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CPT 12007: Simple Repair of Superficial Wounds Over 30.0 cm
CPT code 12007 denotes the simple repair of superficial wounds longer than 30.0 cm across a range of anatomic sites including the scalp, neck, axillae, external genitalia, trunk, and extremities. This code matters nationally because wound management is a common acute-care procedure across emergency, outpatient, and office-based settings; accurate coding affects clinical documentation, billing consistency, and payment for frequently performed minor surgical services. Key payers included in the analysis are Aetna, Blue Cross Blue Shield, Cigna Health, UnitedHealthcare, and Medicare.
Readers will find an overview of the clinical context for simple superficial wound repairs, typical sites of service, and where 12007 fits among adjacent simple repair codes (for shorter or longer total wound lengths). The summary covers common ICD-10 diagnoses that map to simple lacerations and related encounter codes, typical modifier usage patterns, and the specialty taxonomies most likely to bill this service (surgery, family medicine, dermatology). The piece also highlights practical billing considerations such as code adjacency (related simple repair codes) and typical payer coverage patterns. Data not available in the input is noted where applicable.
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Billing Code Overview
CPT code 12007 describes the simple repair of superficial wounds to the scalp, neck, axillae, external genitalia, trunk, and/or extremities (including the hands and feet) when the total length of the wound(s) is over 30.0 cm. The service type is simple wound repair, and the typical site of service includes ambulatory surgery centers, hospital outpatient departments, emergency departments, and physician offices where minor surgical wound repairs are performed.
National Reimbursement Benchmarks
National averages show Medicare at $262.3 versus BUCA (average commercial) at $349.5, indicating BUCA pays about $87.2 more on average than Medicare for CPT 12007. Blue Cross Blue Shield and Cigna sit above Medicare as well, while Aetna and UnitedHealth Group cluster between Medicare and BUCA on mean rates.
Rate dispersion (P75 minus P25) highlights variability: Blue Cross Blue Shield has the widest interquartile spread at $246. (P75 $523.7 − P25 $278.4 = $245.3 rounded to $246), followed by UnitedHealth Group with a spread of $213.3 (P75 $435.9 − P25 $224.6 = $211.3 rounded to $213), and Cigna with $194.9. Aetna displays the tightest IQR at $150.8, and BUCA’s IQR is $221.8.