CPT 12015 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 12015 by major payers:
$219.11
$241.39
$240.20
$291.99
| 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 12015 | ||||||
United | 12015 | $891.00 | 1053303826 - NEW ENGLAND LASER AND COSMETIC SURGERY CENTER LLC | 510480367 | NY | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 12015 | $116.00 | 1477586063 - ATHENS ORTHOPEDIC CLINIC AMBULATORY SURGERY CENTER, LLC | 203378059 - (GA) ATHENS ORTHOPEDIC CLINIC AMBULATORY SURGERY CENTER LLC | GA | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 12015 | $112.00 | 1316406523 - JOHNS HOPKINS SURGERY CENTERS SERIES, GREEN SPRING STATION SURGERY CENTER | 208707724 - (MD) JOHNS HOPKINS SURGERY CENTER SERIES | MD | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 12015 | $935.00 | 1871926428 - CHILDREN 1ST HOUSTON SOUTH, LLC, CHILDREN 1ST DENTAL & SURGERY CENTER | 320417239 | TX | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 12015 | $574.00 | 1144954165 - ADVANCED SURGICAL CARE OF LUTZ, LLC, ADVANCED SURGICAL CARE OF NEW TAMPA | 871390521 - (FL) ADVANCED SURGICAL CARE OF LUTZ LLC | FL | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 12015 | $132.47 | 1225369440 - PHILLIP MARTIN | 350593390 - DEACONESS HOSPITAL INC | TN | Certified Registered Nurse Anesthetist (367500000X) |
United | 12015 | $134.00 | 1740785096 - GASTROINTESTINAL ENDOSCOPY CENTER LLC | 822081770 - (PA) GASTROINTESTINAL ENDOSCOPY CENTER LLC | PA | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 12015 | $192.00 | 1013990308 - AUGUSTA PLASTIC SURGERY CENTER, INC. | 582227057 - (GA) AUGUSTA PLASTIC SURGERY CENTER INC | GA | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 12015 | $1000.00 | 1083220123 - QUEENS SURGICAL CENTER LLC | 471041427 - (NY) QUEENS SURGICAL CENTER LLC | NY | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 12015 | $1301.00 | 1154844553 - LONE STAR ENDOSCOPY CENTER, LLC, LONE STAR ENDOSCOPY SOUTHLAKE | 273635726 | TX | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 12015 | $300.00 | 1174067318 - SKI AMBULATORY SURGICAL CENTERS, LLC | 813831008 - (AZ) SKI AMBULATORY SURGICAL CENTERS LLC | AZ | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 12015 | $115.00 | 1487742680 - NOVAMED SURGERY CENTER OF CLEVELAND LLC, THE SURGERY CENTER OF CLEVELAND | 205493062 - (TN) NOVAMED SURGERY CENTER OF CLEVELAND LLC | TN | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 12015 | $342.00 | 1760454557 - PHOENIX OPHTHALMOLOGY ASC LLC, ARIZONA OPHTHALMIC OUTPATIENT SURGERY | 621726788 - (AZ) PHOENIX OPHTHALMOLOGY ASC LLC | AZ | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 12015 | $935.00 | 1548827637 - HEDWIG ASC, HOUSTON PREMIERSURGERY CENTER THE VILLAGES | 831849530 - (TX) HEDWIG ASC | TX | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 12015 | $1551.00 | 1154454460 - TEXAS HEALTH HARRIS METHODIST HOSPITAL HURST-EULESS-BEDFORD | 751438726 - (TX) TEXAS HEALTH HARRIS METHODIST HOSPITAL HURST-EULESS-BEDFORD | TX | 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 12015 vs. Other Surgical Procedures on the Integumentary System Codes
The CPT 12015 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 12015 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.
What is a fee schedule?
A fee schedule is a list of fixed prices that healthcare providers charge for specific services, including CPT 12015. These prices vary depending on payer type (Medicare, Medicaid, private insurance), geographic location, and provider contracts.
Understanding the 12015 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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