumentary System subgroup.
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 | 59 - Distinct Procedural Service AG - Primary physician |
| Complexity Level | Low |
| Medicare Fee Schedule | $113.90 national non-facility rate (2026) · View Medicare rates for 12001 |
| Medicaid Fee Schedule | $86.45 median across 45 state programs · View Medicaid rates for 12001 |
National average reimbursement for CPT 12001 by major payers:
$117.23
BCBS / Anthem
$132.25
UnitedHealthcare
$134.10
Aetna
$159.97
Cigna
Compare published rates across providers.
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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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Payer Contract Negotiation
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See a sample payer proposalCPT 12001 vs. Other Surgical Procedures on the Integumentary System Codes
The table lists codes related to 12001. Select one to see its fee schedule.
| 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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Frequently Asked Questions
CPT 12001 is a Current Procedural Terminology code for the simple repair of superficial wounds of the scalp, neck, axillae, external genitalia, trunk, and/or extremities (including hands and feet) that are 2.5 cm or less.
PayerPrice provides access to negotiated rates for billing codes like CPT 12001, allowing users to benchmark current rates, identify opportunities for rate optimization, and integrate real-time payer data into workflows for contract negotiation and market prospecting.