CPT 12006
Global 000 ActiveRpr s/n/a/gen/trk20.1-30.0cm
CPT 12006 Billing & Documentation Guide
CPT code 12006 (Rpr s/n/a/gen/trk20.1-30.0cm) is classified under Anesthesia with a global period indicator of 000. The 2026 Medicare Physician Fee Schedule assigns a work RVU of 2.33, a non-facility practice expense RVU of 4.35, and a malpractice RVU of 0.51, a total non-facility RVU of 7.19 and facility RVU of 3.27. With the current conversion factor of $33.4009, the national average non-facility reimbursement is approximately $245.63, though rates vary from $211.4 to $305.03 based on MAC locality and Geographic Practice Cost Indices (GPCIs).
When billing 12006, ensure documentation supports medical necessity and the specific components required for the code's level of service. For E/M codes, document MDM (medical decision-making) elements: problems addressed, data reviewed, and risk. For procedural codes, document the indication, technique, and any complications. Always verify NCCI edits before bundling 12006 with related codes; this code has 10 PTP bundling relationships on file (see table below).
Payment Status & Global Period
Active code (paid under MPFS)
Endoscopic or minor procedure with related preoperative and postoperative work performed on the same day
MUE Limit (Medically Unlikely Edits)
Submitting more than 1 units of 12006 for the same patient on the same date triggers automatic line denial unless an appropriate modifier and supporting documentation justify the higher quantity.
RVU Breakdown, CPT 12006
| Component | Non-Facility | Facility |
|---|---|---|
| Work RVU | 2.33 | 2.33 |
| Practice Expense RVU | 4.35 | 0.43 |
| Malpractice RVU | 0.51 | 0.51 |
| Total RVU | 7.19 | 3.27 |
| Conversion Factor | $33.4009 | |
2026 Medicare Reimbursement by State, CPT 12006
State-level averages across all MAC localities. Non-facility rates typically apply to office-based services; facility rates apply to hospital outpatient / inpatient.
| State | Non-Facility | Facility | Range (Non-Fac) | Localities |
|---|---|---|---|---|
| California | $261.77 | $106.85 | $247.52 - $305.03 | 29 |
| Florida | $256.77 | $125.4 | $242.33 - $272.16 | 3 |
| Georgia | $236.93 | $112.03 | $227.73 - $246.13 | 2 |
| Illinois | $251.04 | $124.53 | $237.1 - $263.48 | 4 |
| Michigan | $238.23 | $115.29 | $229.71 - $246.75 | 2 |
| North Carolina | $224.27 | $102.11 | $224.27 - $224.27 | 1 |
| New York | $266.76 | $120.69 | $227.83 - $287.19 | 5 |
| Ohio | $227.65 | $108.11 | $227.65 - $227.65 | 1 |
| Pennsylvania | $239.05 | $110.81 | $227.3 - $250.8 | 2 |
| Texas | $237.12 | $108.22 | $225.87 - $246.79 | 8 |
Source: CMS PFSRVU 2026 · Updated 2026-04-01. Full locality-level detail available for all 53 states, contact us for custom reports.
NCCI Bundling Edits, CPT 12006
Procedure-to-procedure (PTP) edits. If you bill any of these codes with 12006 on the same date of service, review the modifier indicator and payer policy before submission.
| Partner Code | Relationship | Modifier Allowed | Rationale |
|---|---|---|---|
| 01995 | Column 1 (primary), can be billed with modifier | No | Anesthesia service included in surgical procedure |
| 0213T | Column 1 (primary), can be billed with modifier | No | Misuse of Column Two code with Column One code |
| 0216T | Column 1 (primary), can be billed with modifier | No | Misuse of Column Two code with Column One code |
| 0228T | Column 1 (primary), can be billed with modifier | No | Standards of medical/surgical practice |
| 0230T | Column 1 (primary), can be billed with modifier | No | Standards of medical/surgical practice |
| 0543T | Column 1 (primary), can be billed with modifier | Yes | Misuse of Column Two code with Column One code |
| 0544T | Column 1 (primary), can be billed with modifier | Yes | Misuse of Column Two code with Column One code |
| 0545T | Column 1 (primary), can be billed with modifier | Yes | Misuse of Column Two code with Column One code |
| 0567T | Column 1 (primary), can be billed with modifier | Yes | Misuse of Column Two code with Column One code |
| 0568T | Column 1 (primary), can be billed with modifier | Yes | Misuse of Column Two code with Column One code |
Frequently Asked Questions, CPT 12006
What does CPT code 12006 mean? +
CPT code 12006 represents: Rpr s/n/a/gen/trk20.1-30.0cm. It's in the Anesthesia category with a global period of 000.
What is the Medicare reimbursement for CPT 12006? +
The 2026 Medicare national average non-facility payment for CPT 12006 is $245.63. Rates range from $211.4 to $305.03 across 53 states depending on MAC locality and GPCIs.
What modifiers can I use with CPT 12006? +
Surgery codes commonly use modifier 22 (increased procedural services), 50 (bilateral), 51 (multiple procedures), 52 (reduced services), 58/78/79 (staged, unplanned return, unrelated within global), 62 (co-surgeons), 80/82 (assistant surgeon), and 59 or the X{EPSU} subset for distinct procedural service.
What bundling edits apply to CPT 12006? +
This code has 10 NCCI PTP bundling relationships. See the NCCI Bundling section below for full list.
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Reviewed by the PayerReady Medical Coding Team
Verified against the CMS 2026 code set on May 31, 2026.
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