12007 Rpr s/n/ax/gen/trnk >30.0 cm
What 12007 is
CMS fee schedule short descriptor: Rpr s/n/ax/gen/trnk >30.0 cm.
Full CPT long descriptions are licensed by the American Medical Association and are not published on this site; the short descriptor above is the one CMS prints in its own fee schedule file. See About CPT.
Medicare payment for 12007 (CY2026)
| Work RVU | Practice expense RVU | Malpractice RVU | Total | Medicare rate | |
|---|---|---|---|---|---|
| Non-facility (office) | 2.83 | 4.21 | 0.62 | 7.66 | $255.85 |
| Facility (hospital, ASC) | 2.83 | 0.56 | 0.62 | 4.01 | $133.94 |
National rates: total RVUs x the CY2026 conversion factor of 33.4009 (non-QP), before geographic adjustment. Actual Medicare payment is 80% of the rate shown after the deductible; the patient or secondary payer owes the 20% coinsurance.
Status: Active - payable under the Physician Fee Schedule. Global period: Global concept does not apply (endoscopic or minor procedure: global period is the day of the procedure).
Medically Unlikely Edit (MUE)
Medicare caps 12007 at 1 unit per date of service for practitioner claims (MAI 2 - date of service edit (absolute): units above the MUE never pay), rationale: Anatomic Consideration. Units above the cap are denied unless the edit's adjudication rules allow an appeal with documentation.
Billed with 12007? These codes are bundled into it
12007 is a Column 1 code in 185 active NCCI PTP edits. When one of these Column 2 codes is reported on the same date of service, it is denied as bundled - unless the edit's modifier indicator is 1 and documentation supports a distinct service with an NCCI-associated modifier.
| Column 2 code | Short description | Modifier indicator | |
|---|---|---|---|
0213T | Njx paravert w/us cer/thor | 0 - no modifier bypass | Check pair |
0216T | Njx paravert w/us lumb/sac | 0 - no modifier bypass | Check pair |
0543T | Ta mv rpr w/artif chord tend | 1 - modifier may bypass | Check pair |
0544T | Tcat mv annulus rcnstj | 1 - modifier may bypass | Check pair |
0545T | Tcat tv annulus rcnstj | 1 - modifier may bypass | Check pair |
0569T | Ttvr perq appr 1st prosth | 1 - modifier may bypass | Check pair |
0570T | Ttvr perq ea addl prosth | 1 - modifier may bypass | Check pair |
0571T | Insj/rplcmt icds ss eltrd | 1 - modifier may bypass | Check pair |
0572T | Insertion ss dfb electrode | 1 - modifier may bypass | Check pair |
0573T | Removal ss dfb electrode | 1 - modifier may bypass | Check pair |
0574T | Repos prev ss impl dfb eltrd | 1 - modifier may bypass | Check pair |
0580T | Rmvl ss impl dfb pg only | 1 - modifier may bypass | Check pair |
0581T | Abltj mal brst tum perq crtx | 1 - modifier may bypass | Check pair |
0582T | Trurl abltj mal prst8 tiss | 1 - modifier may bypass | Check pair |
0655T | Tprnl focal abltj mal prst8 | 1 - modifier may bypass | Check pair |
0903T | Ecg alg 12 lead reduced i&r | 1 - modifier may bypass | Check pair |
0904T | Ecg alg 12 ld rdcd trcg only | 1 - modifier may bypass | Check pair |
0905T | Ecg alg 12 ld rdcd i&r only | 1 - modifier may bypass | Check pair |
11900 | Inject skin lesions </w 7 | 1 - modifier may bypass | Check pair |
11901 | Inject skin lesions >7 | 1 - modifier may bypass | Check pair |
12001 | Rpr s/n/ax/gen/trnk 2.5cm/< | 0 - no modifier bypass | Check pair |
12002 | Rpr s/n/ax/gen/trnk2.6-7.5cm | 0 - no modifier bypass | Check pair |
12004 | Rpr s/n/ax/gen/trk7.6-12.5cm | 0 - no modifier bypass | Check pair |
12005 | Rpr s/n/a/gen/trk12.6-20.0cm | 0 - no modifier bypass | Check pair |
12006 | Rpr s/n/a/gen/trk20.1-30.0cm | 0 - no modifier bypass | Check pair |
12018 | Rpr f/e/e/n/l/m >30.0 cm | 1 - modifier may bypass | Check pair |
15772 | Grfg autol fat lipo ea addl | 1 - modifier may bypass | Check pair |
15774 | Gfrg autol fat lipo ea addl | 1 - modifier may bypass | Check pair |
20560 | Ndl insj w/o njx 1 or 2 musc | 1 - modifier may bypass | Check pair |
20561 | Ndl insj w/o njx 3+ musc | 1 - modifier may bypass | Check pair |
Showing 30 of 185 column 2 codes. Use the pair checker for any specific combination.
12007 is bundled into these codes
12007 appears as a Column 2 code in 5583 active edits. Reported with one of these Column 1 codes on the same date of service, 12007 is the code that denies.
| Column 1 code | Short description | Modifier indicator | |
|---|---|---|---|
0219T | Plmt post facet implt cerv | 1 | Check pair |
0220T | Plmt post facet implt thor | 1 | Check pair |
0221T | Plmt post facet implt lumb | 1 | Check pair |
0308T | Insj ocular telescope prosth | 1 | Check pair |
0335T | Insj sinus tarsi implant | 1 | Check pair |
0338T | Trnscth renal symp denrv unl | 1 | Check pair |
0339T | Trnscth renal symp denrv bil | 1 | Check pair |
0342T | Thxp apheresis w/hdl delip | 1 | Check pair |
0345T | Transcath mtral vlve repair | 1 | Check pair |
0347T | Ins bone device for rsa | 1 | Check pair |
0395T | Hdr elctr ntrst/ntrcv brchtx | 1 | Check pair |
0397T | Ercp w/optical endomicroscpy | 1 | Check pair |
0402T | Colgn crs-link crn&pachymtry | 1 | Check pair |
0408T | Insj/rplc cardiac modulj sys | 1 | Check pair |
0409T | Insj/rplc car modulj pls gn | 1 | Check pair |
Data: CMS CY2026 Physician Fee Schedule RVU file (October release, RVU26D) and Medicare NCCI PTP practitioner edits v32.3 (2026 Q4). Verify against the official files before billing or contracting decisions.