How much does Medicare pay for CPT 12002?

Medicare allowed an average of $68.13 per service and paid $51.94 of that, the balance being the patient's coinsurance and deductible (2024 data). Providers submitted an average of $371.49, which is what they billed rather than what they received — Medicare pays its fee schedule regardless of the charge.

What is CPT code 12002?

Simple repair of surface wound of scalp, neck, underarms, trunk, arms, or legs, 2.6-7.5 cm. It was billed 4,126 times to 3,909 Medicare beneficiaries by 245 providers in 2024.

Does 12002 pay differently in an office than a hospital?

Yes. The allowed amount averaged $87.04 in an office setting and $53.38 in a facility. The office rate is generally higher because the practice supplies the room, staff and equipment out of that single payment; in a hospital those are billed separately by the facility.

Which specialty bills 12002 most?

Emergency Medicine, with 1,088 services from 84 clinicians. Next are Physician Assistant, Dermatology, Nurse Practitioner.

CPT 12002

Simple repair of surface wound of scalp, neck, underarms, trunk, arms, or legs, 2.6-7.5 cm

$68.13Medicare-allowed amount per service, averaged across 4,126 services

Providers submitted

$371.49

Asking price, not received

Medicare allowed

$68.13

The fee schedule figure

Medicare paid

$51.94

Balance is patient coinsurance

Providers submitted an average of $371.49 for this code and Medicare allowed $68.13 — 5.5× less. That gap is normal and means nothing on its own: Medicare pays its fee schedule regardless of what is billed, so the submitted figure describes a hospital chargemaster, not a price anyone paid. Of the allowed amount Medicare paid $51.94 (76%); the rest is the patient’s coinsurance and deductible.

Office pays differently to hospital

Office / non-facility: $87.04
Hospital / facility: $53.38

The office rate is higher because the practice supplies the room, staff and equipment out of that payment. In a hospital the facility bills those separately, so the clinician's share is smaller — the total cost to Medicare is usually higher, not lower. 1,807 services were billed in an office setting and 2,319 in a facility.

Services: 4,126
Beneficiaries: 3,909
Providers billing it: 245
Total allowed: $281,104

What Medicare pays for CPT 12002

Across 4,126 services billed by 245 providers to 3,909 beneficiaries, Medicare allowed an average of $68.13 per service. The allowed amount is the figure that matters: it is what Medicare and the patient together owe, set by the fee schedule and adjusted for local practice costs. What a provider chose to submit has no bearing on it.

Who bills 12002

Specialty	Services	Beneficiaries	Avg allowed	Providers
Emergency Medicine	1,088	1,084	$64.98	84
Physician Assistant	860	860	$52.53	64
Dermatology	671	646	$55.97	29
Nurse Practitioner	504	477	$56.95	34
Internal Medicine	343	304	$110.17	10
Podiatry	225	143	$114.51	1
Micrographic Dermatologic Surgery	156	139	$70.20	7
Family Practice	104	104	$94.02	7
Orthopedic Surgery	58	39	$100.13	1
General Surgery	26	24	$93.13	2
Plastic and Reconstructive Surgery	24	22	$109.44	1
Nephrology	18	18	$31.12	1
Osteopathic Manipulative Medicine	14	14	$54.59	1
Vascular Surgery	13	13	$53.96	1
Critical Care (Intensivists)	11	11	$56.19	1

12002 reimbursement by state

Two different numbers. Allowed is what Medicare actually allowed in that state, which includes the local practice-cost adjustment. Standardized strips that geographic adjustment out of the payment, so it is the column to use when comparing states — a difference there reflects how the code was billed, not what it costs to run a practice locally.

State	Services	Allowed	Standardized pmt	Providers
Florida	685	$69.19	$49.40	46
California	534	$89.87	$64.02	26
New York	275	$106.43	$80.54	5
Texas	271	$73.68	$57.12	14
New Jersey	251	$52.46	$37.37	18
Pennsylvania	221	$65.92	$49.34	8
Maryland	155	$55.16	$39.88	10
Massachusetts	153	$50.38	$37.87	11
Virginia	132	$53.71	$42.90	7
Arizona	124	$50.87	$39.14	9
Arkansas	106	$45.64	$38.03	7
South Carolina	105	$73.93	$56.57	8
Tennessee	93	$53.54	$42.70	7
Ohio	89	$67.27	$43.33	6
Georgia	84	$56.68	$45.24	6
Mississippi	77	$54.71	$44.78	6
Illinois	77	$57.13	$38.82	6
Alabama	75	$52.39	$43.63	3
Indiana	70	$49.09	$38.15	6
Delaware	51	$67.04	$45.83	4
Michigan	47	$74.30	$52.98	3
North Carolina	41	$48.83	$39.10	3
Connecticut	40	$52.58	$37.93	3
New Hampshire	39	$97.52	$68.07	1
South Dakota	35	$53.91	$44.72	1
Minnesota	35	$55.17	$45.74	3
Oklahoma	31	$55.59	$49.52	2
District of Columbia	30	$63.99	$44.69	1
Hawaii	30	$58.43	$45.15	2
Kentucky	28	$53.59	$40.93	2
Missouri	27	$52.29	$40.37	2
Wisconsin	22	$54.58	$45.28	2
Oregon	21	$47.81	$33.18	1
North Dakota	14	$121.61	$80.22	1
Rhode Island	13	$114.89	$89.55	1
Iowa	12	$52.59	$39.04	1
Montana	11	$49.99	$35.39	1
Maine	11	$59.17	$45.66	1
Utah	11	$52.69	$39.52	1

Related codes

12032Intermediate repair of wound of scalp$250.68
12052Intermediate repair of wound of face$174.94
12042Intermediate repair of wound of neck$198.63
12051Intermediate repair of wound of face$170.56
12031Intermediate repair of wound of scalp$221.43
12034Intermediate repair of wound of scalp$235.14
12053Intermediate repair of wound of face$180.85
12001Simple repair of surface wound of scalp$64.10
12041Intermediate repair of wound of neck$171.72
12011Simple repair of surface wound of face$58.25
12013Simple repair of surface wound of face$54.97

Billing this code is not the same as earning it

An allowed amount is revenue to a practice, not income to a clinician. It funds staff, premises, equipment and supplies before anyone is paid. What clinicians actually earn is published separately by the Department of Labor, and what industry pays them is published separately again by CMS — this site carries both.

What doctors are paid →·Look up a clinician →·All procedure codes →

Where this comes from. CMS Medicare Physician & Other Practitioners, by Provider and Service, 2024. It covers fee-for-service Original Medicare Part B only — not Medicare Advantage, not Medicaid, and not commercial insurance, which typically pays more for the same code.

How it is averaged. CMS publishes one average per provider per code. Every figure here is re-weighted by the number of services, so a clinician who billed the code 4,000 times counts 4,000 times more than one who billed it twice. CMS also suppresses any provider-code pair with fewer than 11 beneficiaries, so low-volume practice is missing from these totals by design.