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CPT 12021 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.

Treat Superficial Dehiscence W/Pack
Key FactDetail
Service Type

Surgery

Surgical Procedures on the Integumentary System

Common Place of Service

11 - Office

21 - Inpatient Hospital

Common Modifiers

None

58 - Staged or related procedure during postoperative period

79 - Unrelated procedure - postop period

Complexity LevelModerate

National average reimbursement for CPT 12021 by major payers:

bcbs

$203.54

uhc

$212.56

aetna

$220.83

cigna

$284.00

Preview provider-level rates for...
For billing codeCPT 12021
PayerCodeRateNPITax IDStateSpecialty

Select a payer to view fee schedule data

Choose a payer from the options above to see rates for CPT 12021

United
12021$391.001386113090 - SURGERY CENTER OF MT. SCOTT, LLC832600045ORAmbulatory Surgical Clinic/Center (261QA1903X)
United
12021$225.001679001028 - CENTERVIEW SURGERY CENTER, LLC815461133 - (AR) CENTERVIEW SURGERY CENTER LLCARAmbulatory Surgical Clinic/Center (261QA1903X)
United
12021$68.001669668943 - POOLE ENDOSCOPY CENTER, NEEL KAMAL MD521831316MDAmbulatory Surgical Clinic/Center (261QA1903X)
United
12021$150.001427577840 - DIALYSIS ACCESS CENTER OF CINCINNATI, INC.815023998 - (OH) DIALYSIS ACCESS CENTER OF CINCINNATI INCOHAmbulatory Surgical Clinic/Center (261QA1903X)
United
12021$566.001538461348 - THE OUTPATIENT CENTER, LLC, THE OUTPATIENT CENTER OF BOYNTON BEACH, LTD. D/B/A THE OUTPATIENT CENT650440864 - (FL) THE OUTPATIENT CENTER OF BOYNTON BEACH, LTD.FLAmbulatory Surgical Clinic/Center (261QA1903X)
United
12021$370.001043254162 - FVOSA SURGICAL PARTNERS, LLC, ORTHOPEDIC & SPORTS SURGERY CENTER202394424 - (WI) FVOSA SURGICAL PARTNERS, LLCWIAmbulatory Surgical Clinic/Center (261QA1903X)
United
12021$150.001427577840 - DIALYSIS ACCESS CENTER OF CINCINNATI, INC.815023998 - (OH) DIALYSIS ACCESS CENTER OF CINCINNATI INCOHAmbulatory Surgical Clinic/Center (261QA1903X)
United
12021$643.001144970807 - MEDICAL CITY SURGERY CENTER SOUTHLAKE, LLC881391141TXAmbulatory Surgical Clinic/Center (261QA1903X)
United
12021$200.001467557678 - BEAN CENTER FOR FOOT SURGERY INC, SIERRA CENTER FOR FOOT SURGERY880309955 - (NV) BEAN CENTER FOR FOOT SURGERY INCNVAmbulatory Surgical Clinic/Center (261QA1903X)
United
12021$66.001639215502 - BOSTON EYE SURGERY & LASER CENTER TRUST, BOSTON EYE SURGERY & LASER CENTER43092292 - (MA) BOSTON EYE SURGERY & LASER CENTER TRUSTMAAmbulatory Surgical Clinic/Center (261QA1903X)
United
12021$706.001316949415 - NEWPORT BEACH SURGERY CENTER, LLC, NEWPORT BEACH SURGERY CENTER330488134 - (CA) NEWPORT BEACH SURGERY CENTER LLCCAAmbulatory Surgical Clinic/Center (261QA1903X)
United
12021$719.001306833009 - SOUTH BROWARD ENDOSCOPY L L C113685842FLAmbulatory Surgical Clinic/Center (261QA1903X)
United
12021$103.001093214819 - PREMIER SURGICAL CENTER, LLC823438730 - (MS) PREMIER SURGICAL CENTER LLCMSAmbulatory Surgical Clinic/Center (261QA1903X)
United
12021$792.001922075167 - NORTH CENTRAL METHODIST ASC, LP, METHODIST AMBULATORY SURGERY CENTER NORTH CENTRAL742998447 - (TX) NORTH CENTRAL METHODIST ASC LPTXAmbulatory Surgical Clinic/Center (261QA1903X)
United
12021$123.001881101335 - BROWN MEDICINE, BROWN MEDICINE ENDOSCOPY CENTER50450410 - BROWN MEDICINERIAmbulatory 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 12021 vs. Other Surgical Procedures on the Integumentary System Codes

The CPT 12021 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 12021 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
12020-CPTModerateClosure Superfic Wound Dehiscence
12021-CPTModerateTreat Superficial Dehiscence W/Pack
12031-CPTModerateRep Intermed Scalp Etc Und 2.5cm
12041-CPTModerateRep Intermed Neck Etc Und 2.5cm

What is a fee schedule?

A fee schedule is a list of fixed prices that healthcare providers charge for specific services, including CPT 12021. These prices vary depending on payer type (Medicare, Medicaid, private insurance), geographic location, and provider contracts.

Understanding the 12021 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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