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See a sample rate comparisonCPT 12031 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.
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
| Key Fact | Detail |
|---|---|
| Service Type | Surgery Surgical Procedures on the Integumentary System |
| Common Place of Service | 11 - Office 23 - Emergency Room |
| Common Modifiers | None 59 - Distinct Procedural Service 51 - Multiple procedures |
| Complexity Level | Moderate |
| Medicare Fee Schedule | View Medicare rates for 12031 |
| Medicaid Fee Schedule | View Medicaid rates for 12031 |
National average reimbursement for CPT 12031 by major payers:
$270.10
$303.97
$333.27
$401.65
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CPT 12031
5 of 25 sample ratesHigher to lower in this preview
Olasunkanmi Oyetunde
Aspirus Stevens Point Hospital & Clinics Inc
$798.40Published rateNeeta Motiwala
$461.64Published rateSukhjender Goraya
$277.57Published rateMahnaz Tantawi
Saddle Brook Medical Center PA
$163.13Published rateLeslie Cauvin
Bc Medical Care LLC
$82.98Published rate
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See a sample payer proposalCPT 12031 vs. Other Surgical Procedures on the Integumentary System Codes
The CPT 12031 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 12031 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 |
|---|---|---|
| 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 |
| 12032-CPT | Moderate | Intmd Rpr S A T Ext 2 6 7 5, Repair Intermediate Wounds Of Scalp Axillae Trunk And Or Extremities Excluding Hands And Feet 2 6 Cm To 7 5 Cm |
| 12034-CPT | Moderate | Intmd Rpr S Tr Ext 7 6 12 5, Repair Intermediate Wounds Of Scalp Axillae Trunk And Or Extremities Excluding Hands And Feet 7 6 Cm To 12 5 Cm |
| 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 12031. These prices vary depending on payer type (Medicare, Medicaid, private insurance), geographic location, and provider contracts.
Understanding the 12031 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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