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See a sample rate comparisonCPT 12005 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 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
| Key Fact | Detail |
|---|---|
| Service Type | Surgery Surgical Procedures on the Integumentary System |
| Common Place of Service | 23 - Emergency Room 21 - Inpatient Hospital |
| Common Modifiers | None 59 - Distinct Procedural Service AG - Primary physician |
| Complexity Level | Moderate |
| Medicare Fee Schedule | View Medicare rates for 12005 |
| Medicaid Fee Schedule | View Medicaid rates for 12005 |
National average reimbursement for CPT 12005 by major payers:
$216.15
$233.95
$237.30
$290.54
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CPT 12005
5 of 25 sample ratesHigher to lower in this preview
Henry Ford Medical Center Fairlane, Henry Ford Health System
Henry Ford Health System
$1,735.00Published rateDoctors Outpatient Surgery Center Of Jupiter, LLC, Laser & Surgery Center Of The Palm Beaches
Drs. Outpatient Surgery Center Of Jupiter, LLC
$574.00Published ratePend Oreille Surgery Center LLC
$383.00Published rateRebecca Schadler
Deaconess Hospital Inc
$132.46Published rateGynemed Surgical Center
$40.00Published rate
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See a sample payer proposalCPT 12005 vs. Other Surgical Procedures on the Integumentary System Codes
The CPT 12005 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 12005 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 |
|---|---|---|
| 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 |
| 12006-CPT | Moderate | Rpr S N A Gen Trk20 1 30 0cm, Simple Repair Of Superficial Wounds Of Scalp Neck Axillae External Genitalia Trunk And Or Extremities Including Hands And Feet 20 1 Cm To 30 0 Cm |
| 12007-CPT | Moderate | Rpr S N Ax Gen Trnk 30 0 Cm, Simple Repair Of Superficial Wounds Of Scalp Neck Axillae External Genitalia Trunk And Or Extremities Including Hands And Feet Over 30 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 12005. These prices vary depending on payer type (Medicare, Medicaid, private insurance), geographic location, and provider contracts.
Understanding the 12005 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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