# CPT 12004: Simple Rpr Scalp/neck/ax/genit/trunk 7.6-12.5cm

Medicare CPT 12004 pays $161.99 in a non-facility setting and $72.15 in a facility setting under the 2026 Medicare Physician Fee Schedule, before geographic adjustment. After geographic adjustment, state amounts run from $141.95 in Arkansas to $187.20 in Alaska, a 32% spread.

Web page: https://www.med-reveal.com/rates/12004-cpt-fee-schedule
Section: Surgery and Procedures
Billed by: Dermatology, Emergency Medicine

## Medicare rates

| | Amount |
| --- | --- |
| National non-facility | $161.99 |
| National facility | $72.15 |
| Conversion factor | 33.4009 |
| Release | 2026 Q4 (effective 2026-10-01) |

## By state

| State | Non-facility | Facility |
| --- | --- | --- |
| Alaska | $187.20 | $91.51 |
| District of Columbia | $184.31 | $78.47 |
| New York | $180.22 | $79.98 |
| New Jersey | $178.44 | $77.28 |
| California | $177.72 | $71.41 |
| Washington | $175.73 | $73.31 |
| Massachusetts | $174.48 | $73.53 |
| Connecticut | $173.27 | $76.50 |
| Florida | $172.78 | $82.63 |
| Hawaii | $171.63 | $69.47 |
| Illinois | $168.68 | $81.87 |
| Maryland | $167.89 | $74.22 |
| Colorado | $166.81 | $71.21 |
| Rhode Island | $165.13 | $72.32 |
| Oregon | $164.90 | $70.24 |
| New Hampshire | $164.89 | $71.36 |
| Puerto Rico | $162.98 | $72.14 |
| Virgin Islands | $162.98 | $72.14 |
| Montana | $161.97 | $72.12 |
| Pennsylvania | $161.04 | $73.03 |
| Nevada | $160.26 | $70.32 |
| Michigan | $160.13 | $75.76 |
| Delaware | $159.86 | $71.09 |
| Texas | $159.85 | $71.40 |
| Georgia | $159.44 | $73.72 |
| Wyoming | $159.13 | $69.28 |
| Minnesota | $157.26 | $64.80 |
| Arizona | $157.18 | $70.11 |
| Virginia | $156.98 | $68.66 |
| New Mexico | $155.56 | $73.17 |
| Vermont | $155.51 | $66.56 |
| North Dakota | $155.45 | $65.60 |
| South Dakota | $154.68 | $64.83 |
| Utah | $154.62 | $70.16 |
| Louisiana | $153.45 | $71.41 |
| Maine | $153.24 | $67.39 |
| Missouri | $153.24 | $70.79 |
| West Virginia | $153.09 | $75.02 |
| Ohio | $153.02 | $70.98 |
| South Carolina | $152.42 | $69.40 |
| North Carolina | $151.03 | $67.20 |
| Wisconsin | $149.99 | $63.92 |
| Kentucky | $149.49 | $69.61 |
| Indiana | $148.72 | $65.43 |
| Oklahoma | $148.39 | $68.15 |
| Idaho | $147.85 | $65.19 |
| Tennessee | $147.41 | $65.74 |
| Nebraska | $147.11 | $64.18 |
| Kansas | $146.52 | $65.30 |
| Iowa | $146.49 | $64.28 |
| Mississippi | $144.63 | $67.27 |
| Alabama | $144.18 | $65.57 |
| Arkansas | $141.95 | $64.78 |

## Related codes

- 10140: I&d Hematoma Seroma/fluid Collection — https://www.med-reveal.com/rates/10140-cpt-fee-schedule
- 11055: Paring/cutting Benign Hyperkeratotic Lesion 1 — https://www.med-reveal.com/rates/11055-cpt-fee-schedule
- 11056: Paring/cutting Benign Hyperkeratotic Lesion 2-4 — https://www.med-reveal.com/rates/11056-cpt-fee-schedule
- 11057: Paring/cutting Benign Hyperkeratotic Lesion >4 — https://www.med-reveal.com/rates/11057-cpt-fee-schedule
- 11403: Exc B9 Lesion Mrgn Xcp Sk Tg T/a/l 2.1-3.0 Cm — https://www.med-reveal.com/rates/11403-cpt-fee-schedule
- 11404: Exc B9 Lesion Mrgn Xcp Sk Tg T/a/l 3.1-4.0 Cm — https://www.med-reveal.com/rates/11404-cpt-fee-schedule
- 11406: Exc B9 Lesion Mrgn Xcp Sk Tg T/a/l >4.0 Cm — https://www.med-reveal.com/rates/11406-cpt-fee-schedule
- 11603: Excision Mal Lesion Trunk/arm/leg 2.1-3.0 Cm — https://www.med-reveal.com/rates/11603-cpt-fee-schedule

Commercial negotiated rates for 12004 by payer and state: https://www.med-reveal.com/solutions/rate-benchmarking

## Sources

- CMS Medicare fee schedules (2026 Q4): https://www.cms.gov/medicare/payment/fee-schedules