CPT 12001 Surgery
Simple wound repair, up to 2.5 cm Cost
Body System: Integumentary
Medicare Facility Rate
$76
CMS PFS CY2026
Medicare Non-Facility Rate
$123
Office/clinic setting
Hospital Outpatient
$205
OPPS rate
Relative Value Units (RVUs)
Medicare payment = Total RVU × Conversion Factor ($33.40 for CY 2026)
1.51
Work RVU
0.72
Facility PE RVU
0.13
Malpractice RVU
Cost by Location
| 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 |
Frequently Asked Questions
How much does Simple wound repair, up to 2.5 cm cost?
The Medicare facility rate is $76. Commercial insurance typically pays 150-250% of Medicare rates (varies). Hospital outpatient rate: $205.
How much does Simple wound repair, up to 2.5 cm cost without insurance?
Without insurance, you may pay the hospital's chargemaster rate, which is often 300-500% of Medicare. Ask about cash-pay discounts — many facilities offer 20-40% off for self-pay patients. The Medicare baseline for this procedure is $76.