CPT 12034
Global 010 ActiveIntmd rpr s/tr/ext 7.6-12.5
CPT 12034 Billing & Documentation Guide
CPT code 12034 (Intmd rpr s/tr/ext 7.6-12.5) is classified under Anesthesia with a global period indicator of 010. The 2026 Medicare Physician Fee Schedule assigns a work RVU of 2.9, a non-facility practice expense RVU of 6.73, and a malpractice RVU of 0.39, a total non-facility RVU of 10.02 and facility RVU of 5.39. With the current conversion factor of $33.4009, the national average non-facility reimbursement is approximately $344.59, though rates vary from $296.66 to $438.64 based on MAC locality and Geographic Practice Cost Indices (GPCIs).
When billing 12034, 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 12034 with related codes; this code has 10 PTP bundling relationships on file (see table below).
Payment Status & Global Period
Active code (paid under MPFS)
10-day global period (minor procedure: pre-op day + procedure + 10 days post-op)
MUE Limit (Medically Unlikely Edits)
Submitting more than 1 units of 12034 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 12034
| Component | Non-Facility | Facility |
|---|---|---|
| Work RVU | 2.9 | 2.9 |
| Practice Expense RVU | 6.73 | 2.1 |
| Malpractice RVU | 0.39 | 0.39 |
| Total RVU | 10.02 | 5.39 |
| Conversion Factor | $33.4009 | |
2026 Medicare Reimbursement by State, CPT 12034
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 | $373.38 | $190.4 | $351.86 - $438.64 | 29 |
| Florida | $347.76 | $192.6 | $331.34 - $363.81 | 3 |
| Georgia | $327.04 | $179.51 | $312.9 - $341.18 | 2 |
| Illinois | $339.29 | $189.87 | $322.45 - $353.35 | 4 |
| Michigan | $326.28 | $181.06 | $316.8 - $335.75 | 2 |
| North Carolina | $314.91 | $170.63 | $314.91 - $314.91 | 1 |
| New York | $369.94 | $197.41 | $319.57 - $394.52 | 5 |
| Ohio | $315.22 | $174.03 | $315.22 - $315.22 | 1 |
| Pennsylvania | $331.84 | $180.36 | $315.53 - $348.15 | 2 |
| Texas | $330.8 | $178.55 | $313.52 - $346.42 | 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 12034
Procedure-to-procedure (PTP) edits. If you bill any of these codes with 12034 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 |
| 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 |
| 0569T | Column 1 (primary), can be billed with modifier | Yes | Misuse of Column Two code with Column One code |
Frequently Asked Questions, CPT 12034
What does CPT code 12034 mean? +
CPT code 12034 represents: Intmd rpr s/tr/ext 7.6-12.5. It's in the Anesthesia category with a global period of 010.
What is the Medicare reimbursement for CPT 12034? +
The 2026 Medicare national average non-facility payment for CPT 12034 is $344.59. Rates range from $296.66 to $438.64 across 53 states depending on MAC locality and GPCIs.
What modifiers can I use with CPT 12034? +
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 12034? +
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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