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See a sample rate comparisonCPT 12034 Fee Schedule
Medicare rates as of October 2026
CPT 12034 is classified under Surgery, in the Surgical Procedures on the Integumentary System subgroup.
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
| Key Fact | Detail |
|---|---|
| Service Type | Surgery Surgical Procedures on the Integumentary System |
| Common Place of Service | 11 - Office 23 - Emergency Room |
| Common Modifiers | 59 - Distinct Procedural Service 51 - Multiple procedures |
| Complexity Level | Moderate |
| Medicare Fee Schedule | $334.68 national non-facility rate (2026) · View Medicare rates for 12034 |
| Medicaid Fee Schedule | $261.725 median of the 8 states in the free preview · View Medicaid rates for 12034 |
National average reimbursement for CPT 12034 by major payers:
$369.68
BCBS / Anthem
$394.56
UnitedHealthcare
$431.05
Aetna
$513.94
Cigna
Compare published rates across providers.
Choose a payer to see a sample of rates for CPT 12034.
CPT 12034
5 of 25 sample ratesHigher to lower in this preview
Port Warwick Surgery Center, LLC
Port Warwick Surgery Center LLC
$1,016.00Published ratePhoenix Endoscopy LLC
$410.00Published rateWarren Gastro Endoscopy Ctr Inc
$254.00Published ratePardee Ambulatory Surgery Center LLC, The Surgery Center At Mills River
Pardee Ambulatory Surgery Center LLC
$125.00Published rateFemi-Care Surgery Center, LLC
Femicare Surgery Center LLC
$53.00Published rate
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Payer Contract Negotiation
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See a sample payer proposalCPT 12034 vs. Other Surgical Procedures on the Integumentary System Codes
The table lists codes related to 12034. Select one to see its fee schedule.
| Code | Complexity | Description |
|---|---|---|
| 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 |
| 12035-CPT | Moderate | Intmd Rpr S A T Ext 12 6 20, Repair Intermediate Wounds Of Scalp Axillae Trunk And Or Extremities Excluding Hands And Feet 12 6 Cm To 20 0 Cm |
| 12036-CPT | Moderate | Intmd Rpr S A T Ext 20 1 30, Repair Intermediate Wounds Of Scalp Axillae Trunk And Or Extremities Excluding Hands And Feet 20 1 Cm To 30 0 Cm |
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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