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See a sample rate comparisonCPT 12036 Fee Schedule
Medicare rates as of October 2026
CPT 12036 is classified under Surgery, in the Surgical Procedures on the Integumentary System subgroup.
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
| Key Fact | Detail |
|---|---|
| Service Type | Surgery Surgical Procedures on the Integumentary System |
| Common Place of Service | 22 - On Campus Outpatient Hospital 21 - Inpatient Hospital |
| Common Modifiers | 59 - Distinct Procedural Service LT - Left side of body |
| Complexity Level | Moderate |
| Medicare Fee Schedule | $479.97 national non-facility rate (2026) · View Medicare rates for 12036 |
| Medicaid Fee Schedule | $369.825 median of the 8 states in the free preview · View Medicaid rates for 12036 |
National average reimbursement for CPT 12036 by major payers:
$461.84
BCBS / Anthem
$536.28
UnitedHealthcare
$564.29
Aetna
$460.31
Cigna
Compare published rates across providers.
Choose a payer to see a sample of rates for CPT 12036.
CPT 12036
5 of 25 sample ratesHigher to lower in this preview
Doctors Same Day Surgery Center, Ltd
Doctors Same Day Surgery Center Ltd
$2,965.00Published rateWestminster Surgery Center
Westminster Surgery Center LLC
$665.00Published rateUnited Shockwave Services, Ltd., United Therapies
$355.00Published rateNew Britain Surgery Center LLC
New Britain Surgery Center, LLC
$140.00Published rateHawthorne Surgery Center LLC
$79.00Published rate
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Payer Contract Negotiation
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See a sample payer proposalCPT 12036 vs. Other Surgical Procedures on the Integumentary System Codes
The table lists codes related to 12036. Select one to see its fee schedule.
| 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 12036. These prices vary depending on payer type (Medicare, Medicaid, private insurance), geographic location, and provider contracts.
Understanding the 12036 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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