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CPT 12036 · Surgery

Intmd rpr s/a/t/ext 20.1-30

Intermediate scalp, arm, or trunk wound repair (20-30 cm) costs range from $271.56 to $612.13 depending on facility type, so verify your bill matches the appropriate Medicare benchmark rate.

By David Park , Healthcare Cost Researcher · ·
Data from CMS files published FY 2024 CMS IPPS. Refreshed weekly.
About the analyst

David Park researches procedure pricing and insurance reimbursement patterns at BillRazor Research. He specializes in cost comparison across care settings and metropolitan areas. Expertise: procedure pricing, insurance reimbursement, cost comparison.

Medicare + CMS benchmark data
Publicly available pricing
Updated 2026-04-03
Rate comparison — Intmd rpr s/a/t/ext 20.1-30
Non-facility$99Medicare facility$272ASC rate$328Hospital outpatient$612$513 difference between lowest and highest rate
$272
Medicare facility rate
$99
Non-facility rate
$328
ASC rate
$284
ASC vs hospital gap

This procedure covers intermediate-level stitching to repair wounds on the scalp, arms, trunk, or limbs that measure 20.1 to 30 centimeters in length. Patients typically receive this after accidents, falls, or surgeries requiring moderately complex wound closure beyond simple suturing. The Medicare benchmark for code 12036 varies significantly based on geographic location and facility type.

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Compare by care setting
The same procedure costs different amounts depending on where you receive care.
$612
Hospital Outpatient rate for Intmd rpr s/a/t/ext 20.1-30
Medicare facility benchmark: $272
Regional rate comparison — Intmd rpr s/a/t/ext 20.1-30
Top 5 lowest and highest localities by Medicare facility rate
National avg $272REST OF ILLINOIS, IL$314DETROIT, MI$330QUEENS, NY$334MIAMI, FL$413CHICAGO, IL$390NYC SUBURBS/LONG ISLAND, NY$372

Facility rate

$272

National Medicare benchmark

Non-facility rate

$99

Office setting benchmark

Data sources

4

24 data points

Key insights for CPT 12036

ASC vs hospital outpatient savings

$284

Having this done at an ambulatory surgery center costs $328 vs $612 at a hospital outpatient

Facility vs office setting

$173 difference

Non-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.

SettingMedicare ratevs lowest
Facility (physician office)$272+174%
Non-facility (office)$99Lowest
Outpatient (APC)$612+518%
Ambulatory surgery (ASC)$328+232%

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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.

Rates shown are from the 2026 Medicare Physician Fee Schedule and CMS IPPS. BillRazor compares your bill against these data sources. See how it works →

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

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