CPT 12001: Simple Repair, Scalp/Neck/Axilla/Trunk 2.5 cm or Less
CPT 12001 reports simple, single-layer repair of a superficial wound of the scalp, neck, axilla, external genitalia, trunk, or extremities measuring 2.5 cm or less. In 2026 Medicare pays about $113.90 non-facility and $44.09 facility, with a 000-day global period.
- Code type
- Surgical - simple repair, superficial wound 2.5 cm or less
- 2026 non-facility
- $113.90
- 2026 facility
- $44.09
- Global period
- 000 days
What is CPT 12001 used for?
CPT 12001 reports a simple repair of a superficial wound of the scalp, neck, axillae, external genitalia, trunk, or extremities (including hands and feet) measuring 2.5 cm or less. Simple means a one-layer closure with sutures, staples, or tissue adhesive, involving mainly the epidermis and dermis without deeper structures.
It is the entry-level laceration repair code. Larger wounds in the same body group step up to 12002 and beyond, while layered or contaminated wounds move to the intermediate series 12031-12037.
How much does 12001 pay in 2026?
Under the 2026 Medicare fee schedule, 12001 allows about $113.90 non-facility and $44.09 facility. The gap is large because the office absorbs the entire supply and staff cost.
| Setting | 2026 Medicare allowed |
|---|---|
| Non-facility (office) | ~$113.90 |
| Facility (hospital outpatient) | ~$44.09 |
Example: an urgent care closes a 2 cm forearm laceration with a single layer of nylon sutures. You bill 12001 at about $113.90 in the office. Check your locality figure with the Medicare fee calculator.
How do you measure and sum simple repairs?
Measure the wound length in centimeters before closure, and code to that length. When several simple wounds fall in the same anatomic grouping, add their lengths together and report a single code for the total, not one code per wound:
- Confirm each wound is a simple, single-layer repair.
- Group wounds by the CPT anatomic classification they share.
- Sum the lengths within each group and select the length-based code.
Which modifiers and edits apply?
With a 000 global period, no post-op days are bundled. When 12001 is performed with another distinct procedure, modifier 51 may flag it as a multiple procedure, and modifier 59 can identify a distinct service when an NCCI edit would otherwise bundle it. Simple repair is bundled into most excision codes, so do not report 12001 separately alongside a lesion excision on the same wound. Related closure work includes 10060 for abscess drainage.
Frequently asked questions
In 2026 the national non-facility allowed amount is about $113.90, and the facility rate is about $44.09. The office rate is much higher because the practice supplies the suture tray, anesthetic, and staff time. Medicare pays 80 percent and the patient owes 20 percent coinsurance after the deductible.
12001 is for single-layer closure of a superficial wound. If the note documents layered closure, extensive cleaning, or removal of particulate debris, that is an intermediate repair (12031-12037), not 12001. The word "layered" in an operative note is the clearest signal you have coded the wrong tier.
Add the lengths of wounds in the same classification and anatomic grouping and report one code for the summed length. Do not report a separate 12001 for each laceration in the same group; sum first, then pick the length-appropriate code.
Sources & further reading
Reviewed by the ImmediCare Solutions RCM team
Certified billers and coders handling claims across 50+ specialties nationwide. This entry is reviewed against current payer policy and CMS rules. Last review: Jul 5, 2026.
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