CPT 12002 Surgery - Integumentary

How Much Does Simple Wound Repair (2.6-7.5 cm) Cost?

Also known as: Rpr s/n/ax/gen/trnk2.6-7.5cm (CPT 12002)

Stitches to close a medium-sized clean cut or laceration.

Simple Wound Repair (2.6-7.5 cm) (CPT 12002) costs $57 at Medicare rates. Hospital outpatient rate: $205.

Cost Comparison by Payer

How much Rpr s/n/ax/gen/trnk2.6-7.5cm costs across different settings and payers

Medicare
Facility rate
$57
Hospital Outpatient
OPPS rate
$205
Medicare (Facility)
$57
CMS PFS 2026 national rate
Medicare (Office/Clinic)
$139
Non-facility setting
Hospital Outpatient
$205
OPPS rate

Patient Guide: Simple Wound Repair (2.6-7.5 cm)

What you need to know before your appointment

What to Expect

The wound is thoroughly cleaned, numbed, and closed with stitches. The number of stitches depends on the wound size.

How Long Does It Take?

20-40 minutes

Common Reasons Doctors Order This

Medium laceration, cut requiring stitches, wound from accident

How to Prepare

Apply pressure to control bleeding. Avoid eating in case sedation is needed for larger wounds.

Procedures Commonly Done Together

These procedures are frequently performed alongside Rpr s/n/ax/gen/trnk2.6-7.5cm

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How to Reduce Your Cost for Rpr s/n/ax/gen/trnk2.6-7.5cm

Practical tips that can save you hundreds or thousands of dollars

  • 1
    Ask about cash-pay discounts

    Many hospitals and clinics offer 20-40% discounts for self-pay patients. Always ask before scheduling.

  • 2
    Compare facility vs. office setting costs

    For this procedure, the office rate ($139) differs from the facility rate ($57). Ask if it can be done in an office setting.

  • 3
    Shop around — costs vary significantly

    Costs can vary 2-3x between providers in the same city. Get quotes from multiple facilities.

How is the Price Calculated?

Medicare calculates procedure payments using Relative Value Units (RVUs). Each procedure has three components multiplied by a conversion factor ($33.40 in 2026) and adjusted by geographic cost indices.

1.11
Work RVU
0.37
Practice Expense RVU
0.24
Malpractice RVU
4.17
Total RVU

Payment = Total RVU (4.17) x CF ($33.40) = $139

Frequently Asked Questions

How much does Rpr s/n/ax/gen/trnk2.6-7.5cm cost?

The Medicare facility rate for Rpr s/n/ax/gen/trnk2.6-7.5cm is $57. In a hospital outpatient setting, the rate is $205. Commercial insurance rates typically range from 150% to 250% of Medicare (varies by plan).

How much does Rpr s/n/ax/gen/trnk2.6-7.5cm cost without insurance?

Without insurance, the cost of Rpr s/n/ax/gen/trnk2.6-7.5cm can range from 150% of Medicare to 500% of Medicare depending on the facility. Many hospitals and clinics offer self-pay discounts of 20-40% off their chargemaster price. Always ask about cash pricing before your visit.

Does insurance cover Rpr s/n/ax/gen/trnk2.6-7.5cm?

Most commercial health insurance plans and Medicare cover Rpr s/n/ax/gen/trnk2.6-7.5cm when ordered by a physician for a medically necessary reason. Your out-of-pocket cost depends on your plan's deductible, copay/coinsurance structure, and whether you use an in-network provider. Check with your insurance company before scheduling to confirm coverage and get a cost estimate.

Why does the cost vary so much by location?

Medicare adjusts payments using Geographic Practice Cost Indices (GPCIs) that reflect local differences in physician work costs, practice expenses, and malpractice insurance. Manhattan, San Francisco, and other high-cost areas pay significantly more than rural regions. Commercial insurers follow similar geographic patterns.

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