CLOSURE OF SPLIT WOUND at Samaritan Medical Center

Watertown, NY

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Payers reporting CPT 12020-PO at Samaritan Medical Center

Negotiated rates from the hospital’s own file: 2 payers, 2 plan rates. A facility fee, a professional fee, a per diem and a case rate are different bills, so each is listed on its own. Open a payer to see it across hospitals.

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1	UnitedHealthcare commercial facility · case rate · outpatient	$300	$300	—	—	—	$300 – $300
2	Aetna commercial facility · percent of total billed charges · outpatientfrom % of charges	$1.1k	$1.1k	—	—	—	$1.1k – $1.1k

Last updated: Feb 2, 2026

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CPT 12020-PO