Rpr f/e/e/n/l/m >30.0 cm
Complex wound repair procedures for cuts longer than 30 centimeters range from $106.77 to $198.70 across different facilities, making it essential to verify your specific charges before payment.
About the analyst
Priya Iyengar leads the billing code review team at BillRazor Research. She analyzes NCCI bundling edits, DRG coding, and regional rate variation. Expertise: NCCI bundling, DRG analysis, regional pricing.
Code 12018 covers repair of wounds measuring 2.6 to 7.5 cm on the face, eyelids, nose, lips, or mucous membranes using layered closure techniques. Patients typically receive this procedure after facial trauma, accidents, or surgical excisions requiring precise tissue repair. This code charges approximately 8.2x the Medicare reimbursement rate of $284, with potential billing differences of $1,890 depending on facility type.
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Facility rate
$175
National Medicare benchmark
Non-facility rate
$99
Office setting benchmark
Data sources
4
24 data points
Key insights for CPT 12018
ASC vs hospital outpatient savings
$92Having this done at an ambulatory surgery center costs $107 vs $199 at a hospital outpatient
Facility vs office setting
$76 differenceNon-facility setting is less expensive for this procedure
What this procedure costs across different settings
The same procedure can cost very different amounts depending on where it's performed. These are the Medicare-allowed amounts — what hospitals actually charge can be 3-10x higher.
| Setting | Medicare rate | vs lowest |
|---|---|---|
| Facility (physician office) | $175 | +77% |
| Non-facility (office) | $99 | Lowest |
| Outpatient (APC) | $199 | +101% |
| Ambulatory surgery (ASC) | $107 | +8% |
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About this data
Rates shown are from the 2026 Medicare Physician Fee Schedule, Hospital Outpatient Prospective Payment System (OPPS), Ambulatory Surgery Center Payment System, Clinical Laboratory Fee Schedule, Durable Medical Equipment Fee Schedule, and CMS Inpatient Prospective Payment System (DRG weights). Regional adjustments use CMS Geographic Practice Cost Indices (GPCI). Hospital charges are from CMS Hospital Price Transparency machine-readable files. All data is publicly available under federal law (45 CFR Part 180).
This data is for informational purposes only and does not constitute medical or financial advice. Actual costs depend on insurance coverage, negotiated rates, and individual circumstances.
Data: Medicare Physician Fee Schedule, CMS Inpatient PPS (IPPS), Outpatient PPS (OPPS), ASC Payment System, Clinical Lab Fee Schedule (CLFS), National Average Drug Acquisition Cost (NADAC). FY 2024 data. All publicly available from CMS.
Methodology: Facility rate applies when the procedure is performed in a hospital or ASC. Non-facility rate applies in a physician office. GPCI adjustments reflect regional cost-of-living differences.
This information is for educational purposes only and is not medical, financial, or legal advice. Actual costs depend on your insurance and provider. We recommend verifying costs directly with your provider. Full methodology · Terms of use