CPT 12051 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 |
| Medicare Fee Schedule | View Medicare rates for 12051 |
National average reimbursement for CPT 12051 by major payers:
$320.03
$335.56
$367.02
$455.49
| 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 12051 | ||||||
United | 12051 | $200.00 | 1881845907 - NORTH PACIFIC DERMATOLOGY PS | 204269950 - (WA) NORTH PACIFIC DERMATOLOGY PS | WA | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 12051 | $90.00 | 1295710317 - CENTRAL FLORIDA ENDOSCOPY & SURGICAL INSTITUTE OF OCALA LLC | 203520333 - (FL) CENTRAL FLORIDA ENDOSCOPY SURGICAL INSTITUTE OF OCALA LLC | FL | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 12051 | $220.00 | 1871538694 - SOUTHWEST ENDOSCOPY LTD | 850452091 - (NM) SOUTHWEST ENDOSCOPY LTD | NM | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 12051 | $1016.00 | 1700341468 - PORT WARWICK SURGERY CENTER, LLC | 832749039 - (VA) PORT WARWICK SURGERY CENTER LLC | VA | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 12051 | $76.00 | 1144607862 - DEKALB SURGICAL SERVICES, LLC | 471088369 - (IL) DEKALB SURGICAL SERVICES LLC | IL | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 12051 | $39.00 | 1871718270 - PRINCE GEORGES MULTI SPECIALTY SURGERY CENTER | 521842302 - (MD) PRINCE GEORGES MULTI SPECIALTY SURGERY CENTER | MD | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 12051 | $175.00 | 1518280684 - NORTHWEST SURGERY CENTER, INC. | 364663721 - (CA) NORTHWEST SURGERY CENTER INC | CA | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 12051 | $136.00 | 1588619811 - LAWRENCEVILLE SURGERY CENTER, LLC | 582591488 - (GA) LAWRENCEVILLE SURGERY CENTER LLC | GA | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 12051 | $979.00 | 1770252868 - STONESPRINGS SURGICENTER, LLC | 812929320 - (VA) STONESPRINGS SURGICENTER LLC | VA | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 12051 | $113.00 | 1578643607 - PAIN CENTER LLC | 331048492 - (AR) THE PAIN CENTER OF JONESBORO, LLC | AR | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 12051 | $175.00 | 1972096568 - NUVISION SAME DAY PROCEDURE CENTER LLC | 830820085 - (TX) NUVISION SAME DAY PROCEDURE CENTER LLC | TX | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 12051 | $145.00 | 1174571970 - DCR SURGERY CENTER, LLC | 200019313 - (OH) DCR SURGERY CENTER LLC | OH | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 12051 | $602.00 | 1497465249 - CENTRAL WASHINGTON HEALTH SERVICES ASSOCIATION, CONFLUENCE HEALTH MOSES LAKE ASC | 910171250 - CENTRAL WASHINGTON HEALTH SERVICES ASSOCIATION | WA | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 12051 | $546.00 | 1790724862 - PROLIANCE SURGEONS, INC., P.S., PROLIANCE EASTSIDE SURGERY CENTER | 911606533 - (WA) PROLIANCE SURGEONS, INC., P.S. | WA | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 12051 | $555.00 | 1003861998 - PHYSICIANS SURGERY CENTER OF CHATTANOOGA, LLC, PHYSICIANS SURGERY CENTER OF CHATTANOOGA | 621817952 - (TN) PHYSICIANS SURGERY CENTER OF CHATTANOOGA LLC | TN | 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 12051 vs. Other Surgical Procedures on the Integumentary System Codes
The CPT 12051 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 12051 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.
What is a fee schedule?
A fee schedule is a list of fixed prices that healthcare providers charge for specific services, including CPT 12051. These prices vary depending on payer type (Medicare, Medicaid, private insurance), geographic location, and provider contracts.
Understanding the 12051 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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