CPT 12031
Intermediate wound repair, up to 2.5 cm
A layered closure of a cut on the scalp, trunk, arm or leg, up to 2.5 centimetres. Intermediate means the wound needed deeper sutures beneath the skin, or extensive cleaning of debris, in addition to the skin closure. It is priced well above a simple repair.
Billed to Medicare
$835
What providers submitted, on average, for this code in a hospital setting.
Medicare accepted
$125
What Medicare treated as payable. Not a commercial rate or a cash price.
The gap
6.7x
How many times the accepted amount the billed figure was.
National averages from the Centers for Medicare & Medicaid Services, 2024 data, retrieved 2026-09-14. Medicare fee-for-service, physician and practitioner claims only. The hospital's own charge for the same code is separate and is usually higher. Based on 6,764 services.
Among the 10 er procedures and injections codes on this site with CMS figures, this gap ranks 4 of 10 (median 4.7x). The widest is Simple wound repair, up to 2.5 cm at 9.9x.
Where this line goes wrong
The note has to say layered
If the ER note describes a single layer of sutures with no deep closure and no extensive cleaning, the correct code is the simple repair (12001), which costs less.
Length and group rules
As with simple repairs, multiple wounds of the same type in the same body group are summed into one code.
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- 1
Ask for the ER note and check whether a layered closure or extensive cleaning is documented.
- 2
Check the wound length against the code's length band.
- 3
Check for separate supply or anaesthetic lines that are part of the procedure.
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Codes that travel with this one
People also ask
What makes a wound repair intermediate?
Closure of deeper tissue layers in addition to the skin, or a wound that needed extensive cleaning or removal of debris before a single-layer closure. Either has to be written in the note.
Sources
This page explains a billing code in general terms. It is not a coding, legal or medical opinion about your bill, and the code descriptions are mediloop's own plain-English summaries, not the official CPT descriptors, which are owned by the American Medical Association. Whether a charge was correct depends on the record of your visit and your payer's rules.