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CPT code 12053: Wound repair, face and mucous membranes2026 Medicare rate & RVUs in Queens, NY

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.

CMS RVU26DEffective Oct 1, 2026One payment locality16.8K Medicare services in 2024

In Queens, NY, Medicare pays $417.99 for 12053 in the office and $212.30 when it’s performed in a hospital or facility.

$417.99Office (non-facility)
$212.30Hospital or facility
+15.8%vs the national office rate ($361.06)

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.

We’ll open 12053 for the payment locality that covers the ZIP.

On this page 11 sections
  1. Rate in Queens, NY
  2. What 12053 covers
  3. Compared with other areas
  4. Rate map
  5. How it’s calculated
  6. Payment rules
  7. Related codes
  8. Rate history
  9. Where it applies
  10. Billing questions
  11. Sources

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 Queens, NY 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. Queens, NY pays $417.99. The RVUs are the same everywhere; the geographic indexes change the dollars.

12053 in Queens, NY vs other payment areas
  1. Queens, NY · this page$417.99
  2. Manhattan, NY · New York$414.96−$3.03
  3. NYC suburbs and Long Island, NY · New York$425.11+$7.12
  4. Poughkeepsie and northern NYC suburbs, NY · New York$391.70−$26.29
  5. Rest of New York · New York$344.95−$73.04
  6. Los Angeles, CA · California$405.72−$12.27
  7. Washington, DC area · District of Columbia$411.69−$6.30

Other areas in New York first, then benchmark localities. Bars start at $0.

Every other payment area

12053 in every other Medicare payment locality
Payment localityOfficeFacility
Miami, FLFlorida$391.02$209.87
Chicago, ILIllinois$379.88$204.99
AlaskaAlaska$422.73$237.40
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

12053 rates by state

Office rate range in each state. Select a state to see its payment localities.

MEWIVTNHMTNDMNMINYMARIWAIDWYSDIAILINOHPANJCTORNVUTCONEMOKYWVVAMDDECAAZNMKSOKARTNNCSCDCTXLAMSALGAFLAKHI

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
12053 office rate range by state
State / territoryOffice rate rangeLocalities
AK$422.731
AL$324.811
AR$320.231
AZ$351.601
CA$380.28–$474.5929
CO$375.121
CT$384.721
DC$411.691
DE$357.331
FL$356.84–$391.023
GA$337.12–$367.912
GU$389.121
HI$389.121
IA$332.401
ID$334.611
IL$347.10–$379.884
IN$336.501
KS$331.101
KY$332.781
LA$332.36–$348.392
MA$373.05–$411.362
MD$363.97–$411.693
ME$336.55–$354.052
MI$341.44–$361.432
MN$358.991
MO$326.94–$349.343
MS$323.631
MT$361.041
NC$339.961
ND$353.331
NE$334.111
NH$369.471
NJ$388.98–$407.622
NM$343.361
NV$359.131
NY$344.95–$425.115
OH$339.871
OK$331.961
OR$356.22–$386.562
PA$340.27–$375.472
PR$363.561
RI$369.701
SC$340.501
SD$352.411
TN$332.751
TX$338.10–$373.998
UT$345.051
VA$353.07–$411.692
VI$363.561
VT$352.181
WA$372.27–$419.422
WI$341.771
WV$334.611
WY$357.681

See 12053 in every payment locality

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

Office or facility?

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 Queens, NY 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

81

Locality
Queens, NY
Physician work
1.064
Practice expense
1.182
Malpractice
1.442
Office calculation for 12053 in Queens, NY
ComponentRVULocality factorAdjusted
Physician work3.09× 1.0643.2878
Practice expense7.33× 1.1828.6641
Malpractice0.39× 1.4420.5624
Total RVUs12.5142
Conversion factor× 33.4009

Office rate, Queens, NY$417.99

Office: (3.09 × 1.064 + 7.33 × 1.182 + 0.39 × 1.442) × $33.4009 = $417.99

Facility: (3.09 × 1.064 + 2.12 × 1.182 + 0.39 × 1.442) × $33.4009 = $212.30

Open 12053 in the RVU calculator

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

RuleCMS valueWhat it means
Global period010Minor procedure: the day of the procedure plus 10 days after are included.
Multiple procedures2Standard reduction: highest-valued procedure at 100%, others at 50%.
Bilateral (modifier 50)0The 150% bilateral adjustment doesn’t apply.
Assistant at surgery (80/81/82/AS)1Not paid (statutory restriction).
Co-surgeons (62)0Not permitted.
Team surgery (66)0Not permitted.
Professional/technical0Physician service: no professional/technical split.
Split (54/55/56)0.10/0.80/0.10Share 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.

SurgeryVisit
Sep 28, 2026Oct 14, 2026

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%).

When to use modifier 51

Codes related to 12053

Related codes aren’t interchangeable: bill the code that matches the service performed.

Codes related to 12053
CodeHow it relatesOffice range, Queens, NY
Same family
12051Facial repair, intermediate, 2.5 cm or lessIntermediate repair in the same anatomic group for the shortest length range.$327.97
12052Wound repair, face, 2.6–5 cmIntermediate repair in the same anatomic group for the next shorter length range.$360.66
12054Wound repair, face, 7.6–12.5 cmIntermediate repair in the same anatomic group for the next longer length range.$453.69
12031Wound repair, scalp, trunk, or extremityIntermediate repair for a different anatomic group and shorter length range.$301.47
Used instead
12015Simple wound repair, face and related sites, 7.6-12.5 cmSimple repair for a longer facial-region wound when the closure does not qualify as intermediate.$245.33

How 12053 has changed in Queens, NY

12053 · Office / nonfacility

$417.99

Effective 2026-10-01

The base rate is $9.33 higher than on 2025-10-01, moving from $408.66 to $417.99 (2.3%).

It is unchanged from the immediately preceding available release, effective 2026-07-01.

Base rate by release · bars start at $0 · select a bar to compare

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

  1. January 1, 2026

    RVU26A

    $408.66changed to$417.99

    • 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
    • Work GPCI 1.065 changed to 1.064
    • Practice expense GPCI 1.195 changed to 1.182
    • Malpractice GPCI 1.462 changed to 1.442

    Held through RVU26B, RVU26C, RVU26D.

  2. January 1, 2025

    RVU25A

    $424.62changed to$408.66

    • 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.

  3. March 9, 2024

    RVU24AR

    $417.69changed to$424.62

    • Conversion factor 32.7442 changed to 33.2875

    Held through RVU24B, RVU24C, RVU24D.

  4. January 1, 2024

    RVU24A

    $445.72changed to$417.69

    • 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
    • Work GPCI 1.061 changed to 1.065
    • Practice expense GPCI 1.212 changed to 1.195
    • Malpractice GPCI 2.061 changed to 1.462

  5. January 1, 2023

    RVU23A

    $464.18changed to$445.72

    • 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
    • Work GPCI 1.056 changed to 1.061
    • Practice expense GPCI 1.228 changed to 1.212
    • Malpractice GPCI 2.661 changed to 2.061

    Held through RVU23B, RVU23C, RVU23D.

  6. January 1, 2022

    RVU22A

    $468.67changed to$464.18

    • 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.

  7. January 1, 2021

    RVU21A

    $444.25changed to$468.67

    • 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
    • Work GPCI 1.054 changed to 1.056
    • Practice expense GPCI 1.214 changed to 1.228
    • Malpractice GPCI 2.391 changed to 2.661

    Held through RVU21B, RVU21C, RVU21D.

  8. January 1, 2020

    RVU20A

    $431.16changed to$444.25

    • 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
    • Work GPCI 1.052 changed to 1.054
    • Practice expense GPCI 1.200 changed to 1.214
    • Malpractice GPCI 2.121 changed to 2.391

    Held through RVU20B, RVU20C, RVU20D.

  9. January 1, 2019

    RVU19A

    $424.54changed to$431.16

    • 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.

  10. January 1, 2018

    RVU18AR1

    $421.60changed to$424.54

    • Conversion factor 35.8887 changed to 35.9996
    • Practice expense RVU 6.15 changed to 6.20
    • Malpractice GPCI 2.151 changed to 2.121

    Held through RVU18B, RVU18C, RVU18D.

  11. January 1, 2017

    RVU17A

    $419.61changed to$421.60

    • Conversion factor 35.8043 changed to 35.8887
    • Practice expense RVU 6.12 changed to 6.15
    • Practice expense GPCI 1.199 changed to 1.200
    • Malpractice GPCI 2.181 changed to 2.151

    Held through RVU17B, RVU17C, RVU17D.

  12. January 1, 2016

    RVU16A

    $419.56changed to$419.61

    • Conversion factor 35.9335 changed to 35.8043
    • Malpractice RVU 0.46 changed to 0.48

    Held through RVU16B, RVU16C, RVU16D.

  13. July 1, 2015

    RVU15C

    $417.47changed to$419.56

    • Conversion factor 35.7547 changed to 35.9335

    Held through RVU15D.

  14. January 1, 2015

    RVU15A

    $408.45changed to$417.47

    • 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
    • Work GPCI 1.057 changed to 1.052
    • Practice expense GPCI 1.197 changed to 1.199
    • Malpractice GPCI 1.836 changed to 2.181

    Held through RVU15B.

  15. January 1, 2014

    RVU14A

    $414.75changed to$408.45

    • 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
    • Work GPCI 1.062 changed to 1.057
    • Practice expense GPCI 1.195 changed to 1.197
    • Malpractice GPCI 1.491 changed to 1.836

    Held through RVU14B, RVU14C, RVU14D.

  16. January 1, 2013

    RVU13AR

    Earliest loaded release: $414.75

    Held through RVU13B, RVU13C, RVU13D.

Rates in every CMS release
Effective fromOfficeFacilityCMS release
2026-10-01$417.99$212.30RVU26D
2026-07-01$417.99$212.30RVU26C
2026-04-01$417.99$212.30RVU26B
2026-01-01$417.99$212.30RVU26A
2025-10-01$408.66$240.90RVU25D
2025-07-01$408.66$240.90RVU25C
2025-04-01$408.66$240.90RVU25B
2025-01-01$408.66$240.90RVU25A
2024-10-01$424.62$246.01RVU24D
2024-07-01$424.62$246.01RVU24C
2024-04-01$424.62$246.01RVU24B
2024-03-09$424.62$246.01RVU24AR
2024-01-01$417.69$242.00RVU24A
2023-10-01$445.72$258.43RVU23D
2023-07-01$445.72$258.43RVU23C
2023-04-01$445.72$258.43RVU23B
2023-01-01$445.72$258.43RVU23A
2022-10-01$464.18$267.00RVU22D
2022-07-01$464.18$267.00RVU22C
2022-04-01$464.18$267.00RVU22B
2022-01-01$464.18$267.00RVU22A
2021-10-01$468.67$270.71RVU21D
2021-07-01$468.67$270.71RVU21C
2021-04-01$468.67$270.71RVU21B
2021-01-01$468.67$270.71RVU21A
2020-10-01$444.25$270.75RVU20D
2020-07-01$444.25$270.75RVU20C
2020-04-01$444.25$270.75RVU20B
2020-01-01$444.25$270.75RVU20A
2019-10-01$431.16$269.42RVU19D
2019-07-01$431.16$269.42RVU19C
2019-04-01$431.16$269.42RVU19B
2019-01-01$431.16$269.42RVU19A
2018-10-01$424.54$270.75RVU18D
2018-07-01$424.54$270.75RVU18C
2018-04-01$424.54$270.75RVU18B
2018-01-01$424.54$270.75RVU18AR1
2017-10-01$421.60$270.00RVU17D
2017-07-01$421.60$270.00RVU17C
2017-04-01$421.60$270.00RVU17B
2017-01-01$421.60$270.00RVU17A
2016-10-01$419.61$268.93RVU16D
2016-07-01$419.61$268.93RVU16C
2016-04-01$419.61$268.93RVU16B
2016-01-01$419.61$268.93RVU16A
2015-10-01$419.56$268.33RVU15D
2015-07-01$419.56$268.33RVU15C
2015-04-01$417.47$267.00RVU15B
2015-01-01$417.47$267.00RVU15A
2014-10-01$408.45$260.94RVU14D
2014-07-01$408.45$260.94RVU14C
2014-04-01$408.45$260.94RVU14B
2014-01-01$408.45$260.94RVU14A
2013-10-01$414.75$254.15RVU13D
2013-07-01$414.75$254.15RVU13C
2013-04-01$414.75$254.15RVU13B
2013-01-01$414.75$254.15RVU13AR

Price 12053 for an earlier date of service

Where the Queens, NY rate applies

Queens, NY is a Medicare payment area, not a city. Our Census mapping connects it to 1 cities and communities in New York. Some span more than one payment area; confirm with the service ZIP.

Browse all communities in New York

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
RVUs for 12053PPRRVU2026_Oct_nonQPP.csv, line 1,426 (RVU26D)
Geographic factors for Queens, NYGPCI2026.csv, line 81 (RVU26D)

Open CMS sourceHow we calculate rates

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