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See a sample rate comparisonCPT 12002 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 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
| 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 AG - Primary physician 59 - Distinct Procedural Service |
| Complexity Level | Low |
| Medicare Fee Schedule | View Medicare rates for 12002 |
| Medicaid Fee Schedule | View Medicaid rates for 12002 |
National average reimbursement for CPT 12002 by major payers:
$148.70
$154.58
$158.04
$188.43
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CPT 12002
5 of 25 sample ratesHigher to lower in this preview
Ochsner Medical Center- Westbank
Ochsner Clinic Foundation
$2,500.00Published rateSouthwest Louisiana Hospital Association Inc, Lake Charles Memorial Hospital
Southwest Louisiana Hospital Association Inc
$669.00Published rateOrthopaedic Clinic Of Monroe, North Louisiana Orthopaedic And Sports Medicine Clinic
Orthopaedic Clinic Of Monroe, Amc
$341.26Published rateSouth Plains Surgery Center LLC
$150.00Published rateCarolina Digestive Diseases, PA
Carolina Digestive Diseases
$77.00Published rate
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See a sample payer proposalCPT 12002 vs. Other Surgical Procedures on the Integumentary System Codes
The CPT 12002 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 12002 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 |
| 12005-CPT | Moderate | Rpr S N A Gen Trk12 6 20 0cm, Simple Repair Of Superficial Wounds Of Scalp Neck Axillae External Genitalia Trunk And Or Extremities Including Hands And Feet 12 6 Cm To 20 0 Cm |
What is a fee schedule?
A fee schedule is a list of fixed prices that healthcare providers charge for specific services, including CPT 12002. These prices vary depending on payer type (Medicare, Medicaid, private insurance), geographic location, and provider contracts.
Understanding the 12002 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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