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CPT 12002: Simple Repair of Superficial Wounds 2.6–7.5 cm
CPT code 12002 designates the simple repair of superficial wounds measuring 2.6 to 7.5 cm on anatomical sites including the scalp, neck, axillae, external genitalia, trunk, and extremities (including hands and feet). This code is widely used across urgent care, emergency medicine, family medicine, and surgical settings for straightforward laceration management that does not require complex layered closure. Nationally, correct use of this CPT code affects clinical documentation, coding consistency, and payer adjudication for a common procedural category in ambulatory and emergency care.
Key payers in the analysis include Aetna, Blue Cross Blue Shield, Cigna Health, UnitedHealthcare, and Medicare. The report outlines common clinical scenarios, coding boundaries relative to wound size and complexity, and the primary settings where the service is delivered. Readers will find benchmarks for utilization and common payer considerations, a concise overview of allowable ICD-10 principal diagnoses for typical encounters, and context for related simple repair codes for adjacent wound-size ranges. The summary supports billing staff, clinicians, and compliance teams seeking clear, national-level guidance on the clinical intent and administrative use of CPT code 12002 without providing prescriptive clinical or billing advice.
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Billing Code Overview
CPT code 12002 describes the simple repair of superficial wounds to the scalp, neck, axillae, external genitalia, trunk, and/or extremities (including the hands and feet) for wounds measuring 2.6 to 7.5 cm.
Service Type: Simple wound repair (superficial)
Typical Site of Service: Ambulatory clinic, urgent care, emergency department, or outpatient surgical suite, depending on clinical setting and patient presentation.
National Reimbursement Benchmarks
National commercial averages for CPT 12002 sit above Medicare: BUCA’s mean rate is $207.80 while Medicare’s mean is $143.70, a gap of $64.10. Blue Cross Blue Shield and UnitedHealth Group show higher mean levels at $262.30 and $161.70 respectively, with Cigna and Aetna lower than BCBS but generally above Medicare. This positions Medicare as a lower baseline vs. several commercial payers, with BUCA representing a mid-to-high commercial average.
Dispersion measured as the interquartile spread (P75–P25) varies notably by payer. Blue Cross Blue Shield has the widest IQR at $86.00 (P75 $319.90 minus P25 $211.30), followed by UnitedHealth Group at $111.10 (P75 $203.80 minus P25 $102.70) and Cigna at $103.60. Aetna’s IQR is $78.00. BUCA’s IQR is $102.50 and Medicare’s IQR is $16.00, making Medicare the tightest and Blue Cross Blue Shield among the widest in absolute interquartile spread.