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See a sample rate comparisonCPT 12020 Fee Schedule
Medicare rates as of October 2026
CPT 12020 is classified under Surgery, in the Surgical Procedures on the Integumentary System subgroup.
Re-Close Surgical Opening, Procedure To Close A Surgical Cut That Has Opened Up. Techniques That May Be Used Include Stitching The Wound Or Inserting A Packing Material For Drainage.
| Key Fact | Detail |
|---|---|
| Service Type | Surgery Surgical Procedures on the Integumentary System |
| Common Place of Service | 11 - Office 23 - Emergency Room |
| Common Modifiers | 78 - Return to OR - related procedure 58 - Staged or related procedure during postoperative period |
| Complexity Level | Moderate |
| Medicare Fee Schedule | $316.64 national non-facility rate (2026) · View Medicare rates for 12020 |
| Medicaid Fee Schedule | $246.49 median of the 8 states in the free preview · View Medicaid rates for 12020 |
National average reimbursement for CPT 12020 by major payers:
$336.70
BCBS / Anthem
$360.48
UnitedHealthcare
$379.59
Aetna
$463.35
Cigna
Compare published rates across providers.
Choose a payer to see a sample of rates for CPT 12020.
CPT 12020
5 of 25 sample ratesHigher to lower in this preview
Hss Asc Of Manhattan LLC, Hss Asc Of Manhattan
$2,018.00Published rateWest Coast Centers For Surgeries LLC
$552.00Published rateSalina Surgical Arts Center, LLC, David A. Hendrick M.D., P.A.
David A. Hendrick Md
$390.00Published rateDlv Vision Asc
$120.00Published rateFredericksburg Endoscopy Center, LLC
Fredericksburg Endoscopy Center LLC
$44.00Published rate
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Payer Contract Negotiation
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See a sample payer proposalCPT 12020 vs. Other Surgical Procedures on the Integumentary System Codes
The table lists codes related to 12020. Select one to see its fee schedule.
| Code | Complexity | Description |
|---|---|---|
| 12001-CPT | Low | Rpr S N Ax Gen Trnk 2 5cm, Simple Repair Of Superficial Wounds Of Scalp Neck Axillae External Genitalia Trunk And Or Extremities Including Hands And Feet 2 5 Cm Or Less |
| 12020-CPT | Moderate | Re-Close Surgical Opening, Procedure To Close A Surgical Cut That Has Opened Up. Techniques That May Be Used Include Stitching The Wound Or Inserting A Packing Material For Drainage. |
| 12021-CPT | Moderate | Re-Close Surgical Opening, Procedure To Close A Surgical Cut That Has Opened Up. Techniques That May Be Used Include Stitching The Wound Or Inserting A Packing Material For Drainage. |
| 12031-CPT | Moderate | Intmd Rpr S A T Ext 2 5 Cm, Repair Intermediate Wounds Of Scalp Axillae Trunk And Or Extremities Excluding Hands And Feet 2 5 Cm Or Less |
What is a fee schedule?
A fee schedule is a list of fixed prices that healthcare providers charge for specific services, including CPT 12020. These prices vary depending on payer type (Medicare, Medicaid, private insurance), geographic location, and provider contracts.
Understanding the 12020 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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