CPT 12034 Fee Schedule
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.
| 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 |
National average reimbursement for CPT 12034 by major payers:
$369.68
$394.56
$431.05
$534.48
| Payer | Code | Rate | NPI | Tax ID | State | Specialty |
|---|---|---|---|---|---|---|
Select a payer to view fee schedule data Choose a payer from the options above to see rates for CPT 12034 | ||||||
United | 12034 | $60.00 | 1801855127 - CENTER FOR THE SURGICAL ARTS LLC, CSA | 113741353 - (PA) CENTER FOR THE SURGICAL ARTS LLC | PA | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 12034 | $286.00 | 1104907328 - ANDREWS INSTITUTE ASC LLC | 352274952 - (FL) ANDREWS INSTITUTE ASC, LLC | FL | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 12034 | $147.00 | 1245288257 - SURGICAL CENTER OF GREENSBORO, LLC | 631251243 - (NC) SURGICAL CENTER OF GREENSBORO LLC | NC | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 12034 | $1251.00 | 1669895512 - AMBULATORY SURGICAL CENTER OF SOMERVILLE LLC, SOMERSET AMBULATORY SURGICAL CENTER | 371743209 | NJ | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 12034 | $136.00 | 1285678979 - BAY SURGERY CENTERS LLC, CLEARWAY SURGERY CENTER OF ANNAPOLIS | 204934078 - (MD) BAY SURGERY CENTERS LLC | MD | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 12034 | $566.00 | 1295176139 - LOWCOUNTRY AMBULATORY CENTER, LLC | 274109893 - (SC) LOWCOUNTRY AMBULATORY CENTER LLC | SC | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 12034 | $300.00 | 1790145480 - TWIN CITIES SURGERY CENTER | 463311193 - (MN) TWIN CITIES SURGERY CENTER | MN | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 12034 | $566.00 | 1336142413 - TEXAN AMBULATORY SURGERY CENTER, LP | 331058382 | TX | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 12034 | $1042.00 | 1992713010 - NORTHFIELD SURGICAL CENTER LLC, NORTHFIELD SURGICAL CENTER | 223509801 - (NJ) NORTHFIELD SURGICAL CENTER LLC | NJ | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 12034 | $120.00 | 1902284045 - MURRIETA SPECIALTY SURGERY CENTER PC A PROFESSIONAL CORPORATION | 463493543 - (CA) MURRIETA SPECIALTY SURGERY CENTER PC A PROFESSIONAL CORPORATION | CA | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 12034 | $531.00 | 1881905792 - SURGCENTER PINELLAS, LLC | 271372259 - (FL) SURGCENTER PINELLAS, LLC | FL | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 12034 | $230.00 | 1639605595 - QUEEN CREEK SURGICAL CENTER, LLC | 821292127 - (AZ) QUEEN CREEK SURGICAL CENTER LLC | AZ | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 12034 | $155.00 | 1295700086 - WESTERN WASHINGTON ENDOSCOPY CENTERS, LLC | 200289310 - (WA) WESTERN WASHINGTON ENDOSCOPY CENTERS LLC | WA | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 12034 | $531.00 | 1548203888 - NORTH VALLEY ORTHOPEDIC SURGERY CENTER LLC, THE ORTHOPEDIC SURGERY CENTER OF ARIZONA | 202684773 - (AZ) NORTH VALLEY ORTHOPEDIC SURGERY CENTER LLC | AZ | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 12034 | $566.00 | 1588260343 - ADVENTHEALTH SURGERY CENTER WELLSWOOD LLC, ADVENTHEALTH SURGERY CENTER WELLSWOOD | 854111089 - (FL) ADVENTHEALTH SURGERY CENTER WELLSWOOD LLC | FL | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 99202 | $100.00 | 1234567890 | 1234567890 | CA | Cardiologist |
United | 99202 | $100.00 | 1234567890 | 1234567890 | CA | Cardiologist |
United | 99202 | $100.00 | 1234567890 | 1234567890 | CA | Cardiologist |
United | 99202 | $100.00 | 1234567890 | 1234567890 | CA | Cardiologist |
United | 99202 | $100.00 | 1234567890 | 1234567890 | CA | Cardiologist |
United | 99202 | $100.00 | 1234567890 | 1234567890 | CA | Cardiologist |
United | 99202 | $100.00 | 1234567890 | 1234567890 | CA | Cardiologist |
United | 99202 | $100.00 | 1234567890 | 1234567890 | CA | Cardiologist |
United | 99202 | $100.00 | 1234567890 | 1234567890 | CA | Cardiologist |
United | 99202 | $100.00 | 1234567890 | 1234567890 | CA | Cardiologist |
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CPT 12034 vs. Other Surgical Procedures on the Integumentary System Codes
The CPT 12034 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 12034 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 |
|---|---|---|
| 12032-CPT | Moderate | Int Rpr Sclp Trnk Extrm 2.6-7.5 Cm |
| 12034-CPT | Moderate | Rep Intermed Scalp Etc 7.5-12.5cm |
| 12035-CPT | Moderate | Repair Intermediate Wounds Of Scalp Axillae K Atrunk And/Or Extremities (Excluding Hands And Feet) 12.6 Cm To 20.0 Cm) |
| 12036-CPT | Moderate | Rep Intermed Scalp Etc 20.0-30cm |
What is a fee schedule?
A fee schedule is a list of fixed prices that healthcare providers charge for specific services, including CPT 12034. These prices vary depending on payer type (Medicare, Medicaid, private insurance), geographic location, and provider contracts.
Understanding the 12034 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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