CPT 12015: Simple Repair of Superficial Facial Wounds 7.6–12.5 cm
Medicare pays $217 and commercial payers pay $254 on average nationally for this procedure.
CPT code 12015 describes a simple repair procedure for superficial lacerations of the face, ears, eyelids, nose, lips, and/or mucous membranes measuring 7.6 to 12.5 cm; the service type is simple wound repair, typically performed in outpatient surgical or emergency department settings for initial or subsequent wound 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
Commercial averages sit above Medicare for CPT 12015: Blue Cross Blue Shield and UnitedHealth Group show mean rates of $297.60 and $251.50 respectively, while BUCA’s mean is $253.90 as a representative commercial average; Medicare’s mean is $216.80. This places Medicare about $37 below BUCA’s mean and notably lower than the highest commercial means, indicating that commercial payers on average reimburse at higher levels than Medicare for this code. Dispersion (P75 minus P25) varies meaningfully by payer. Blue Cross Blue Shield has a wide interquartile spread of $132.20, and UnitedHealth Group and Cigna also show substantial spreads of $159.70 and $160.00 respectively, indicating higher variability; Aetna’s spread is $99.60, and BUCA’s spread is $135.90. Medicare’s interquartile spread is tight at $23.00, showing the narrowest range among these payers.