2025 CPT code 12036
(Active) Effective Date: N/A Revision Date: N/A Surgery - Repair-Intermediate Procedures on the Integumentary System Surgery Feed
Intermediate repair of wounds to the scalp, axillae, trunk, and/or extremities (excluding hands and feet); 20.1 to 30 cm.
Modifier 59 (Distinct Procedural Service) may be used if this procedure is performed in conjunction with other procedures.Modifiers may also be necessary for location (e.g., RT or LT).
Medical necessity for this procedure is established when a wound of significant size and depth requires layered closure for proper healing and to prevent complications such as infection or scarring. The documentation should support the complexity of the repair and justify the use of this specific code.
The physician's responsibility includes evaluating the wound, performing appropriate debridement if necessary, administering anesthesia, closing the wound using sutures or other appropriate methods (including layered closure), and ensuring proper hemostasis.
In simple words: This code is used when a doctor repairs a medium-sized wound (20.1 to 30 centimeters long) on the scalp, armpits, torso, or arms/legs (not including the hands or feet). The repair needs more than a simple stitch; it involves closing multiple layers of skin and tissue.
This CPT code encompasses the intermediate repair of wounds located on the scalp, axillae, trunk, and/or extremities (excluding hands and feet).The repair involves layered closure of one or more deeper layers of subcutaneous tissue and superficial (non-muscle) fascia, in addition to skin closure.The total length of the repaired wound(s) must measure between 20.1 and 30.0 centimeters.Multiple wounds requiring intermediate repair in these same anatomic locations are summed together for coding purposes.Extensive cleaning or removal of particulate matter may also qualify a single-layer closure as an intermediate repair.
Example 1: A patient presents with a 25cm laceration across their abdomen after a motor vehicle accident. The wound requires layered closure of subcutaneous tissue and superficial fascia. Code 12036 is used., A patient sustains a 22cm laceration to their thigh during a sporting event. The wound is heavily contaminated and requires extensive cleaning prior to a single-layer closure. Code 12036 is used., A patient has three separate lacerations on their back after a fall – one is 8cm, one is 10cm and another is 7cm. All three are intermediate and on the same area. Total length is 25cm.Code 12036 is used.
** Accurate measurement of the wound length is crucial for proper code selection.If the wound extends beyond the 30cm limit for 12036, code 12037 should be used. The use of this code is dependent upon proper documentation to support the complexity of the procedure and the length of the wound. Review current payer specific guidelines for any additional requirements.
- Revenue Code: P5A (Ambulatory Procedures - Skin)
- RVU: The RVUs for this code vary depending on geographic location and other factors. Consult your local Medicare fee schedule or other payer's fee schedule for the most up-to-date information.
- Global Days: The global period for this procedure is dependent on the specific payer and may vary.Consult payer-specific guidelines for accurate information.
- Payment Status: Active
- Modifier TC rule: Not applicable
- Fee Schedule: Historical fee schedules vary widely by payer and location. Consult the appropriate payer's historical fee schedules for accurate data.
- Specialties:General Surgery, Plastic Surgery, Emergency Medicine
- Place of Service:Office, Ambulatory Surgical Center, Hospital (Inpatient and Outpatient), Emergency Room