Summary & Overview
CPT 12002: Simple Repair of Superficial Wounds, 2.6–7.5 cm
CPT code 12002 is a nationally recognized billing code for the simple repair of superficial wounds, specifically those measuring between 2.6 cm and 7.5 cm on areas such as the scalp, neck, axillae, external genitalia, trunk, and extremities. This code is widely used in clinical practice for treating lacerations that require basic closure techniques, making it relevant across emergency medicine, family medicine, and surgical specialties. The procedure is most often performed in an office setting, reflecting its routine nature in outpatient care.
Major payers including Aetna, Blue Cross Blue Shield, Cigna Health, Medicare, and UnitedHealthcare provide coverage for services billed under CPT 12002. The publication offers a comprehensive overview of payer policies, clinical benchmarks, and coding practices associated with this procedure. Readers will gain insight into the clinical context of wound repair, relevant modifiers such as 51 for multiple procedures and 59 for distinct procedural services, and associated provider taxonomies. Additionally, the article highlights common ICD-10 diagnoses linked to this code, such as lacerations of the head, forearm, finger, foot, and shoulder, and references related CPT codes for similar wound repairs.
This summary equips healthcare professionals, billing specialists, and policy analysts with essential information on CPT 12002, supporting accurate coding and understanding of payer coverage for simple wound repairs.
CPT Code Overview
CPT 12002 describes the simple repair of superficial wounds measuring 2.6 cm to 7.5 cm on the scalp, neck, axillae, external genitalia, trunk, and extremities, including hands and feet. This procedure is classified under the surgical repair of the integumentary system and is commonly performed in an office setting (Place of Service 11). The code is used when treating lacerations that do not involve complex closure techniques or extensive tissue involvement, providing a straightforward approach to wound management for a variety of anatomical sites.
Clinical & Coding Specifications
Clinical Context
A patient presents to the office (Place of Service 11) with a superficial laceration on the left forearm sustained during a fall. The wound measures 3.5 cm in length and does not contain a foreign body. After clinical assessment, the provider determines that a simple repair is appropriate. The area is cleaned, local anesthesia is administered, and the wound is closed using simple suturing techniques. The procedure is performed by a provider specializing in surgery, family medicine, or emergency medicine. Documentation includes wound location, length, and repair method.
Coding Specifications
-
Modifier
51(Multiple Procedures):- Used when more than one procedure is performed during the same session. Indicates that
12002is one of several procedures.
- Used when more than one procedure is performed during the same session. Indicates that
-
Modifier
59(Distinct Procedural Service):- Used to identify procedures/services that are not normally reported together, but are appropriate under the circumstances. Indicates that
12002is distinct from other services provided.
- Used to identify procedures/services that are not normally reported together, but are appropriate under the circumstances. Indicates that
| Taxonomy Code | Specialty Name |
|---|---|
208600000X | Surgery Physician |
207Q00000X | Family Medicine Physician |
207P00000X | Emergency Medicine Physician |
- These taxonomies represent providers who commonly perform simple wound repairs in office or emergency settings.
Related Diagnoses
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S01.81XA: Laceration without foreign body of other part of head, initial encounter- Relevant for superficial head wounds requiring simple repair.
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S51.812A: Laceration without foreign body of left forearm, initial encounter- Indicates a forearm laceration suitable for simple closure.
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S61.219A: Laceration without foreign body of unspecified finger without damage to nail, initial encounter- Used for finger lacerations not involving the nail, appropriate for simple repair.
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S91.312A: Laceration without foreign body of left foot, initial encounter- Represents a left foot laceration, often managed with simple closure.
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S41.012A: Laceration without foreign body of left shoulder, initial encounter- Applies to shoulder lacerations, typically treated with simple repair.
-
Each diagnosis code corresponds to a wound location and scenario where CPT code
12002may be used for closure.
Related CPT Codes
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12001: Simple repair of superficial wounds of scalp, neck, axillae, external genitalia, trunk and/or extremities (including hands and feet) up to 2.5 cm.- Used for smaller wounds; may be performed in the same session if multiple wounds are present.
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12004: Simple repair of superficial wounds of scalp, neck, axillae, external genitalia, trunk and/or extremities (including hands and feet) 7.6 cm to 12.5 cm.- Used for larger wounds; may be an alternative or used together if multiple wounds of varying sizes are repaired.
-
These codes are related to
12002by wound size and location. They are commonly used together when multiple wounds are repaired, or as alternatives based on wound length.
National Reimbursement Benchmarks
Medicare's national mean rate for CPT code 12002 is $143.73, which is higher than the BUCA (Blue Cross Blue Shield, UnitedHealth Group, Cigna, and Aetna) average commercial mean rate of $124.57. Among individual commercial payers, UnitedHealth Group has the highest mean rate at $165.05, while Aetna is the lowest at $101.20.
Rate dispersion, measured by the difference between the 75th and 25th percentiles, varies significantly across payers. Medicare shows the tightest range at $16.00, indicating relatively consistent rates nationally. In contrast, UnitedHealth Group has the widest dispersion at $89.67, reflecting greater variability in contracted rates. Cigna and Blue Cross Blue Shield also exhibit broad ranges, while Aetna and BUCA are more moderate.
The table and chart below present a detailed breakdown of national mean rates and percentile benchmarks for each payer.
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.