Code Reality Check
12001 reimbursement rate: Simple wound repair, ≤2.5cm
Simple wound repair, ≤2.5cm (CPT 12001) pays a median $202.12 in Alaska and $76.89 in Kentucky, against a Medicare anchor of $127.66. 51 of 51 states clear the publication floor.
spread 2.6x top to bottom
Medicare anchor $127.66
51/51 states published
The 50-state spread
as of 2026-07-15| State | Median | vs Medicare | Band | Rate points | Tier |
|---|---|---|---|---|---|
| Alaska | $202.12 | 1.58x | $99–$226 · P90 $342 | 1,569 | Benchmark |
| Nebraska | $182.65 | 1.43x | $106–$212 · P90 $244 | 5,371 | Benchmark |
| South Dakota | $154.95 | 1.21x | $78–$240 · P90 $251 | 2,171 | Benchmark |
| Oregon | $147.15 | 1.15x | $101–$237 · P90 $314 | 10,494 | Benchmark |
| Montana | $137.28 | 1.08x | $82–$164 · P90 $246 | 2,948 | Benchmark |
| New Mexico | $133.41 | 1.05x | $92–$182 · P90 $215 | 5,095 | Benchmark |
| Wisconsin | $133.30 | 1.04x | $86–$278 · P90 $414 | 140,719 | Benchmark |
| North Carolina | $132.44 | 1.04x | $132–$190 · P90 $224 | 124,344 | Benchmark |
| Minnesota | $131.35 | 1.03x | $84–$237 · P90 $322 | 32,960 | Benchmark |
| Idaho | $128.41 | 1.01x | $90–$161 · P90 $192 | 4,391 | Benchmark |
| Iowa | $126.94 | 0.99x | $88–$213 · P90 $400 | 9,392 | Benchmark |
| South Carolina | $126.48 | 0.99x | $79–$190 · P90 $235 | 21,044 | Benchmark |
| Washington | $126.42 | 0.99x | $98–$213 · P90 $273 | 19,662 | Benchmark |
| Delaware | $126.31 | 0.99x | $81–$164 · P90 $208 | 3,246 | Benchmark |
| Massachusetts | $125.83 | 0.99x | $78–$209 · P90 $320 | 35,250 | Benchmark |
| Ohio | $125.55 | 0.98x | $85–$185 · P90 $283 | 261,511 | Benchmark |
| Connecticut | $123.96 | 0.97x | $81–$178 · P90 $250 | 17,648 | Benchmark |
| Colorado | $123.31 | 0.97x | $78–$158 · P90 $240 | 23,678 | Benchmark |
| Hawaii | $122.15 | 0.96x | $94–$122 · P90 $190 | 3,808 | Benchmark |
| California | $120.46 | 0.94x | $93–$212 · P90 $467 | 197,936 | Benchmark |
| Wyoming | $118.73 | 0.93x | $81–$169 · P90 $253 | 1,438 | Benchmark |
| New Hampshire | $116.58 | 0.91x | $67–$165 · P90 $207 | 28,556 | Benchmark |
| Louisiana | $116.37 | 0.91x | $78–$171 · P90 $235 | 11,305 | Benchmark |
| District of Columbia | $115.87 | 0.91x | $57–$189 · P90 $264 | 6,337 | Benchmark |
| Pennsylvania | $115.45 | 0.90x | $79–$182 · P90 $216 | 46,043 | Benchmark |
| Vermont | $114.14 | 0.89x | $65–$156 · P90 $257 | 4,869 | Benchmark |
| Nevada | $113.60 | 0.89x | $83–$164 · P90 $228 | 6,709 | Benchmark |
| West Virginia | $113.21 | 0.89x | $71–$181 · P90 $315 | 8,043 | Benchmark |
| Michigan | $112.66 | 0.88x | $88–$155 · P90 $223 | 29,594 | Benchmark |
| Indiana | $112.42 | 0.88x | $90–$167 · P90 $232 | 156,417 | Benchmark |
| New York | $111.58 | 0.87x | $74–$158 · P90 $286 | 589,673 | Benchmark |
| North Dakota | $111.38 | 0.87x | $84–$168 · P90 $244 | 1,856 | Benchmark |
| Illinois | $108.83 | 0.85x | $77–$169 · P90 $256 | 58,654 | Benchmark |
| New Jersey | $105.39 | 0.83x | $63–$162 · P90 $252 | 43,522 | Benchmark |
| Mississippi | $104.13 | 0.82x | $70–$188 · P90 $216 | 6,553 | Benchmark |
| Florida | $102.72 | 0.80x | $70–$149 · P90 $213 | 69,575 | Benchmark |
| Arizona | $101.40 | 0.79x | $75–$149 · P90 $230 | 18,496 | Benchmark |
| Georgia | $101.00 | 0.79x | $66–$157 · P90 $229 | 302,292 | Benchmark |
| Kansas | $98.47 | 0.77x | $66–$133 · P90 $173 | 9,294 | Benchmark |
| Maryland | $98.37 | 0.77x | $69–$154 · P90 $210 | 21,229 | Benchmark |
| Rhode Island | $98.08 | 0.77x | $74–$130 · P90 $184 | 7,962 | Benchmark |
| Utah | $97.41 | 0.76x | $85–$141 · P90 $201 | 6,355 | Benchmark |
| Arkansas | $96.78 | 0.76x | $74–$145 · P90 $188 | 7,580 | Benchmark |
| Tennessee | $96.41 | 0.76x | $71–$149 · P90 $206 | 28,859 | Benchmark |
| Missouri | $96.38 | 0.75x | $65–$146 · P90 $209 | 173,367 | Benchmark |
| Oklahoma | $96.14 | 0.75x | $74–$140 · P90 $176 | 8,391 | Benchmark |
| Texas | $95.27 | 0.75x | $65–$143 · P90 $212 | 82,275 | Benchmark |
| Virginia | $94.86 | 0.74x | $66–$133 · P90 $191 | 80,429 | Benchmark |
| Alabama | $87.87 | 0.69x | $62–$143 · P90 $193 | 13,124 | Benchmark |
| Maine | $87.54 | 0.69x | $54–$148 · P90 $213 | 32,660 | Benchmark |
| Kentucky | $76.89 | 0.60x | $48–$123 · P90 $180 | 66,227 | Benchmark |
Payer-blind local peer percentiles per state, full verified distribution. Publication floor: 11 verified rate points and a non-degenerate spread; the P25–P75 band unlocks at 25 points, P90 at 100 (a smaller cell's P90 is one contract, not a statistic).
Documented reimbursement figures are modeled, not guaranteed. Derived from federally mandated Transparency in Coverage data (45 CFR 147.212). No PHI.
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Cite this page
Source: Reddenda Code Reality Check, CPT 12001. Reddenda. https://reddenda.health/code/12001/
Derivation federally mandated TiC MRFs, verified to provider identity2,850,921 verified rate points across 51 statesas of 2026-07-15 · methodology v1.0