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See a sample rate comparisonCPT 12035 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 12 6 20, Repair Intermediate Wounds Of Scalp Axillae Trunk And Or Extremities Excluding Hands And Feet 12 6 Cm To 20 0 Cm
| Key Fact | Detail |
|---|---|
| Service Type | Surgery Surgical Procedures on the Integumentary System |
| Common Place of Service | 23 - Emergency Room 22 - On Campus Outpatient Hospital |
| Common Modifiers | None 59 - Distinct Procedural Service 51 - Multiple procedures |
| Complexity Level | Moderate |
| Medicare Fee Schedule | View Medicare rates for 12035 |
| Medicaid Fee Schedule | View Medicaid rates for 12035 |
National average reimbursement for CPT 12035 by major payers:
$416.59
$480.21
$512.73
$396.01
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CPT 12035
5 of 25 sample ratesHigher to lower in this preview
Franciscan Orthopedic Surgery Center LLC
$2,204.00Published rateMethodist Surgery Center Germantown Lp
$770.00Published rateNorthern Illinois Surgery Center Limited Patrnership, The Center For Surgery
Northern Illinois Surgery Center Lp
$325.00Published rateCenter For Minimally Invasive Surgery PLLC, Soundview Ambulatory Surgery Center
Center For Minimally Invasive Surgery, PLLC
$175.00Published rate20-20 Surgery Center LLC
2020 Surgery Center LLC
$60.00Published rate
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See a sample payer proposalCPT 12035 vs. Other Surgical Procedures on the Integumentary System Codes
The CPT 12035 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 12035 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 |
|---|---|---|
| 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 |
| 12037-CPT | Moderate | Intmd Rpr S Tr Ext 30 0 Cm, Repair Intermediate Wounds Of Scalp Axillae Trunk And Or Extremities Excluding Hands And Feet Over 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 12035. These prices vary depending on payer type (Medicare, Medicaid, private insurance), geographic location, and provider contracts.
Understanding the 12035 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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