CPT 12013

Simple Repair F/E/E/N/L/M 2.6cm-5.0 Cm

CPT 12013 pays $145.63 in a non-facility setting and $55.78 in a facility setting under the 2026 Medicare Physician Fee Schedule, before geographic adjustment. After geographic adjustment, state amounts run from $127.60 in Arkansas to $167.75 in Alaska, a 31% spread.

National non-facility rate

$145.63

Office and other outpatient settings

Facility rate
$55.78

Hospital and ASC settings

Highest state
$167.75

Alaska

Lowest state
$127.60

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 $145.63
CPT 12013 Medicare reimbursement rate by state, 33.4009 conversion factor, 2026 Physician Fee Schedule. National non-facility $145.63, national facility $55.78.
StateRate compared visuallyNon-facilityFacility
Alaska
$167.75$72.06
District of Columbia
$166.03$60.19
New York
$161.95$61.72
California
$160.68$54.36
New Jersey
$160.62$59.45
Washington
$158.54$56.11
Massachusetts
$157.31$56.37
Connecticut
$155.78$59.01
Hawaii
$155.10$52.94
Florida
$154.49$64.34
Maryland
$150.96$57.29
Illinois
$150.71$63.90
Colorado
$150.33$54.73
Oregon
$148.63$53.98
Rhode Island
$148.61$55.79
New Hampshire
$148.47$54.94
Puerto Rico
$146.56$55.72
Virgin Islands
$146.56$55.72
Montana
$145.61$55.76
Pennsylvania
$144.62$56.62
Nevada
$144.22$54.28
Delaware
$143.75$54.98
Texas
$143.70$55.25
Michigan
$143.39$59.03
Wyoming
$143.28$53.43
Georgia
$143.00$57.29
Minnesota
$142.09$49.63
Arizona
$141.33$54.26
Virginia
$141.33$53.01
North Dakota
$140.27$50.42
Vermont
$140.20$51.25
South Dakota
$139.64$49.79
New Mexico
$139.40$57.01
Utah
$138.90$54.44
Maine
$137.95$52.10
Louisiana
$137.62$55.59
Missouri
$137.51$55.06
Ohio
$137.27$55.24
South Carolina
$136.91$53.89
West Virginia
$136.83$58.75
North Carolina
$135.88$52.05
Wisconsin
$135.32$49.24
Kentucky
$134.11$54.23
Indiana
$133.92$50.63
Oklahoma
$133.25$53.02
Idaho
$133.13$50.47
Tennessee
$132.64$50.97
Nebraska
$132.56$49.63
Iowa
$131.96$49.75
Kansas
$131.86$50.63
Mississippi
$129.81$52.45
Alabama
$129.61$50.99
Arkansas
$127.60$50.42

Billed by 1 specialties

Commercial rates for 12013

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

See negotiated rates