CPT code 12053: Wound repair, face and mucous membranes2026 Medicare rate & RVUs in Indiana
Report this code for intermediate layered repair of qualifying facial or mucous membrane wounds when the total repaired length is 5.1 to 7.5 cm.
In Indiana, Medicare pays $336.50 for 12053 in the office and $175.18 when it’s performed in a hospital or facility.
Check a contract rate as a % of Medicare · 12053 nationwide
Medicare allowed amount for participating (non-QP) physicians, before deductible, coinsurance and claim adjustments. Not a patient’s bill or a hospital charge.
On this page 11 sections
What 12053 covers
This code covers intermediate repair of wounds involving the face, ears, eyelids, nose, lips, or mucous membranes, with a total repaired length of 5.1 to 7.5 cm. The closure involves layered repair, such as closing deeper tissue and the skin, or a single-layer closure of a heavily contaminated wound that requires extensive cleaning. Physicians and other qualified practitioners commonly perform these repairs in emergency departments, offices, and outpatient settings after injuries such as facial lacerations.
Select the code based on the documented repair method, eligible anatomic group, and measured length of the repaired wound or wounds. For multiple qualifying wounds in the same anatomic group, report the code level supported by their combined repaired length. The note should identify the sites, lengths, and layered or contamination-related work supporting an intermediate repair. Medicare includes related postoperative visits during the 10-day global period. When multiple procedures are performed in the same session, the highest-valued procedure is paid in full and other procedures are subject to the standard multiple-procedure reduction. Assistant-at-surgery payment is restricted; co-surgeons and team surgery are not permitted.
This summary was written with AI assistance from CMS physician fee schedule data and checked against the CMS billing rules shown here. Rates on this page come directly from CMS files.
How Indiana compares for 12053
Across 109 of 109 payment localities, the office rate for 12053 runs from $320.23 in Arkansas to $474.59 in San Benito County, CA. Indiana pays $336.50. The RVUs are the same everywhere; the geographic indexes change the dollars.
- Indiana · this page$336.50
- Los Angeles, CA · California$405.72+$69.22
- Washington, DC area · District of Columbia$411.69+$75.19
- Miami, FL · Florida$391.02+$54.52
- Chicago, IL · Illinois$379.88+$43.38
- Manhattan, NY · New York$414.96+$78.46
- Alaska · Alaska$422.73+$86.23
Other areas in Indiana first, then benchmark localities. Bars start at $0.
Every other payment area
| Payment locality | Office | Facility |
|---|---|---|
| AlabamaAlabama | $324.81 | $172.54 |
| ArkansasArkansas | $320.23 | $170.74 |
| ArizonaArizona | $351.60 | $182.97 |
| Bakersfield, CACalifornia | $381.43 | $190.71 |
| Chico, CACalifornia | $380.28 | $189.55 |
| El Centro, CACalifornia | $380.34 | $189.62 |
| Fresno, CACalifornia | $380.28 | $189.55 |
| Hanford, CACalifornia | $380.28 | $189.55 |
| Madera, CACalifornia | $380.28 | $189.55 |
| Merced, CACalifornia | $380.28 | $189.55 |
| Modesto, CACalifornia | $380.28 | $189.55 |
| Napa, CACalifornia | $439.01 | $209.66 |
| Oxnard, CACalifornia | $403.60 | $197.91 |
| Redding, CACalifornia | $380.28 | $189.55 |
| Rest of CaliforniaCalifornia | $380.28 | $189.55 |
| Riverside, CACalifornia | $384.51 | $193.79 |
| Sacramento, CACalifornia | $398.64 | $196.26 |
| Salinas, CACalifornia | $397.15 | $195.46 |
| San Diego, CACalifornia | $406.18 | $198.05 |
| Marin County, CACalifornia | $464.20 | $218.83 |
| San Francisco, CACalifornia | $463.76 | $218.39 |
| San Benito County, CACalifornia | $474.59 | $223.65 |
| Santa Clara County, CACalifornia | $472.78 | $221.84 |
| San Luis Obispo, CACalifornia | $390.81 | $192.60 |
| Santa Cruz, CACalifornia | $409.83 | $198.39 |
| Santa Maria, CACalifornia | $398.55 | $195.65 |
| Santa Rosa, CACalifornia | $413.94 | $200.24 |
| Stockton, CACalifornia | $380.28 | $189.55 |
| Vallejo, CACalifornia | $438.37 | $209.02 |
| Visalia, CACalifornia | $380.28 | $189.55 |
| Yuba City, CACalifornia | $380.28 | $189.55 |
| ColoradoColorado | $375.12 | $189.96 |
| ConnecticutConnecticut | $384.72 | $197.30 |
| DelawareDelaware | $357.33 | $185.40 |
| Fort Lauderdale, FLFlorida | $374.77 | $198.49 |
| Rest of FloridaFlorida | $356.84 | $190.48 |
| Atlanta, GAGeorgia | $367.91 | $191.11 |
| Rest of GeorgiaGeorgia | $337.12 | $181.90 |
| Hawaii, Guam, HIHawaii | $389.12 | $191.26 |
| IowaIowa | $332.40 | $173.17 |
| IdahoIdaho | $334.61 | $174.52 |
| East St. Louis, ILIllinois | $354.69 | $194.59 |
| Rest of IllinoisIllinois | $347.10 | $188.22 |
| Suburban Chicago, ILIllinois | $378.45 | $199.74 |
| KansasKansas | $331.10 | $173.79 |
| KentuckyKentucky | $332.78 | $178.08 |
| New Orleans, LALouisiana | $348.39 | $184.64 |
| Rest of LouisianaLouisiana | $332.36 | $178.35 |
| Metropolitan Boston, MAMassachusetts | $411.36 | $203.58 |
| Rest of MassachusettsMassachusetts | $373.05 | $189.80 |
| Baltimore area, MDMaryland | $383.67 | $196.95 |
| Rest of MarylandMaryland | $363.97 | $187.86 |
| Rest of MaineMaine | $336.55 | $176.46 |
| Southern Maine, MEMaine | $354.05 | $181.60 |
| Detroit, MIMichigan | $361.43 | $193.50 |
| Rest of MichiganMichigan | $341.44 | $182.56 |
| MinnesotaMinnesota | $358.99 | $179.93 |
| Metropolitan Kansas City, MOMissouri | $345.83 | $182.43 |
| Metropolitan St. Louis, MOMissouri | $349.34 | $183.67 |
| Rest of MissouriMissouri | $326.94 | $176.93 |
| MississippiMississippi | $323.63 | $173.80 |
| MontanaMontana | $361.04 | $187.02 |
| North CarolinaNorth Carolina | $339.96 | $177.60 |
| North DakotaNorth Dakota | $353.33 | $179.31 |
| NebraskaNebraska | $334.11 | $173.49 |
| New HampshireNew Hampshire | $369.47 | $188.32 |
| Northern New JerseyNew Jersey | $407.62 | $205.76 |
| Rest of New JerseyNew Jersey | $388.98 | $198.95 |
| New MexicoNew Mexico | $343.36 | $183.79 |
| NevadaNevada | $359.13 | $184.94 |
| NYC suburbs and Long Island, NYNew York | $425.11 | $218.20 |
| Poughkeepsie and northern NYC suburbs, NYNew York | $391.70 | $201.15 |
| Queens, NYNew York | $417.99 | $212.30 |
| Rest of New YorkNew York | $344.95 | $179.64 |
| OhioOhio | $339.87 | $180.99 |
| OklahomaOklahoma | $331.96 | $176.56 |
| Portland, OROregon | $386.56 | $193.22 |
| Rest of OregonOregon | $356.22 | $182.89 |
| Metropolitan Philadelphia, PAPennsylvania | $375.47 | $194.32 |
| Rest of PennsylvaniaPennsylvania | $340.27 | $180.52 |
| Puerto RicoPuerto Rico | $363.56 | $187.63 |
| Rhode IslandRhode Island | $369.70 | $189.94 |
| South CarolinaSouth Carolina | $340.50 | $179.71 |
| South DakotaSouth Dakota | $352.41 | $178.40 |
| TennesseeTennessee | $332.75 | $174.57 |
| Austin, TXTexas | $373.99 | $189.87 |
| Beaumont, TXTexas | $338.10 | $179.75 |
| Brazoria, TXTexas | $356.82 | $184.37 |
| Dallas, TXTexas | $359.16 | $185.84 |
| Fort Worth, TXTexas | $356.88 | $185.30 |
| Galveston, TXTexas | $357.94 | $185.13 |
| Houston, TXTexas | $365.07 | $192.27 |
| Rest of TexasTexas | $347.31 | $182.17 |
| UtahUtah | $345.05 | $181.47 |
| VirginiaVirginia | $353.07 | $182.01 |
| Virgin Islands, VIUnited States Virgin Islands | $363.56 | $187.63 |
| VermontVermont | $352.18 | $179.90 |
| Rest of WashingtonWashington | $372.27 | $189.03 |
| King County, WAWashington | $419.42 | $205.90 |
| WisconsinWisconsin | $341.77 | $175.06 |
| West VirginiaWest Virginia | $334.61 | $183.38 |
| WyomingWyoming | $357.68 | $183.66 |
12053 rates by state
Office rate range in each state. Select a state to see its payment localities.
Explore a state
Local rates. Clear comparisons.
Hover or focus a tile to see its rate range. Select it to open the state’s fee schedule.
$320.23
$427.43
Color shows the midpoint of each state’s locality range.
View every state and territory as a table
| State / territory | Office rate range | Localities |
|---|---|---|
| AK | $422.73 | 1 |
| AL | $324.81 | 1 |
| AR | $320.23 | 1 |
| AZ | $351.60 | 1 |
| CA | $380.28–$474.59 | 29 |
| CO | $375.12 | 1 |
| CT | $384.72 | 1 |
| DC | $411.69 | 1 |
| DE | $357.33 | 1 |
| FL | $356.84–$391.02 | 3 |
| GA | $337.12–$367.91 | 2 |
| GU | $389.12 | 1 |
| HI | $389.12 | 1 |
| IA | $332.40 | 1 |
| ID | $334.61 | 1 |
| IL | $347.10–$379.88 | 4 |
| IN | $336.50 | 1 |
| KS | $331.10 | 1 |
| KY | $332.78 | 1 |
| LA | $332.36–$348.39 | 2 |
| MA | $373.05–$411.36 | 2 |
| MD | $363.97–$411.69 | 3 |
| ME | $336.55–$354.05 | 2 |
| MI | $341.44–$361.43 | 2 |
| MN | $358.99 | 1 |
| MO | $326.94–$349.34 | 3 |
| MS | $323.63 | 1 |
| MT | $361.04 | 1 |
| NC | $339.96 | 1 |
| ND | $353.33 | 1 |
| NE | $334.11 | 1 |
| NH | $369.47 | 1 |
| NJ | $388.98–$407.62 | 2 |
| NM | $343.36 | 1 |
| NV | $359.13 | 1 |
| NY | $344.95–$425.11 | 5 |
| OH | $339.87 | 1 |
| OK | $331.96 | 1 |
| OR | $356.22–$386.56 | 2 |
| PA | $340.27–$375.47 | 2 |
| PR | $363.56 | 1 |
| RI | $369.70 | 1 |
| SC | $340.50 | 1 |
| SD | $352.41 | 1 |
| TN | $332.75 | 1 |
| TX | $338.10–$373.99 | 8 |
| UT | $345.05 | 1 |
| VA | $353.07–$411.69 | 2 |
| VI | $363.56 | 1 |
| VT | $352.18 | 1 |
| WA | $372.27–$419.42 | 2 |
| WI | $341.77 | 1 |
| WV | $334.61 | 1 |
| WY | $357.68 | 1 |
How the 12053 rate is calculated
Each of 12053’s three RVUs is multiplied by a geographic index (GPCI) for the payment locality, added up, and multiplied by the conversion factor. Drag the indexes or enter a ZIP to see what moves the rate.
How the rate is built · 12053
RVUs × geographic indexes × conversion factor
Work3.09
3.09 RVUs× 1.000 GPCI
Practice expense7.33
7.33 RVUs× 1.000 GPCI
Malpractice0.39
0.39 RVUs× 1.000 GPCI
Adjusted RVUs
10.8100
Conversion factor
$33.4009
Medicare rate
$361.06
Every GPCI starts at 1.000, the national rate. Enter a ZIP or drag a slider.
The exact Indiana inputs and CMS source lines
PPRRVU2026_Oct_nonQPP.csv
1,426
- Code
- 12053
- Physician work
- 3.09
- Practice expense
- 7.33
- Malpractice
- 0.39
GPCI2026.csv
52
- Locality
- Indiana
- Physician work
- 1.000
- Practice expense
- 0.927
- Malpractice
- 0.486
| Component | RVU | Locality factor | Adjusted |
|---|---|---|---|
| Physician work | 3.09 | × 1.000 | 3.0900 |
| Practice expense | 7.33 | × 0.927 | 6.7949 |
| Malpractice | 0.39 | × 0.486 | 0.1895 |
| Total RVUs | 10.0745 | ||
| Conversion factor | × 33.4009 | ||
Office rate, Indiana$336.50
Office: (3.09 × 1 + 7.33 × 0.927 + 0.39 × 0.486) × $33.4009 = $336.50
Facility: (3.09 × 1 + 2.12 × 0.927 + 0.39 × 0.486) × $33.4009 = $175.18
Payment rules and modifiers for 12053
12053 has a 10-day global period: related visits in that window are included in the surgery payment.
CMS payment indicators · 12053
Wound repair, face and mucous membranes
| Rule | CMS value | What it means |
|---|---|---|
| Global period | 010 | Minor procedure: the day of the procedure plus 10 days after are included. |
| Multiple procedures | 2 | Standard reduction: highest-valued procedure at 100%, others at 50%. |
| Bilateral (modifier 50) | 0 | The 150% bilateral adjustment doesn’t apply. |
| Assistant at surgery (80/81/82/AS) | 1 | Not paid (statutory restriction). |
| Co-surgeons (62) | 0 | Not permitted. |
| Team surgery (66) | 0 | Not permitted. |
| Professional/technical | 0 | Physician service: no professional/technical split. |
| Split (54/55/56) | 0.10/0.80/0.10 | Share of the payment for pre-op, the procedure itself, and post-op care. |
Global surgery period · 12053
Wound repair, face and mucous membranes
10-day global period ends
Oct 11, 2026
Covers Oct 1, 2026 through Oct 11, 2026 (11 days).
Visit on Oct 31, 2026
After the global period ends: visits and procedures are billed normally.
What modifiers do to the payment
Modifier 51 · payment effect
With and without the modifier
12053 without 51 · national office
$361.06
Wound repair, face and mucous membranes
12053-51 · Second procedure: 50%
$180.53
When this isn’t the highest-valued procedure in the session, Medicare pays 50% of its fee schedule amount (the highest is paid at 100%).
How 12053 has changed in Indiana
12053 · Office / nonfacility
$336.50
Effective 2026-10-01
The base rate is $11.03 higher than on 2025-10-01, moving from $325.47 to $336.50 (3.4%).
It is unchanged from the immediately preceding available release, effective 2026-07-01.
One bar per available release, ordered by effective date. Missing rates remain gaps. These comparisons hold the code, setting and locality identifiers constant; they do not isolate which policy or input caused a change.
What changed, release by release
January 1, 2026
RVU26A
$325.47changed to$336.50
- Conversion factor 32.3465 changed to 33.4009
- Work RVU 3.17 changed to 3.09
- Practice expense RVU 7.27 changed to 7.33
- Practice expense GPCI 0.922 changed to 0.927
- Malpractice GPCI 0.485 changed to 0.486
Held through RVU26B, RVU26C, RVU26D.
January 1, 2025
RVU25A
$337.87changed to$325.47
- Conversion factor 33.2875 changed to 32.3465
- Practice expense RVU 7.36 changed to 7.27
- Malpractice RVU 0.40 changed to 0.39
Held through RVU25B, RVU25C, RVU25D.
March 9, 2024
RVU24AR
$332.35changed to$337.87
- Conversion factor 32.7442 changed to 33.2875
Held through RVU24B, RVU24C, RVU24D.
January 1, 2024
RVU24A
$341.85changed to$332.35
- Conversion factor 33.8872 changed to 32.7442
- Practice expense RVU 7.38 changed to 7.36
- Malpractice RVU 0.41 changed to 0.40
- Practice expense GPCI 0.911 changed to 0.922
- Malpractice GPCI 0.475 changed to 0.485
January 1, 2023
RVU23A
$344.44changed to$341.85
- Conversion factor 34.6062 changed to 33.8872
- Practice expense RVU 7.33 changed to 7.38
- Malpractice RVU 0.40 changed to 0.41
- Practice expense GPCI 0.900 changed to 0.911
- Malpractice GPCI 0.465 changed to 0.475
Held through RVU23B, RVU23C, RVU23D.
January 1, 2022
RVU22A
$346.21changed to$344.44
- Conversion factor 34.8931 changed to 34.6062
- Practice expense RVU 7.28 changed to 7.33
- Malpractice RVU 0.43 changed to 0.40
Held through RVU22B, RVU22C, RVU22D.
January 1, 2021
RVU21A
$336.75changed to$346.21
- Conversion factor 36.0896 changed to 34.8931
- Practice expense RVU 6.58 changed to 7.28
- Malpractice RVU 0.41 changed to 0.43
- Practice expense GPCI 0.910 changed to 0.900
- Malpractice GPCI 0.422 changed to 0.465
Held through RVU21B, RVU21C, RVU21D.
January 1, 2020
RVU20A
$331.31changed to$336.75
- Conversion factor 36.0391 changed to 36.0896
- Practice expense RVU 6.36 changed to 6.58
- Malpractice RVU 0.47 changed to 0.41
- Practice expense GPCI 0.919 changed to 0.910
- Malpractice GPCI 0.379 changed to 0.422
Held through RVU20B, RVU20C, RVU20D.
January 1, 2019
RVU19A
$325.79changed to$331.31
- Conversion factor 35.9996 changed to 36.0391
- Practice expense RVU 6.20 changed to 6.36
- Malpractice RVU 0.48 changed to 0.47
Held through RVU19B, RVU19C, RVU19D.
January 1, 2018
RVU18AR1
$325.40changed to$325.79
- Conversion factor 35.8887 changed to 35.9996
- Practice expense RVU 6.15 changed to 6.20
- Practice expense GPCI 0.920 changed to 0.919
- Malpractice GPCI 0.498 changed to 0.379
Held through RVU18B, RVU18C, RVU18D.
January 1, 2017
RVU17A
$325.92changed to$325.40
- Conversion factor 35.8043 changed to 35.8887
- Practice expense RVU 6.12 changed to 6.15
- Practice expense GPCI 0.921 changed to 0.920
- Malpractice GPCI 0.617 changed to 0.498
Held through RVU17B, RVU17C, RVU17D.
January 1, 2016
RVU16A
$326.65changed to$325.92
- Conversion factor 35.9335 changed to 35.8043
- Malpractice RVU 0.46 changed to 0.48
Held through RVU16B, RVU16C, RVU16D.
July 1, 2015
RVU15C
$325.02changed to$326.65
- Conversion factor 35.7547 changed to 35.9335
Held through RVU15D.
January 1, 2015
RVU15A
$321.97changed to$325.02
- Conversion factor 35.8228 changed to 35.7547
- Practice expense RVU 5.99 changed to 6.12
- Malpractice RVU 0.48 changed to 0.46
- Practice expense GPCI 0.922 changed to 0.921
- Malpractice GPCI 0.615 changed to 0.617
Held through RVU15B.
January 1, 2014
RVU14A
$330.57changed to$321.97
- Conversion factor 34.0230 changed to 35.8228
- Practice expense RVU 6.76 changed to 5.99
- Malpractice RVU 0.50 changed to 0.48
- Practice expense GPCI 0.923 changed to 0.922
- Malpractice GPCI 0.613 changed to 0.615
Held through RVU14B, RVU14C, RVU14D.
January 1, 2013
RVU13AR
Earliest loaded release: $330.57
Held through RVU13B, RVU13C, RVU13D.
| Effective from | Office | Facility | CMS release |
|---|---|---|---|
| 2026-10-01 | $336.50 | $175.18 | RVU26D |
| 2026-07-01 | $336.50 | $175.18 | RVU26C |
| 2026-04-01 | $336.50 | $175.18 | RVU26B |
| 2026-01-01 | $336.50 | $175.18 | RVU26A |
| 2025-10-01 | $325.47 | $196.04 | RVU25D |
| 2025-07-01 | $325.47 | $196.04 | RVU25C |
| 2025-04-01 | $325.47 | $196.04 | RVU25B |
| 2025-01-01 | $325.47 | $196.04 | RVU25A |
| 2024-10-01 | $337.87 | $200.06 | RVU24D |
| 2024-07-01 | $337.87 | $200.06 | RVU24C |
| 2024-04-01 | $337.87 | $200.06 | RVU24B |
| 2024-03-09 | $337.87 | $200.06 | RVU24AR |
| 2024-01-01 | $332.35 | $196.80 | RVU24A |
| 2023-10-01 | $341.85 | $201.08 | RVU23D |
| 2023-07-01 | $341.85 | $201.08 | RVU23C |
| 2023-04-01 | $341.85 | $201.08 | RVU23B |
| 2023-01-01 | $341.85 | $201.08 | RVU23A |
| 2022-10-01 | $344.44 | $199.92 | RVU22D |
| 2022-07-01 | $344.44 | $199.92 | RVU22C |
| 2022-04-01 | $344.44 | $199.92 | RVU22B |
| 2022-01-01 | $344.44 | $199.92 | RVU22A |
| 2021-10-01 | $346.21 | $201.12 | RVU21D |
| 2021-07-01 | $346.21 | $201.12 | RVU21C |
| 2021-04-01 | $346.21 | $201.12 | RVU21B |
| 2021-01-01 | $346.21 | $201.12 | RVU21A |
| 2020-10-01 | $336.75 | $206.69 | RVU20D |
| 2020-07-01 | $336.75 | $206.69 | RVU20C |
| 2020-04-01 | $336.75 | $206.69 | RVU20B |
| 2020-01-01 | $336.75 | $206.69 | RVU20A |
| 2019-10-01 | $331.31 | $207.44 | RVU19D |
| 2019-07-01 | $331.31 | $207.44 | RVU19C |
| 2019-04-01 | $331.31 | $207.44 | RVU19B |
| 2019-01-01 | $331.31 | $207.44 | RVU19A |
| 2018-10-01 | $325.79 | $208.01 | RVU18D |
| 2018-07-01 | $325.79 | $208.01 | RVU18C |
| 2018-04-01 | $325.79 | $208.01 | RVU18B |
| 2018-01-01 | $325.79 | $208.01 | RVU18AR1 |
| 2017-10-01 | $325.40 | $209.18 | RVU17D |
| 2017-07-01 | $325.40 | $209.18 | RVU17C |
| 2017-04-01 | $325.40 | $209.18 | RVU17B |
| 2017-01-01 | $325.40 | $209.18 | RVU17A |
| 2016-10-01 | $325.92 | $210.17 | RVU16D |
| 2016-07-01 | $325.92 | $210.17 | RVU16C |
| 2016-04-01 | $325.92 | $210.17 | RVU16B |
| 2016-01-01 | $325.92 | $210.17 | RVU16A |
| 2015-10-01 | $326.65 | $210.49 | RVU15D |
| 2015-07-01 | $326.65 | $210.49 | RVU15C |
| 2015-04-01 | $325.02 | $209.44 | RVU15B |
| 2015-01-01 | $325.02 | $209.44 | RVU15A |
| 2014-10-01 | $321.97 | $208.36 | RVU14D |
| 2014-07-01 | $321.97 | $208.36 | RVU14C |
| 2014-04-01 | $321.97 | $208.36 | RVU14B |
| 2014-01-01 | $321.97 | $208.36 | RVU14A |
| 2013-10-01 | $330.57 | $206.52 | RVU13D |
| 2013-07-01 | $330.57 | $206.52 | RVU13C |
| 2013-04-01 | $330.57 | $206.52 | RVU13B |
| 2013-01-01 | $330.57 | $206.52 | RVU13AR |
Where the Indiana rate applies
Indiana is a Medicare payment area, not a city. Our Census mapping connects it to 974 cities and communities in Indiana. Some span more than one payment area; confirm with the service ZIP.
- Aberdeen
- Abington
- Adams
- Adams Lake
- Advance
- Akron
- Alamo
- Albany
12053 billing questions
How does this differ from 12052?
Both cover intermediate repair in the same anatomic group. Use 12053 when the qualifying repaired length is 5.1 to 7.5 cm; 12052 covers the shorter length range.
Can separate facial wounds be combined to select the length level?
Qualifying wounds in the same anatomic group may be combined when determining total repaired length. Document each wound's site and length, and do not combine repairs from different anatomic groups.
What documentation supports intermediate repair?
Record the wound sites and lengths, the closure method and layers, and, for a single-layer closure, the heavy contamination and extensive cleaning that support intermediate repair.
Are related postoperative visits separately payable during the global period?
Related postoperative visits during the 10-day global period are included in this procedure's payment.
How are other procedures performed in the same session paid?
The highest-valued procedure is paid in full, and other procedures are subject to the standard multiple-procedure reduction.
Can an assistant surgeon or co-surgeon be reported?
Medicare payment for an assistant at surgery is restricted for this code. Co-surgeons and team surgery are not permitted.
Where these rates come from
FeeBase calculates base physician payments from CMS work, practice-expense and malpractice RVUs, adjusted by each locality’s geographic indexes and the conversion factor. Services without a published rate are labeled, never given a made-up amount. Amounts are Medicare allowed amounts before claim adjustments: not a patient’s bill or a commercial rate.
CMS RVU26D · effective Oct 1, 2026 through the day before Jan 1, 2027
Show the CMS file lines behind this rate
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