CPT 12006 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 • 21 - Inpatient Hospital |
| Common Modifiers | • None • 59 - Distinct Procedural Service • AG - Primary physician |
| Complexity Level | Moderate |
National average reimbursement for CPT 12006 by major payers:
$257.11
$281.04
$279.08
$342.89
| 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 12006 | ||||||
United | 12006 | $290.00 | 1346969789 - ADVENTHEALTH SURGERY CENTER INNOVATION TOWER, LLC | 882744377 - (FL) ADVENTHEALTH SURGERY CENTER INNOVATION TOWER LLC | FL | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 12006 | $121.00 | 1508839473 - NEWARK ENDOSCOPY ASC LLC, ENDOSCOPY CENTER OF DELAWARE | 621867825 - (DE) NEWARK ENDOSCOPY ASC LLC | DE | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 12006 | $249.00 | 1881129351 - OCONTO HOSPITAL & MEDICAL CENTER, INC., BELLIN HEALTH MARINETTE SURGERY CENTER | 61745397 - OCONTO HOSPITAL & MEDICAL CENTER INC | WI | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 12006 | $109.00 | 1306503057 - PAIN CARE SURGERY OF LOUISVILLE, LLC | 844317137 - (KY) PAIN CARE SURGERY OF LOUISVILLE LLC | KY | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 12006 | $464.00 | 1558511881 - ADVANCED EYE MEDICAL GROUP A PROFESSIONAL CORPORATION, OPHTHALMOLOGY MEDICAL CENTER | 953875237 - (CA) ADVANCED EYE MEDICAL GROUP A PROFESSIONAL CORPORATION | CA | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 12006 | $182.00 | 1194209437 - PRECISION SURGICAL CENTER OF NORTHWEST ARKANSAS, LLC | 830659399 - (AR) PRECISION SURGICAL CENTER OF NORTHWEST ARKANSAS LLC | AR | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 12006 | $935.00 | 1013138536 - WESTERN WASHINGTON MEDICAL GROUP, INC, PS, DBA: GATEWAY SURGERY CENTER | 911602128 - (WA) WESTERN WASHINGTON MEDICAL GROUP, INC., P.S. | WA | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 12006 | $480.00 | 1962903831 - CLIFTON PARK ASC LLC, ORTHONY SURGICAL SUITES | 814670264 - (NY) CLIFTON PARK ASC LLC | NY | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 12006 | $800.00 | 1649922485 - NORTHERN LAKES SURGERY CENTER LLC | 874431494 - (MN) NORTHERN LAKES SURGERY CENTER LLC | MN | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 12006 | $76.00 | 1619244175 - BARRINGTON PAIN AND SPINE INSTITUTE, LLC, BARRINGTON AMBULATORY SURGERY CENTER | 273091392 - (IL) BARRINGTON PAIN AND SPINE INSTITUTE LLC | IL | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 12006 | $500.00 | 1316350275 - ORCHARD SURGICAL CENTER, LLC, ORCHARD SURGICAL CENTER | 465568612 - (NH) ORCHARD SURGICAL CENTER, LLC | NH | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 12006 | $464.00 | 1407116361 - MONTEREY PENINSULA SURGERY CENTER CAPITOLA, CAPITOLA SURGERY CENTER | 770470910 - (CA) MONTEREY PENINSULA SURGERY CENTER, LLC | CA | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 12006 | $935.00 | 1316231020 - DESERT VIEW ENDOSCOPY CENTER, LLC. | 272420135 - (CA) DESERT VIEW ENDOSCOPY CENTER LLC | CA | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 12006 | $935.00 | 1922104710 - OAKS SURGERY CENTER LP | 753019861 - (CA) OAKS SURGERY CENTER LP THE OAK | CA | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 12006 | $57.00 | 1538153994 - SOUTH FLORIDA CENTER FOR ENDOSCOPY & DIGESTIVE DISEASE LLC, KENDALL ENDOSCOPY & SURGERY CENTER | 651112489 - (FL) SOUTH FLORIDA CENTER FOR ENDOSCOPY & DIGESTIVE DISEASE, LLC | FL | Ambulatory Surgical Clinic/Center (261QA1903X) |
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 12006 vs. Other Surgical Procedures on the Integumentary System Codes
The CPT 12006 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 12006 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 |
|---|---|---|
| 12005 | 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 |
| 12006 | Moderate | 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 | Moderate | Simple Repair Of Superficial Wounds Of Scalp, Neck, Axillae, External Genitalia, Trunk And/Or Extremities (Including Hands And Feet); Over 30.0 Cm |
| 12020 | Moderate | Closure 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 12006. These prices vary depending on payer type (Medicare, Medicaid, private insurance), geographic location, and provider contracts.
Understanding the 12006 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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