How much does Medicare pay for CPT 12041?

Medicare allowed an average of $171.72 per service and paid $132.93 of that, the balance being the patient's coinsurance and deductible (2024 data). Providers submitted an average of $532.74, which is what they billed rather than what they received — Medicare pays its fee schedule regardless of the charge.

What is CPT code 12041?

Intermediate repair of wound of neck, hands, feet, or genitals, 2.5 cm or less. It was billed 3,057 times to 2,967 Medicare beneficiaries by 172 providers in 2024.

Does 12041 pay differently in an office than a hospital?

Yes. The allowed amount averaged $176.32 in an office setting and $116.95 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 12041 most?

Dermatology, with 2,112 services from 119 clinicians. Next are Micrographic Dermatologic Surgery, Plastic and Reconstructive Surgery, Ambulatory Surgical Center.

CPT 12041

Intermediate repair of wound of neck, hands, feet, or genitals, 2.5 cm or less

$171.72Medicare-allowed amount per service, averaged across 3,057 services

Providers submitted

$532.74

Asking price, not received

Medicare allowed

$171.72

The fee schedule figure

Medicare paid

$132.93

Balance is patient coinsurance

Providers submitted an average of $532.74 for this code and Medicare allowed $171.72 — 3.1× 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 $132.93 (77%); the rest is the patient’s coinsurance and deductible.

Office pays differently to hospital

Office / non-facility: $176.32
Hospital / facility: $116.95

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. 2,820 services were billed in an office setting and 237 in a facility.

Services: 3,057
Beneficiaries: 2,967
Providers billing it: 172
Total allowed: $524,948

What Medicare pays for CPT 12041

Across 3,057 services billed by 172 providers to 2,967 beneficiaries, Medicare allowed an average of $171.72 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 12041

Specialty	Services	Beneficiaries	Avg allowed	Providers
Dermatology	2,112	2,063	$170.98	119
Micrographic Dermatologic Surgery	434	429	$150.35	23
Plastic and Reconstructive Surgery	231	221	$174.12	15
Ambulatory Surgical Center	99	92	$173.73	4
Internal Medicine	56	50	$221.00	3
Physician Assistant	54	53	$203.82	4
Podiatry	27	22	$291.34	1
Family Practice	19	14	$221.10	1
Otolaryngology	13	11	$212.93	1
Orthopedic Surgery	12	12	$243.78	1

12041 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
California	323	$202.50	$135.11	18
Florida	266	$179.11	$137.04	18
Texas	253	$183.66	$146.16	14
Georgia	249	$139.97	$109.52	12
Virginia	188	$166.27	$129.66	10
Illinois	153	$173.01	$129.62	8
Pennsylvania	140	$149.05	$123.82	9
Maryland	132	$196.90	$139.62	6
Ohio	122	$194.08	$151.10	7
Massachusetts	114	$163.16	$106.51	6
Arizona	99	$156.35	$117.44	5
Indiana	75	$114.13	$96.73	4
Alabama	71	$169.16	$159.10	2
Louisiana	69	$175.62	$145.77	4
New Jersey	60	$164.22	$118.54	3
Tennessee	59	$155.49	$127.98	4
Mississippi	58	$225.46	$175.94	4
New York	56	$233.25	$158.60	4
Oregon	55	$162.86	$121.86	4
Washington	47	$189.93	$137.83	3
Oklahoma	46	$106.56	$91.62	3
Utah	42	$138.58	$111.12	2
Wyoming	40	$206.60	$161.81	3
North Carolina	39	$131.19	$105.91	2
Iowa	36	$148.91	$123.19	2
Missouri	33	$148.37	$125.84	1
Connecticut	31	$166.29	$123.07	1
Hawaii	29	$219.88	$159.87	2
Kansas	28	$159.59	$131.37	2
Montana	23	$104.80	$83.00	1
Michigan	22	$211.61	$153.14	2
Kentucky	22	$131.52	$107.95	1
New Mexico	21	$129.96	$103.23	1
Colorado	17	$124.03	$102.98	1
South Dakota	15	$256.62	$200.82	1
Rhode Island	13	$195.13	$151.24	1
Minnesota	11	$85.45	$66.83	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
12002Simple repair of surface wound of scalp$68.13
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.