CPT 12001 Surgery

How Much Does Simple Wound Repair (2.5 cm or Less) Cost?

Also known as: Simple wound repair, up to 2.5 cm (CPT 12001)

Stitches to close a small, clean cut or laceration in the skin.

Simple Wound Repair (2.5 cm or Less) (CPT 12001) costs $76 at Medicare rates. Hospital outpatient rate: $205.

Cost Comparison by Payer

How much Simple wound repair, up to 2.5 cm costs across different settings and payers

Medicare
Facility rate
$76
Hospital Outpatient
OPPS rate
$205
Medicare (Facility)
$76
CMS PFS 2026 national rate
Medicare (Office/Clinic)
$123
Non-facility setting
Hospital Outpatient
$205
OPPS rate

Patient Guide: Simple Wound Repair (2.5 cm or Less)

What you need to know before your appointment

What to Expect

The wound is cleaned and numbed with local anesthetic. The doctor closes the cut with stitches, staples, or skin adhesive.

How Long Does It Take?

15-30 minutes

Common Reasons Doctors Order This

Small cut, laceration, minor wound from accident or fall

How to Prepare

Clean the wound gently if possible before arrival. Apply pressure to stop bleeding.

Procedures Commonly Done Together

These procedures are frequently performed alongside Simple wound repair, up to 2.5 cm

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Simple wound repair, up to 2.5 cm Cost by Location

Medicare-adjusted rates across CMS localities

Location Medicare Rate Est. Commercial
US — Carrier 01112 Locality 05 $48 $72 — $120
US — Carrier 01112 Locality 09 $48 $73 — $121
US — Carrier 01112 Locality 51 $46 $70 — $116
US — Carrier 01112 Locality 52 $48 $72 — $120
US — Carrier 01112 Locality 53 $46 $69 — $115
US — Carrier 01112 Locality 54 $44 $65 — $109
US — Carrier 01112 Locality 55 $43 $65 — $108
US — Carrier 01112 Locality 56 $43 $65 — $108
US — Carrier 01112 Locality 57 $43 $65 — $108
US — Carrier 01112 Locality 58 $43 $65 — $108
US — Carrier 01112 Locality 59 $43 $65 — $108
US — Carrier 01112 Locality 60 $43 $65 — $108
US — Carrier 01112 Locality 61 $43 $65 — $108
US — Carrier 01112 Locality 62 $45 $67 — $112
US — Carrier 01112 Locality 63 $44 $66 — $111
US — Carrier 01112 Locality 64 $44 $66 — $110
US — Carrier 01112 Locality 65 $49 $74 — $123
US — Carrier 01112 Locality 66 $44 $67 — $111
US — Carrier 01112 Locality 67 $45 $67 — $112
US — Carrier 01112 Locality 68 $43 $65 — $108
US — Carrier 01112 Locality 69 $43 $65 — $108
US — Carrier 01112 Locality 70 $43 $65 — $108
US — Carrier 01112 Locality 75 $43 $65 — $108
US — Carrier 01182 Locality 17 $45 $67 — $112
US — Carrier 01182 Locality 18 $45 $68 — $113

How to Reduce Your Cost for Simple wound repair, up to 2.5 cm

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 ($123) differs from the facility rate ($76). Ask if it can be done in an office setting.

  • 3
    Shop around — costs vary significantly

    Medicare rates for this procedure range from $40 to $56 depending on location. Commercial rates vary even more.

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.

1.51
Work RVU
0.72
Practice Expense RVU
0.13
Malpractice RVU

Payment = Total RVU () x CF ($33.40) = N/A

Frequently Asked Questions

How much does Simple wound repair, up to 2.5 cm cost?

The Medicare facility rate for Simple wound repair, up to 2.5 cm is $76. 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 Simple wound repair, up to 2.5 cm cost without insurance?

Without insurance, the cost of Simple wound repair, up to 2.5 cm 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 Simple wound repair, up to 2.5 cm?

Most commercial health insurance plans and Medicare cover Simple wound repair, up to 2.5 cm 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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