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    OpenPayerBilling CodesRepair-Simple Procedures on the Integumentary SystemCPT cpt-12014-simple-repair-superficial-wounds-face-5-1-7-5-cm
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    CPT 12014: Simple Repair of Superficial Facial Wounds 5.1–7.5 cm

    Medicare pays $177 and commercial payers pay $230 on average nationally for this procedure.

    CPT code 12014 describes the simple repair of superficial wounds of the face, ears, eyelids, nose, lips, and mucous membranes measuring 5.1 to 7.5 cm; service type is simple wound repair and the typical site of service is an outpatient clinic, emergency department, or ambulatory surgical setting for minor facial laceration management.

    For related coverage guidance, see recent payer policy updates: Mohs Micrographic Surgery, Mohs Micrographic Surgery, Mohs Micrographic Surgery.

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    National Reimbursement Benchmarks

    Medicare’s mean rate of $177.3 sits below BUCA’s average commercial mean of $230, indicating that BUCA reimburses notably higher on average for CPT 12014 than the Medicare benchmark. The gap of $52.7 between those means highlights a material spread between a public payer baseline and a commercial average for this code.

    Rate dispersion (P75 minus P25) varies meaningfully across payers: Blue Cross Blue Shield shows the widest spread at $121.0 ($344.6 − $223.6), followed by Cigna at $138.7 ($250.9 − $116.2) and UnitedHealth Group at $129.5 ($259.6 − $130.1). Aetna’s dispersion is tighter at $83.4 ($121.7 − $37.8). BUCA’s interquartile spread is $118.8 ($287.2 − $168.4), and Medicare’s interquartile range is narrow at $19 ($185 − $166).

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    National Payer Mean Reimbursement Rates

    State Reimbursement Rates

    State: Alaska1 / 51

    Rate by payer

    Clinical & Coding Specifications

    Clinical Context

    A 28-year-old patient presents to an urgent care clinic after sustaining a 6.0 cm superficial laceration across the right cheek and perioral mucosa after a bicycle accident. The wound involves epidermis and superficial dermis without deep tissue involvement or foreign body, and the patient is hemodynamically stable. Local anesthesia is administered, the area is irrigated and cleansed, and simple layered closure of the superficial wound is performed using interrupted nonabsorbable sutures for the skin and absorbable sutures for any mucosal repair. The procedure is documented as a simple repair of a superficial wound 5.1 to 7.5 cm in length on the face.

    Typical clinical workflow:

    • Triage and wound assessment with vital signs and tetanus status review.

    • Wound photography and measurement (documented length 6.0 cm) and determination of wound complexity (superficial, no contamination, no structural repair required).

    • Informed consent and local anesthesia (e.g., infiltration of lidocaine with or without epinephrine).

    • Wound irrigation, debridement of devitalized tissue as needed, and simple repair technique performed.

    • Post-procedure instructions provided for wound care and suture removal timeline, and documentation of procedure details, wound length, anesthesia, and provider taxonomy.

    • Coding entry: primary CPT code 12014 for simple repair of superficial wound 5.1 to 7.5 cm on the face, with an appropriate ICD-10 diagnosis such as S01.411A to reflect a right cheek laceration initial encounter.

    Related CPT Codes

    Related Modifiers

    5 rows

    ModifierDescriptionWhen to Use
    25CPT modifier 25 indicates that on the same day as another procedure or service, the same physician or other qualified health care professional provided a significant, separately identifiable…- When to apply: Use modifier 25 only on an E/M code to indicate the same provider delivered a significant, separately identifiable E/M service on the same day as another procedure or service — i.e.,…
    91Modifier 91 — “Repeat Clinical Diagnostic Laboratory Test” — is appended when the exact same CPT laboratory test is performed more than once for the same patient on the same day because serial,…- Use modifier 91 when the exact same CPT laboratory test is performed more than once on the same patient on the same date because serial or repeated testing is medically necessary to monitor…
    58Modifier 58 (Staged or related procedure/service by the same physician during the postoperative period) indicates that a subsequent procedure performed by the same provider during the…- Use modifier 58 when the same physician/QHP performs a procedure during the postoperative/global period of an earlier procedure and the subsequent procedure is either planned or anticipated…
    92Modifier 92 (Alternative Laboratory Platform Testing) is used when laboratory tests are performed with single‑use, disposable, portable kits or transportable instruments. The AMA defines it for tests…- Use modifier 92 when a laboratory test is performed using a single‑use, disposable analytical device or kit (an alternative laboratory platform) that is portable and may be taken to or near the…
    33Modifier 33 was created by the American Medical Association in response to the Affordable Care Act to identify services provided for preventive intent. It is appended to CPT/HCPCS codes that could be…- Use modifier -33 when a CPT/HCPCS service that can be billed as either preventive or diagnostic/treatment is provided with preventive intent and aligns with USPSTF A or B recommendations or other…

    Related Provider Taxonomies

    8 rows

    Taxonomy Code
    208600000X
    207X00000X
    207N00000X
    208800000X
    207Y00000X
    164W00000X
    2083P0901X
    237600000X

    Related Payer Policy Updates

    Specialty: Dermatology1 / 3

    10 rows

    PolicyPayerEffective Date
    Mohs Micrographic Surgerypremerabluecrossofwashington2027-02-05
    Mohs Micrographic Surgerypremerabluecrossofwashington2027-02-05
    Mohs Micrographic Surgerypremerabluecrossofwashington2027-02-05
    FilsuvezCigna2026-11-01
    Destruction of Pre-Malignant Skin LesionsAnthem2026-10-01
    Onychomycosis diagnostic testing and coverageOscar Health2026-10-01
    Treatment of Capillary Malformations (Port Wine Stains)universityofutahhealthplans2026-09-28
    AnzupgoCigna2026-09-15
    Hyperhidrosispriority_health_medicare2026-09-01
    Zevaskyn Coverage for Recessive Dystrophic Epidermolysis BullosaCigna2026-09-01

    Related Codes

    CPT-12001-SIMPLE-SUPERFICIAL-WOUND-REPAIR-25CM-OR-LESS

    CPT 12001: Simple repair of superficial wound, ≤2.5 cm

    CPT-12002-SIMPLE-REPAIR-SUPERFICIAL-WOUNDS-26-75MM

    CPT 12002: Simple Repair of Superficial Wounds 2.6–7.5 cm

    CPT-12004-SIMPLE-REPAIR-SUPERFICIAL-WOUND-7-6-12-5-CM

    CPT 12004: Simple Repair of Superficial Wounds 7.6–12.5 cm

    CPT-12005-SIMPLE-REPAIR-SUPERFICIAL-WOUND-12-6-TO-20CM

    CPT 12005: Simple Repair of Superficial Wound 12.6–20.0 cm

    CPT-12006-SIMPLE-REPAIR-SUPERFICIAL-WOUNDS-20-1-30-CM

    CPT 12006: Simple Repair of Superficial Wound 20.1–30.0 cm

    CPT-12007-SIMPLE-REPAIR-SUPERFICIAL-WOUNDS-OVER-30CM

    CPT 12007: Simple repair of superficial wound >30.0 cm

    CPT-12011-SIMPLE-REPAIR-SUPERFICIAL-FACIAL-WOUND-2-5CM-OR-LESS

    CPT 12011: Simple Repair of Superficial Facial/Mucous Membrane Wounds ≤2.5 cm

    CPT-12013-SIMPLE-REPAIR-SUPERFICIAL-WOUNDS-FACE-2-6-5-0-CM

    CPT 12013: Simple Repair of Superficial Facial Wounds, 2.6–5.0 cm

    CPT-12015-SIMPLE-REPAIR-SUPERFICIAL-WOUNDS-FACE-76-125-CM

    CPT 12015: Simple Repair of Superficial Facial Wounds 7.6–12.5 cm

    CPT-12016-SIMPLE-REPAIR-SUPERFICIAL-WOUNDS-FACE-12-6-20-CM

    CPT 12016: Simple Repair of Superficial Wounds, Face 12.6–20 cm

    Showing 1–10 of 14

    Frequently Asked Questions

    References

    1. 1.CPT® Codes and Descriptions. AAPC. Retrieved Aug 11, 2026.Maintains the CPT code set's official descriptions and guidelines, licensed from the American Medical Association, used as the definitional source for CPT codes on this page.
    2. 2.HCPCS Quarterly Update. Centers for Medicare & Medicaid Services (CMS). Retrieved Aug 11, 2026.CMS's quarterly release of HCPCS Level II codes and short/long descriptors, the source for HCPCS code definitions and update history.
    3. 3.ICD-10-CM Full Code List. Centers for Medicare & Medicaid Services (CMS). Retrieved Aug 11, 2026.CMS's complete ICD-10-CM diagnosis code list, used to cross-reference diagnosis codes associated with this procedure or service.
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    Trek Health ingests and normalizes Transparency in Coverage data and payer policy updates to give provider organizations a clear view of how commercial reimbursement behaves across markets, payers, and services. Our platform transforms raw payer disclosures into structured intelligence that supports contract evaluation, payer negotiations, and service line strategy. By combining market benchmarks with ongoing policy visibility, Trek helps teams identify variability, risk, and opportunity in commercial reimbursement. The result is faster insight, stronger negotiating positions, and more informed financial decisions.

    CPT CodeDescriptionRelationship to This Procedure
    12013Simple repair of superficial wounds of face, ears, eyelids, nose, lips and/or mucous membranes; 2.6 cm to 5.0 cmAdjacent size category: used when wound length measures between 2.6 and 5.0 cm instead of 5.1–7.5 cm.
    12015Simple repair of superficial wounds of face, ears, eyelids, nose, lips and/or mucous membranes; 7.6 cm to 12.5 cmAdjacent size category: used when wound length measures between 7.6 and 12.5 cm instead of 5.1–7.5 cm.