How much does Medicare pay for CPT 12034?

Medicare allowed an average of $235.14 per service and paid $183.27 of that, the balance being the patient's coinsurance and deductible (2024 data). Providers submitted an average of $772.07, which is what they billed rather than what they received — Medicare pays its fee schedule regardless of the charge.

What is CPT code 12034?

Intermediate repair of wound of scalp, underarms, trunk, arms, or legs, 7.6-12.5 cm. It was billed 13,923 times to 13,333 Medicare beneficiaries by 670 providers in 2024.

Does 12034 pay differently in an office than a hospital?

Yes. The allowed amount averaged $251.47 in an office setting and $124.91 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 12034 most?

Dermatology, with 9,645 services from 479 clinicians. Next are Micrographic Dermatologic Surgery, General Surgery, Surgical Oncology.

CPT 12034

Intermediate repair of wound of scalp, underarms, trunk, arms, or legs, 7.6-12.5 cm

$235.14Medicare-allowed amount per service, averaged across 13,923 services

Providers submitted

$772.07

Asking price, not received

Medicare allowed

$235.14

The fee schedule figure

Medicare paid

$183.27

Balance is patient coinsurance

Providers submitted an average of $772.07 for this code and Medicare allowed $235.14 — 3.3× 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 $183.27 (78%); the rest is the patient’s coinsurance and deductible.

Office pays differently to hospital

Office / non-facility: $251.47
Hospital / facility: $124.91

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. 12,126 services were billed in an office setting and 1,797 in a facility.

Services: 13,923
Beneficiaries: 13,333
Providers billing it: 670
Total allowed: $3,273,854

What Medicare pays for CPT 12034

Across 13,923 services billed by 670 providers to 13,333 beneficiaries, Medicare allowed an average of $235.14 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 12034

Specialty	Services	Beneficiaries	Avg allowed	Providers
Dermatology	9,645	9,206	$246.84	479
Micrographic Dermatologic Surgery	2,235	2,154	$221.99	93
General Surgery	456	450	$158.62	24
Surgical Oncology	373	365	$138.49	17
Physician Assistant	354	333	$261.76	20
Plastic and Reconstructive Surgery	319	307	$256.60	15
Ambulatory Surgical Center	210	202	$144.32	9
Orthopedic Surgery	134	132	$99.89	3
Family Practice	73	63	$292.79	4
Undefined Physician type	52	52	$262.53	2
General Practice	39	37	$286.48	2
Nurse Practitioner	17	16	$265.26	1
Otolaryngology	16	16	$246.34	1

12034 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	1,199	$263.52	$199.27	53
Texas	884	$219.70	$172.65	46
California	870	$265.32	$184.27	42
North Carolina	833	$232.49	$190.09	41
Virginia	814	$245.91	$191.28	35
Georgia	777	$227.28	$184.15	30
Pennsylvania	639	$241.58	$185.38	29
Tennessee	535	$214.93	$182.33	26
South Carolina	448	$251.06	$205.64	18
Massachusetts	446	$259.52	$186.98	24
Arizona	438	$256.32	$199.20	24
New York	411	$234.01	$166.81	19
Illinois	404	$262.94	$196.73	18
Maryland	363	$279.36	$195.40	18
Ohio	341	$220.99	$180.20	20
Minnesota	315	$194.81	$152.54	16
Washington	307	$236.65	$178.74	15
Indiana	305	$196.23	$162.18	13
Arkansas	269	$182.01	$159.23	10
Alabama	266	$234.23	$200.85	17
Kansas	265	$213.50	$175.43	12
Missouri	225	$209.58	$163.53	15
Wisconsin	193	$189.89	$151.33	12
Idaho	186	$177.22	$149.93	8
Kentucky	184	$194.83	$166.57	8
Mississippi	183	$237.70	$204.44	8
New Hampshire	164	$205.35	$156.15	8
Michigan	153	$228.58	$179.32	9
New Jersey	149	$223.20	$155.72	9
Oklahoma	140	$223.28	$190.42	8
Rhode Island	136	$235.43	$177.08	4
Iowa	128	$181.96	$157.03	4
Connecticut	115	$303.19	$216.67	4
Nevada	90	$266.27	$204.71	5
West Virginia	82	$168.69	$148.30	3
North Dakota	74	$121.74	$95.76	3
Nebraska	72	$238.89	$202.15	4
Louisiana	65	$200.83	$173.46	4
Colorado	63	$282.64	$212.52	5
South Dakota	59	$170.55	$138.87	4
Hawaii	54	$327.26	$221.09	3
Delaware	50	$280.93	$218.52	2
Utah	40	$211.40	$175.63	3
Maine	37	$203.71	$150.82	2
Oregon	35	$274.97	$204.04	2
New Mexico	33	$122.28	$96.22	1
Montana	29	$291.28	$206.37	2
Alaska	27	$339.60	$219.94	2
Vermont	14	$263.93	$215.41	1
Wyoming	14	$327.22	$241.99	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
12053Intermediate repair of wound of face$180.85
12001Simple repair of surface wound of scalp$64.10
12002Simple repair of surface wound of scalp$68.13
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.