What is the top of the local market (P90) for CPT 12001 under Bcbsal for Billings, MT providers?

The P90, the top of the local market and Reddenda's target rate, is $149.33.

How does Bcbsal's rate for CPT 12001 compare to Medicare?

The Bcbsal local median of $149.33 is 131% of Medicare's national non-facility rate of $113.90 for CPT 12001.

Reddenda · Rate Intelligence · Billings, MT

12001 under Bcbsal, for Billings, MT providers

Name: Bcbsal rates for CPT 12001 among Billings, MT providers
Creator: Reddenda

Simple wound repair, ≤2.5cm · Local peer median $149.33 · Medium confidence

$149.33 local peer median. Bcbsal's published rate file lists a local peer median of $149.33 for CPT 12001 (Simple wound repair, ≤2.5cm) among 204 indexed providers in Billings, MT. Where a Blue Cross entity’s label carries a state, that state names the file we found the rate in, not the provider’s location. Blue Cross plans file separately per state and do not share rates, even for the same provider. The top of that filed distribution, the P90 target, is $149.33, which is the same as the median here: this payer's filed rates for this code cluster on one number, so the opportunity in this cell is reaching the median rather than exceeding it. A provider billed below this median is being paid less than peers holding the identical Bcbsal contract for the identical code. Modeled from published rates, not guaranteed.

Local distribution · 204 providers · 204 rate records

P10

$134.39

P25

$149.33

Median

$149.33

P75

$149.33

P90 (target)

$149.33

P10$134.39

P25$149.33

Median (P50)$149.33

P75$149.33

P90 target$149.33

Peer basis: local peer distribution: same CPT, same payer file, same metro (CBSA) Benchmark: local peer median; never a national average Range: $35.52 – $270.42

The local peer median for CPT 12001 under Bcbsal for Billings, MT providers is $149.33, drawn from 204 distinct providers.Source: the federal Transparency in Coverage Rule (45 CFR §147.212), which compels Bcbsal to publish this rate
The bottom of the local market (P10) is $134.39 and the top (P90) is $149.33; the median-to-P90 spread is $0.Source: the federal Transparency in Coverage Rule (45 CFR §147.212), which compels Bcbsal to publish this rate
The lowest published rate in this market is $35.52; the highest is $270.42.Source: the federal Transparency in Coverage Rule (45 CFR §147.212), which compels Bcbsal to publish this rate
This benchmark is drawn from 204 individual rate records that Bcbsal itself published for this code in this metro.Source: the federal Transparency in Coverage Rule (45 CFR §147.212), which compels Bcbsal to publish this rate
Medicare's national non-facility rate for CPT 12001 is $113.90, making the Bcbsal local median 131% of Medicare.Source: Medicare Physician Fee Schedule; the federal Transparency in Coverage Rule (45 CFR §147.212), which compels Bcbsal to publish this rate
87.7% of indexed providers cluster at the single most common rate; the remainder shows a real, scoreable spread across the local market.Source: the federal Transparency in Coverage Rule (45 CFR §147.212), which compels Bcbsal to publish this rate
A federal No Surprises Act arbitrator may weigh up to four plan years of a provider's own contracted rate history and local market share when resolving a payment dispute over this exact code and payer.Source: 45 CFR §149.510(c)(4)(iii)(B)

204 providers bill this code to this payer in this metro.

Find yourself on this curve. Enter your NPI: no account, no email, no PHI.

Free, forever, unmetered. Possession-channel verification only if you choose to claim the record; looking is always free.

See where your rate lands

These are the rates Bcbsal publishes for CPT 12001 (Simple wound repair, ≤2.5cm) among Billings, MT providers. Enter your NPI to see your own contracted rate against this peer curve, per payer and per code. Free, about 15 seconds, no card and no PHI.

Run a free RateScore on your NPI → Talk to us about Bcbsal

Documented reimbursement opportunity, modeled from published rates and never a guaranteed outcome.

Modeled from Bcbsal's own published in-network rates, never guaranteed and never a national average. Peer basis: same CPT, same payer file, same metro (CBSA). Federal citation for the underlying obligation: the federal Transparency in Coverage Rule (45 CFR §147.212), which compels Bcbsal to publish this rate. Page generated 2026-08-23 23:56 UTC; the live index is queried in real time on every request.