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See a sample rate comparisonCPT 12013 Fee Schedule
Last Verified: October 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 F E E N L M 2 6 5 0 Cm, Simple Repair Of Superficial Wounds Of Face Ears Eyelids Nose Lips And Or Mucous Membranes 2 6 Cm To 5 0 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 59 - Distinct Procedural Service AG - Primary physician |
| Complexity Level | Low |
| Medicare Fee Schedule | View Medicare rates for 12013 |
| Medicaid Fee Schedule | View Medicaid rates for 12013 |
National average reimbursement for CPT 12013 by major payers:
$146.91
$164.68
$170.22
$199.48
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CPT 12013
5 of 25 sample ratesHigher to lower in this preview
Glastonbury Surgery Center, LLC
$1,543.00Published rateAdvanced Surgical Care Of Clearwater LLC
$555.00Published rateOphthalmic Surgery Center, LLC
Ophthalmic Surgery Center LLC
$185.00Published rateNorthwest Surgery Center, Inc
Northwest Surgery Center Inc
$154.00Published rateKeystone Kidney Associates, PC
Keystone Kidney Associates PC
$77.00Published rate
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Payer Contract Negotiation
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See a sample payer proposalCPT 12013 vs. Other Surgical Procedures on the Integumentary System Codes
The CPT 12013 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 12013 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 |
|---|---|---|
| 12011-CPT | Low | Rpr F E E N L M 2 5 Cm, Simple Repair Of Superficial Wounds Of Face Ears Eyelids Nose Lips And Or Mucous Membranes 2 5 Cm Or Less |
| 12013-CPT | Low | Rpr F E E N L M 2 6 5 0 Cm, Simple Repair Of Superficial Wounds Of Face Ears Eyelids Nose Lips And Or Mucous Membranes 2 6 Cm To 5 0 Cm |
| 12014-CPT | Low | Rpr F E E N L M 5 1 7 5 Cm, Simple Repair Of Superficial Wounds Of Face Ears Eyelids Nose Lips And Or Mucous Membranes 5 1 Cm To 7 5 Cm |
| 12015-CPT | Moderate | Rpr F E E N L M 7 6 12 5 Cm, Simple Repair Of Superficial Wounds Of Face Ears Eyelids Nose Lips And Or Mucous Membranes 7 6 Cm To 12 5 Cm |
What is a fee schedule?
A fee schedule is a list of fixed prices that healthcare providers charge for specific services, including CPT 12013. These prices vary depending on payer type (Medicare, Medicaid, private insurance), geographic location, and provider contracts.
Understanding the 12013 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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