CPT 12004
Wound Repair - All Levels
Current code64 hospitals with prices
What Washington hospitals publish for this code
Medicare Advantage: Rate for a private Medicare Advantage plan. Applies only to members of that plan.
| Hospital | Medicare Advantage rates (lowest – highest) | Cash price | List price (before discounts) |
|---|---|---|---|
| Arbor Health Morton Hospital | $488 – $637 | $658 | $1,061 |
| BHC Fairfax Hospital | — | $110 – $183 | $110 – $183 |
| Cascade Medical Center | $339 – $564 | $486 – $540 | $607 – $675 |
| Coulee Medical Center | — | $199 | $222 |
| Deaconess Medical Center | — | $321 | $802 |
| EvergreenHealth Medical Center | $223 – $228 | $992 | $1,240 |
| EvergreenHealth Monroe | $219 – $223 | $780 | $975 |
| Grays Harbor Community Hospital | $198 | $384 – $400 | $590 – $615 |
| Harborview Medical Center | — | $1,387 | $1,981 |
| Highline Medical Center | — | $377 | $1,233 |
| Island Hospital | $239 – $254 | $158 – $343 | $158 – $343 |
| Kadlec Regional Medical Center | — | $883 | $1,261 |
| Kittitas Valley Community Hospital | $207 | $489 | $575 |
| Legacy Salmon Creek Medical Center | — | $85.15 – $1,035 | $131 – $1,593 |
| Lincoln Hospital | $286 | $460 | $511 |
| Mason General Hospital & Family of Clinics | $436 – $501 | $369 – $1,174 | $492 – $1,565 |
| MultiCare Valley Hospital | — | $321 | $802 |
| Olympic Medical Center | $251 – $323 | $302 | $377 |
| Overlake Hospital Medical Center & Clinics | — | $758 | $1,515 |
| Prov Sacred HRT Med Ctr & Childs Hosp. | — | $474 | $677 |
| Providence Centralia Hospital | — | $578 | $1,111 |
| Providence Holy Family Hospital | — | $509 | $727 |
| Providence Mount Carmel Hospital | — | $128 – $160 | $183 – $229 |
| Providence Regional Medical Center Everett | — | $361 | $694 |
| Providence St Joseph Hospital | — | $160 – $167 | $229 – $238 |
| Providence St Mary Medical Center | — | $236 – $585 | $337 – $835 |
| Providence St Peter Hospital | — | $578 | $1,111 |
| Quincy Valley Medical Center | $132 – $403 | $206 – $629 | $206 – $629 |
| Seattle Children's Hospital | — | $1,125 | $304 – $1,125 |
| St Anthony Hospital | — | $375 | $1,233 |
| St Clare Hospital | — | $356 | $1,233 |
| St Elizabeth Hospital | — | $436 | $1,233 |
| St Francis Community Hospital | — | $387 | $1,233 |
| St Joseph Medical Center | — | $409 | $1,233 |
| St Michael Medical Center | — | $544 | $1,233 |
| Summit Pacific Medical Center | $346 – $367 | $747 | $1,383 |
| Swedish Issaquah | — | $608 | $1,266 |
| Swedish Medical Center | — | $608 | $1,266 |
| Swedish Medical Center / Cherry Hill | — | $608 | $1,266 |
| Three Rivers Hospital | — | ||
| Trios Health | $212 | — | $51,434 |
| University of Washington Medical Ctr | — | $956 | $1,365 |
| Virginia Mason Medical Center | — | $370 | $725 |
| Yakima Valley Memorial | — | $456 | $1,140 |
Medicare (traditional) reference
Only for people on original Medicare. These are CMS’s 2026 amounts. They aren’t what private insurance or cash patients pay.
- Doctor's fee, Seattle (King County)
- $186 in an office; $75.73 in a hospital or surgery center
- Doctor's fee, rest of Washington
- $165 in an office; $70.88 in a hospital or surgery center
- Hospital outpatient payment (national)
- $205 (APC 5051)
How hospitals also write this code
Some price files write it differently. These are counted as CPT 12004:
- 12004P (with a letter after it, P; 6 price lines)
- 12004T (with a letter after it, T; 3 price lines)