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CPT 12018 Fee Schedule

Last Verified: January 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.

Simp Rpr Face Ear Etc Over 30.0 Cm
Key FactDetail
Service Type

Surgery

Surgical Procedures on the Integumentary System

Common Place of Service

23 - Emergency Room

11 - Office

20 - Urgent Care Facility

Common Modifiers

None

59 - Distinct Procedural Service

GC - Service performed by resident under supervision

Complexity LevelModerate

National average reimbursement for CPT 12018 by major payers:

bcbs

$265.61

uhc

$275.49

aetna

$259.22

cigna

$318.79

Preview provider-level rates for...
For billing codeCPT 12018
PayerCodeRateNPITax IDStateSpecialty

Select a payer to view fee schedule data

Choose a payer from the options above to see rates for CPT 12018

United
12018$6500.001437459617 - UNION HEALTH SERVICES, LLC, ATRIUM HEALTH SURGERY CENTER INDIAN TRAIL300597871 - (NC) UNION HEALTH SERVICES LLCNCAmbulatory Surgical Clinic/Center (261QA1903X)
United
12018$77.001811932270 - PHILADELPHIA SURGI CENTER, INC.232965126PAAmbulatory Surgical Clinic/Center (261QA1903X)
United
12018$99.001114177417 - NISENFELD & CHILTON, MD PA, ORTHOPAEDIC ASSOCIATES OF FREDERICK, ASC521135399 - (MD) NISENFELD & CHILTON, M.D., P.A.MDAmbulatory Surgical Clinic/Center (261QA1903X)
United
12018$574.001104246446 - PACIFIC ENDOSCOPY CENTER LLC203905706 - (HI) PACIFIC ENDOSCOPY CENTER, LLCHIAmbulatory Surgical Clinic/Center (261QA1903X)
United
12018$225.001679001028 - CENTERVIEW SURGERY CENTER, LLC815461133 - (AR) CENTERVIEW SURGERY CENTER LLCARAmbulatory Surgical Clinic/Center (261QA1903X)
United
12018$73.001962743310 - WF ENDOSCOPY CENTER LLC611578919NCAmbulatory Surgical Clinic/Center (261QA1903X)
United
12018$65.001811001548 - AMBULATORY SURGERY CENTER OF OPELOUSAS721502278 - (LA) AMBULATORY SURGERY CENTER OF OLAAmbulatory Surgical Clinic/Center (261QA1903X)
United
12018$1453.001821242488 - SPECIALTY SURGICAL CENTER OF NORTH BRUNSWICK, LLC208770654 - (NJ) SPECIALTY SURGICAL CENTER OF NNJAmbulatory Surgical Clinic/Center (261QA1903X)
United
12018$906.001477516961 - CENTRUM SURGERY CENTER LTD752546712 - (CO) CENTRUM SURGERY CENTER LTDCOAmbulatory Surgical Clinic/Center (261QA1903X)
United
12018$150.001396142733 - DIALYSIS ACCESS SERVICES, LLC472322456 - (MD) DIALYSIS ACCESS SERVICES LLCMDAmbulatory Surgical Clinic/Center (261QA1903X)
United
12018$149.001386677326 - INLAND EYE SPECIALISTS A MEDICAL CORP, INLAND EYE SPECIALISTS330585144 - (CA) INLAND EYE SPECIALISTS, A MEDICAL CORPORATIONCAAmbulatory Surgical Clinic/Center (261QA1903X)
United
12018$555.001801146535 - SURGCENTER AT PARADISE VALLEY, LLC, SURGCENTER AT PIMA CROSSING455364868 - (AZ) SURGCENTER AT PARADISE VALLEYAZAmbulatory Surgical Clinic/Center (261QA1903X)
United
12018$500.001316233612 - CPMSC CARROLLTON274203105 - (GA) CPMSC CARROLLTONGAAmbulatory Surgical Clinic/Center (261QA1903X)
United
12018$935.001770072803 - PACIFIC VASCUCARE SURGERY CENTER823288521 - (CA) PACIFIC VASCUCARE SURGERY CENTERCAAmbulatory Surgical Clinic/Center (261QA1903X)
United
12018$85.001386833044 - THE POTTSVILLE PA ENDOSCOPY ASC LP, SCHUYLKILL ENDOSCOPY CENTER260303896PAAmbulatory Surgical Clinic/Center (261QA1903X)
United
99202$100.0012345678901234567890CACardiologist
United
99202$100.0012345678901234567890CACardiologist
United
99202$100.0012345678901234567890CACardiologist
United
99202$100.0012345678901234567890CACardiologist
United
99202$100.0012345678901234567890CACardiologist
United
99202$100.0012345678901234567890CACardiologist
United
99202$100.0012345678901234567890CACardiologist
United
99202$100.0012345678901234567890CACardiologist
United
99202$100.0012345678901234567890CACardiologist
United
99202$100.0012345678901234567890CACardiologist

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CPT 12018 vs. Other Surgical Procedures on the Integumentary System Codes

The CPT 12018 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 12018 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.

CodeComplexityDescription
12016-CPTModerateSimp Rpr Face Ear Etc 12.6-20.0 Cm
12017-CPTModerateRep Simple Face Adnexa 20.0-30.0cm
12018-CPTModerateSimp Rpr Face Ear Etc Over 30.0 Cm
12020-CPTModerateClosure 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 12018. These prices vary depending on payer type (Medicare, Medicaid, private insurance), geographic location, and provider contracts.

Understanding the 12018 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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