Rate Benchmarking
Compare your rates with similar providers.
Select a published rate, define comparable providers, and see where that rate falls in your market.
See a sample rate comparisonCPT 12042 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.
Rpair Intermed Wounds Of Nck Hands Feet &/Or Xtrnal Geni, Repair Intermediate Wounds Of Neck Hands Feet And/Or External Geni
| 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 12042 |
| Medicaid Fee Schedule | View Medicaid rates for 12042 |
National average reimbursement for CPT 12042 by major payers:
$346.79
$368.17
$396.17
$479.67
Compare published rates across providers.
Choose a payer to see a sample of rates for CPT 12042.
CPT 12042
5 of 25 sample ratesHigher to lower in this preview
Yoram Sharon
Medemerge, LLC
$555.84Published rateShodhan Patel
$319.73Published rateClinton Ogolo
$216.46Published rateJose Sanchez-Pena
North Logistic Services Inc
$186.05Published ratePeter Lee
Princeton Pike Internal Medicine
$86.06Published rate
Get a free rate benchmark for your specialty.
Choose your state and specialty to build a report from payer-published rates.
Use market rates to prepare your payer proposal.
Payer Contract Negotiation
Draft a fee schedule renegotiation letter.
Use your fee schedule and market benchmarks to set target rates and draft a letter for your payer.
See a sample payer proposalCPT 12042 vs. Other Surgical Procedures on the Integumentary System Codes
The CPT 12042 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 12042 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 |
|---|---|---|
| 12041-CPT | Moderate | Rpair Intermed Wounds Of Nck Hands Feet &/Or Xtrnal Geni, Repair Intermediate Wounds Of Neck Hands Feet And/Or External Geni |
| 12042-CPT | Moderate | Rpair Intermed Wounds Of Nck Hands Feet &/Or Xtrnal Geni, Repair Intermediate Wounds Of Neck Hands Feet And/Or External Geni |
| 12044-CPT | Moderate | Rpair Intermed Wounds Of Nck Hands Feet &/Or Xtrnal Geni, Repair Intermediate Wounds Of Neck Hands Feet And/Or External Geni |
| 12045-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 12042. These prices vary depending on payer type (Medicare, Medicaid, private insurance), geographic location, and provider contracts.
Understanding the 12042 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.
FREE SAMPLE MARKET COMPARISON
Let's review your payer contracts side-by-side with the market.
Bring your top codes (like CPT 12042) and we'll show you how you compare in 15 minutes or less.