CPT 12002 Fee Schedule
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.
| 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 |
National average reimbursement for CPT 12002 by major payers:
$148.70
$154.58
$158.04
$188.43
| Payer | Code | Rate | NPI | Tax ID | State | Specialty |
|---|---|---|---|---|---|---|
Select a payer to view fee schedule data Choose a payer from the options above to see rates for CPT 12002 | ||||||
United | 12002 | $1969.00 | 1649273434 - BAYLOR REGIONAL MEDICAL CENTER AT PLANO, BAYLOR SCOTT & WHITE MEDICAL CENTER - PLANO | 820551704 - (TX) BAYLOR REGIONAL MEDICAL CENTER AT PLANO | TX | General Acute Care Hospital (282N00000X) |
United | 12002 | $198.85 | 1053367276 - ELIZABETH WEAVER | 310667480 - (OH) PROFESSIONAL RADIOLOGY, INC. | OH | Diagnostic Radiology Physician (2085R0202X) |
United | 12002 | $401.00 | 1356399539 - FRANKLIN PARISH HOSPITAL SERVICE DISTRICT NO1, FRANKLIN MEDICAL CENTER | 720685044 - (LA) FRANKLIN MEDICAL CENTER EMPLOYEE BENEFIT PLAN TRUST | LA | Rural Acute Care Hospital (282NR1301X) |
United | 12002 | $574.00 | 1730175159 - CHARLOTTE ENDOSCOPIC SURGERY CENTER LLC, CHARLOTTE SURGERY CENTER | 651071112 - (FL) CHARLOTTE ENDOSCOPIC SURGERY CENTER, LLC | FL | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 12002 | $200.00 | 1912547746 - PORT ARTHUR SURGICAL CENTER, LLC, GULF COAST SURGERY CENTER | 843158723 - (TX) PORT ARTHUR SURGICAL CENTER LLC | TX | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 12002 | $935.00 | 1538667035 - CARTHAGE HOSPITAL, LLC | 824005981 | TX | General Acute Care Hospital (282N00000X) |
United | 12002 | $2500.00 | 1831209048 - OCHSNER MEDICAL CENTER- WESTBANK | 720502505 - (LA) OCHSNER CLINIC FOUNDATION | LA | General Acute Care Hospital (282N00000X) |
United | 12002 | $145.00 | 1912627712 - CENTER FOR ROBOTIC SURGERY OF LOUISIANA LLC | 883537315 - CENTER FOR ROBOTIC SURGERY OF LOUISIANA LLC | LA | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 12002 | $77.00 | 1023257300 - CAROLINA DIGESTIVE DISEASES, PA | 202989799 - (NC) CAROLINA DIGESTIVE DISEASES | NC | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 12002 | $935.00 | 1487655627 - UNION PINES SURGERY CENTER,LLC | 731622427 - (OK) UNION PINES SURGERY CENTER, LLC | OK | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 12002 | $136.00 | 1073505616 - THIBODAUX LASER AND SURGERY CENTER, LLC | 364463537 | LA | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 12002 | $551.00 | 1285689133 - EAST TEXAS MEDICAL CENTER JACKSONVILLE | 824037220 | TX | General Acute Care Hospital (282N00000X) |
United | 12002 | $92.00 | 1821279720 - NEW ORLEANS LA UPTOWN WEST BANK ENDOSCOPY ASC LLC, MGA GASTROINTESTINAL DIAGNOSTIC AND THERAPEUTIC CENTER | 205904530 | LA | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 12002 | $185.99 | 1336467323 - BRIAN ETIER | 462605366 - (LA) UNIVERSITY HOSPITAL & CLINICS INC | LA | Orthopaedic Surgery Physician (207X00000X) |
United | 12002 | $1772.00 | 1124305065 - BAYLOR SCOTT & WHITE MEDICAL CENTERS, BAYLOR SCOTT & WHITE MEDICAL CENTER - MCKINNEY | 751037591 - (TX) BAYLOR MEDICAL CENTERS AT GARLAND AND MCKINNEY | TX | General Acute Care Hospital (282N00000X) |
United | 99202 | $100.00 | 1234567890 | 1234567890 | CA | Cardiologist |
United | 99202 | $100.00 | 1234567890 | 1234567890 | CA | Cardiologist |
United | 99202 | $100.00 | 1234567890 | 1234567890 | CA | Cardiologist |
United | 99202 | $100.00 | 1234567890 | 1234567890 | CA | Cardiologist |
United | 99202 | $100.00 | 1234567890 | 1234567890 | CA | Cardiologist |
United | 99202 | $100.00 | 1234567890 | 1234567890 | CA | Cardiologist |
United | 99202 | $100.00 | 1234567890 | 1234567890 | CA | Cardiologist |
United | 99202 | $100.00 | 1234567890 | 1234567890 | CA | Cardiologist |
United | 99202 | $100.00 | 1234567890 | 1234567890 | CA | Cardiologist |
United | 99202 | $100.00 | 1234567890 | 1234567890 | CA | Cardiologist |
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CPT 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 | 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 | 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 | 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 | 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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