CPT 12011

Simple Repair F/E/E/N/L/M 2.5cm/<

CPT 12011 pays $139.62 in a non-facility setting and $54.44 in a facility setting under the 2026 Medicare Physician Fee Schedule, before geographic adjustment. After geographic adjustment, state amounts run from $122.19 in Arkansas to $159.85 in Alaska, a 31% spread.

National non-facility rate

$139.62

Office and other outpatient settings

Facility rate
$54.44

Hospital and ASC settings

Highest state
$159.85

Alaska

Lowest state
$122.19

Arkansas · 31% spread

Medicare rate by state

53 Medicare jurisdictions, highest to lowest. State values average every locality in the jurisdiction at a 33.4009 conversion factor.

Non-facilityFacilityNational $139.62
CPT 12011 Medicare reimbursement rate by state, 33.4009 conversion factor, 2026 Physician Fee Schedule. National non-facility $139.62, national facility $54.44.
StateRate compared visuallyNon-facilityFacility
Alaska
$159.85$69.14
District of Columbia
$159.66$59.33
New York
$155.26$60.24
California
$155.16$54.38
New Jersey
$154.29$58.38
Washington
$152.70$55.60
Massachusetts
$151.41$55.72
Hawaii
$149.70$52.86
Connecticut
$149.41$57.68
Florida
$147.21$61.76
Maryland
$144.79$56.00
Colorado
$144.57$53.95
Illinois
$143.46$61.16
Oregon
$142.97$53.24
Rhode Island
$142.65$54.67
New Hampshire
$142.64$53.98
Puerto Rico
$140.57$54.46
Virgin Islands
$140.57$54.46
Montana
$139.60$54.43
Pennsylvania
$138.47$55.04
Nevada
$138.43$53.17
Delaware
$137.85$53.70
Texas
$137.75$53.90
Wyoming
$137.62$52.45
Minnesota
$137.03$49.38
Michigan
$136.82$56.84
Georgia
$136.71$55.45
Virginia
$135.70$51.98
Arizona
$135.50$52.96
North Dakota
$135.05$49.88
Vermont
$134.85$50.53
South Dakota
$134.51$49.34
New Mexico
$133.09$54.99
Utah
$133.00$52.94
Maine
$132.42$51.04
Louisiana
$131.52$53.76
Missouri
$131.49$53.33
Ohio
$131.22$53.46
South Carolina
$131.08$52.38
North Carolina
$130.33$50.86
Wisconsin
$130.22$48.62
West Virginia
$130.19$56.18
Indiana
$128.57$49.62
Kentucky
$128.17$52.46
Idaho
$127.79$49.43
Oklahoma
$127.50$51.44
Nebraska
$127.35$48.74
Tennessee
$127.21$49.79
Iowa
$126.72$48.79
Kansas
$126.47$49.48
Alabama
$124.13$49.61
Mississippi
$124.10$50.77
Arkansas
$122.19$49.02

Billed by 1 specialties

Commercial rates for 12011

Medicare is the floor, not the market. See what UHC, Aetna, Cigna and BCBS actually pay — down to the TIN.

See negotiated rates