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CPT 12006: Simple Repair of Superficial Wounds, 20.1–30.0 cm
CPT code 12006 designates the simple repair of superficial wounds of the scalp, neck, axillae, external genitalia, trunk, and extremities (including hands and feet) for lacerations measuring 20.1 to 30.0 cm. The code is a common encounter-level surgical code used across emergency departments, urgent care centers, outpatient clinics, and ambulatory surgery settings for straightforward closures that do not require layered reconstruction. Nationally, accurate use of this code affects billing consistency, quality measurement related to wound care, and correct assignment of resources and facility charges.
Key payers included in this analysis are Aetna, Blue Cross Blue Shield, Cigna Health, UnitedHealthcare, and Medicare. Readers will find a concise explanation of the clinical context and service settings for 12006, how it relates to adjacent simple repair codes for smaller and larger wounds, and the typical documentation elements that support its use. The publication also summarizes payer coverage considerations and common billing modifiers observed with simple wound repairs, provides linkage to typical ICD-10 diagnosis options used with laceration encounters, and highlights provider taxonomies commonly associated with claims for this service.
This overview is intended for a national audience of clinicians, coding professionals, and billing managers seeking a clear reference on the clinical definition, coding boundaries, and operational context for CPT code 12006.
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Billing Code Overview
CPT code 12006 describes the simple repair of superficial wounds of the scalp, neck, axillae, external genitalia, trunk, and/or extremities (including the hands and feet) for wound lengths measuring 20.1 to 30.0 cm. This code is used when straightforward, primary closure techniques are performed for superficial lacerations without the need for complex layered repair.
Service type: Simple wound repair / surgical laceration repair
Typical site of service: Ambulatory surgical setting, emergency department, clinic procedure room, or urgent care
National Reimbursement Benchmarks
Medicare’s mean rate sits at $246.90, which is modestly below BUCA’s average commercial mean of $321.70, indicating that BUCA reimbursements are about $74.80 higher on average than Medicare for CPT 12006. That gap highlights how commercial payers can push average rates well above the government baseline, with BUCA positioned near the upper-middle of commercial means in this set of payers.
Across payers, measureable dispersion (P75 minus P25) varies: Aetna’s interquartile range is $122.00 ($166.00 - $42.00), Blue Cross Blue Shield’s is $232.00 ($500.80 - $268.90), BUCA’s is $202.00 ($414.10 - $212.10), Cigna’s is $155.00 ($350.40 - $175.00), and UnitedHealth Group’s is $187.00 ($379.20 - $192.20). Blue Cross Blue Shield shows the widest IQR at $232.00, while Aetna is the tightest at $122.00, with others falling in between.