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See a sample rate comparisonCPT 12021 Fee Schedule
Last Verified: September 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.
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 21 - Inpatient Hospital |
| Common Modifiers | None 58 - Staged or related procedure during postoperative period 79 - Unrelated procedure - postop period |
| Complexity Level | Moderate |
| Medicare Fee Schedule | View Medicare rates for 12021 |
| Medicaid Fee Schedule | View Medicaid rates for 12021 |
National average reimbursement for CPT 12021 by major payers:
$203.54
$212.56
$220.83
$274.03
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CPT 12021
5 of 25 sample ratesHigher to lower in this preview
Alaska Surgery Center, Limited Partnership
Alaska Surgery Center Limited Partnership
$1,122.00Published rateCoast Surgery Center L P, Coast Surgery Center Of South Bay
Coast Surgery Center L P
$688.00Published rateCenterview Surgery Center, LLC
Centerview Surgery Center LLC
$225.00Published rateDialysis Access Center Of Cincinnati, Inc.
Dialysis Access Center Of Cincinnati Inc
$150.00Published rateMississippi Urology Outpatient Surgery Center, LLC
Mississippi Urology Outpatient Surgery Center LLC
$54.00Published rate
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See a sample payer proposalCPT 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.
| Code | Complexity | Description |
|---|---|---|
| 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 |
| 12041-CPT | Moderate | Rpair Intermed Wounds Of Nck Hands Feet &/Or Xtrnal Geni, Repair Intermediate Wounds Of Neck Hands Feet And/Or External Geni |
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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