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CPT 12042Medical Service

Intermediate Repair of Wound of Neck

Intermediate repair of wound of neck, hands, feet, or genitals, 2.6-7.5 cm. Clinical pricing breakdown and utilization metrics across 1,531 practicing doctors nationwide.

$597.35
Peer Median Charge
Gross billed rate
$191.64
Standard Baseline
Customary allowable
3.1x
National Markup
Charge vs baseline
1,531
Active Physicians
Billing this code
Planning care or already received a bill for CPT 12042?Calculate total facility bundle costs or generate an assertive dispute settlement offer.

Understanding This Medical Fee

Gross Charge vs Negotiated Payment: The median physician charge for this service is $597.35. However, insured patients almost never pay this full amount directly. Insurers negotiate rates down toward the $191.64 baseline.

Self-Pay & Uninsured Guidance: If you are paying without insurance or out-of-network, request a prompt-pay cash discount. Most medical practices are willing to settle self-pay bills near the customary baseline rate rather than the full gross charge.

Key Questions for Your Doctor's Billing Office:
  • "Does Dr. [Name] participate in my specific insurance plan network?"
  • "What is the total self-pay or cash rate for code 12042 if paid upfront?"
  • "Are there separate facility, anesthesia, or pathology fees associated with this procedure?"