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CPT code 12054: Wound repair, face, 7.6–12.5 cm2026 Medicare rate & RVUs in Washington, DC area

Report this code for intermediate repair of qualifying facial or mucosal wounds when the combined repaired length falls within the 7.6–12.5 cm range.

CMS RVU26DEffective Oct 1, 2026One payment locality3.9K Medicare services in 2024

In Washington, DC area, Medicare pays $445.91 for 12054 in the office and $216.91 when it’s performed in a hospital or facility.

$445.91Office (non-facility)
$216.91Hospital or facility
+13.9%vs the national office rate ($391.46)

Check a contract rate as a % of Medicare · 12054 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 12054 for the payment locality that covers the ZIP.

On this page 11 sections
  1. Rate in Washington, DC area
  2. What 12054 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 12054 covers

This code covers an intermediate repair on the face or mucous membranes, including sites such as the eyelid, nose, lip, or ear. The repair involves layered closure, including deeper tissue beneath the skin, or a single-layer closure when a heavily contaminated wound requires extensive cleaning. Physicians and other qualified clinicians commonly perform these repairs in emergency departments, offices, and outpatient surgical settings.

Select the code using the total repaired length of qualifying wounds in the same anatomic grouping and repair classification; documentation should identify the sites, measurements, wound characteristics, and closure performed. The code has a 10-day global period, so related postoperative visits during that period are included. When multiple procedures occur in the same session, the highest-valued procedure is paid in full and other procedures are subject to the standard 50% multiple-procedure reduction. Modifier 50 is inappropriate for this code. Medicare does not pay an assistant at surgery, and 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 Washington, DC area compares for 12054

Across 109 of 109 payment localities, the office rate for 12054 runs from $346.46 in Arkansas to $511.24 in San Benito County, CA. Washington, DC area pays $445.91. The RVUs are the same everywhere; the geographic indexes change the dollars.

12054 in Washington, DC area vs other payment areas
  1. Washington, DC area · this page$445.91
  2. Los Angeles, CA · California$438.08−$7.83
  3. Miami, FL · Florida$428.19−$17.72
  4. Chicago, IL · Illinois$415.62−$30.29
  5. Manhattan, NY · New York$450.94+$5.03
  6. Alaska · Alaska$457.69+$11.78
  7. Alabama · Alabama$351.50−$94.41

Other areas in District of Columbia first, then benchmark localities. Bars start at $0.

Every other payment area

12054 in every other Medicare payment locality
Payment localityOfficeFacility
ArkansasArkansas$346.46$179.48
ArizonaArizona$380.93$192.56
Bakersfield, CACalifornia$411.97$198.92
Chico, CACalifornia$410.50$197.45
El Centro, CACalifornia$410.59$197.53
Fresno, CACalifornia$410.50$197.45
Hanford, CACalifornia$410.50$197.45
Madera, CACalifornia$410.50$197.45

12054 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.

$346.46

$460.87

Color shows the midpoint of each state’s locality range.

View every state and territory as a table
12054 office rate range by state
State / territoryOffice rate rangeLocalities
AK$457.691
AL$351.501
AR$346.461
AZ$380.931
CA$410.50–$511.2429
CO$405.771
CT$417.371
DC$445.911
DE$387.181
FL$388.56–$428.193
GA$366.59–$399.392
GU$419.981
HI$419.981
IA$359.041
ID$361.641
IL$378.38–$415.624
IN$363.681
KS$358.001
KY$361.091
LA$360.78–$378.402
MA$403.63–$444.802
MD$394.33–$445.913
ME$364.18–$382.832
MI$370.99–$394.032
MN$387.021
MO$355.06–$378.993
MS$350.801
MT$391.421
NC$367.851
ND$381.341
NE$360.801
NH$400.011
NJ$421.64–$441.482
NM$373.261
NV$388.871
NY$373.37–$462.595
OH$368.931
OK$359.781
OR$385.36–$417.842
PA$369.16–$407.482
PR$394.071
RI$400.381
SC$369.101
SD$380.151
TN$359.861
TX$366.80–$404.858
UT$374.091
VA$382.02–$445.912
VI$394.071
VT$380.441
WA$402.68–$453.182
WI$368.731
WV$364.671
WY$387.031

See 12054 in every payment locality

How the 12054 rate is calculated

Each of 12054’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 · 12054

RVUs × geographic indexes × conversion factor

Office or facility?

Work3.41

3.41 RVUs× 1.000 GPCI

Practice expense7.80

7.80 RVUs× 1.000 GPCI

Malpractice0.51

0.51 RVUs× 1.000 GPCI

Adjusted RVUs

11.7200

Conversion factor

$33.4009

Medicare rate

$391.46

Every GPCI starts at 1.000, the national rate. Enter a ZIP or drag a slider.

The exact Washington, DC area inputs and CMS source lines

PPRRVU2026_Oct_nonQPP.csv

1,427

Code
12054
Physician work
3.41
Practice expense
7.80
Malpractice
0.51

GPCI2026.csv

39

Locality
Washington, DC area
Physician work
1.054
Practice expense
1.178
Malpractice
1.113
Office calculation for 12054 in Washington, DC area
ComponentRVULocality factorAdjusted
Physician work3.41× 1.0543.5941
Practice expense7.80× 1.1789.1884
Malpractice0.51× 1.1130.5676
Total RVUs13.3502
Conversion factor× 33.4009

Office rate, Washington, DC area$445.91

Office: (3.41 × 1.054 + 7.8 × 1.178 + 0.51 × 1.113) × $33.4009 = $445.91

Facility: (3.41 × 1.054 + 1.98 × 1.178 + 0.51 × 1.113) × $33.4009 = $216.91

Open 12054 in the RVU calculator

Payment rules and modifiers for 12054

12054 has a 10-day global period: related visits in that window are included in the surgery payment.

CMS payment indicators · 12054

Wound repair, face, 7.6–12.5 cm

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 · 12054

Wound repair, face, 7.6–12.5 cm

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

12054 without 51 · national office

$391.46

Wound repair, face, 7.6–12.5 cm

12054-51 · Second procedure: 50%

$195.73

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 12054

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

Codes related to 12054
CodeHow it relatesOffice range, Washington, DC area
Same family
12053Wound repair, face and mucous membranesIntermediate facial repair for a shorter total length, 5.1–7.5 cm.$411.69
12055Wound repair, face and mucous membranesIntermediate facial repair for a longer total length, 12.6–20 cm.$622.83
12052Wound repair, face, 2.6–5 cmIntermediate facial repair for a total length of 2.6–5.0 cm.$355.16
Used instead
12015Simple wound repair, face and related sites, 7.6-12.5 cmSimple facial repair in the same length range when the wound does not meet intermediate criteria.$239.33
12034Wound repair, intermediate, 7.6–12.5 cmIntermediate repair in the same length range for a different anatomic grouping.$381.39

How 12054 has changed in Washington, DC area

12054 · Office / nonfacility

$445.91

Effective 2026-10-01

The base rate is $22.04 higher than on 2025-10-01, moving from $423.87 to $445.91 (5.2%).

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

    $423.87changed to$445.91

    • Conversion factor 32.3465 changed to 33.4009
    • Work RVU 3.50 changed to 3.41
    • Practice expense RVU 7.39 changed to 7.80
    • Work GPCI 1.057 changed to 1.054
    • Practice expense GPCI 1.192 changed to 1.178
    • Malpractice GPCI 1.168 changed to 1.113

    Held through RVU26B, RVU26C, RVU26D.

  2. January 1, 2025

    RVU25A

    $440.56changed to$423.87

    • Conversion factor 33.2875 changed to 32.3465
    • Practice expense RVU 7.49 changed to 7.39
    • Malpractice RVU 0.52 changed to 0.51

    Held through RVU25B, RVU25C, RVU25D.

  3. March 9, 2024

    RVU24AR

    $433.37changed to$440.56

    • Conversion factor 32.7442 changed to 33.2875

    Held through RVU24B, RVU24C, RVU24D.

  4. January 1, 2024

    RVU24A

    $458.37changed to$433.37

    • Conversion factor 33.8872 changed to 32.7442
    • Practice expense RVU 7.55 changed to 7.49
    • Malpractice RVU 0.54 changed to 0.52
    • Work GPCI 1.056 changed to 1.057
    • Practice expense GPCI 1.214 changed to 1.192
    • Malpractice GPCI 1.231 changed to 1.168

  5. January 1, 2023

    RVU23A

    $473.54changed to$458.37

    • Conversion factor 34.6062 changed to 33.8872
    • Practice expense RVU 7.50 changed to 7.55
    • Malpractice RVU 0.56 changed to 0.54
    • Work GPCI 1.054 changed to 1.056
    • Practice expense GPCI 1.236 changed to 1.214
    • Malpractice GPCI 1.294 changed to 1.231

    Held through RVU23B, RVU23C, RVU23D.

  6. January 1, 2022

    RVU22A

    $474.41changed to$473.54

    • Conversion factor 34.8931 changed to 34.6062
    • Practice expense RVU 7.45 changed to 7.50
    • Malpractice RVU 0.54 changed to 0.56

    Held through RVU22B, RVU22C, RVU22D.

  7. January 1, 2021

    RVU21A

    $451.75changed to$474.41

    • Conversion factor 36.0896 changed to 34.8931
    • Practice expense RVU 6.68 changed to 7.45
    • Work GPCI 1.049 changed to 1.054
    • Practice expense GPCI 1.221 changed to 1.236
    • Malpractice GPCI 1.277 changed to 1.294

    Held through RVU21B, RVU21C, RVU21D.

  8. January 1, 2020

    RVU20A

    $435.12changed to$451.75

    • Conversion factor 36.0391 changed to 36.0896
    • Practice expense RVU 6.44 changed to 6.68
    • Malpractice RVU 0.52 changed to 0.54
    • Work GPCI 1.045 changed to 1.049
    • Practice expense GPCI 1.205 changed to 1.221
    • Malpractice GPCI 1.261 changed to 1.277

    Held through RVU20B, RVU20C, RVU20D.

  9. January 1, 2019

    RVU19A

    $426.40changed to$435.12

    • Conversion factor 35.9996 changed to 36.0391
    • Practice expense RVU 6.25 changed to 6.44

    Held through RVU19B, RVU19C, RVU19D.

  10. January 1, 2018

    RVU18AR1

    $423.51changed to$426.40

    • Conversion factor 35.8887 changed to 35.9996
    • Practice expense RVU 6.19 changed to 6.25
    • Malpractice RVU 0.53 changed to 0.52
    • Work GPCI 1.048 changed to 1.045
    • Malpractice GPCI 1.271 changed to 1.261

    Held through RVU18B, RVU18C, RVU18D.

  11. January 1, 2017

    RVU17A

    $422.63changed to$423.51

    • Conversion factor 35.8043 changed to 35.8887
    • Practice expense RVU 6.18 changed to 6.19
    • Work GPCI 1.051 changed to 1.048
    • Malpractice GPCI 1.280 changed to 1.271

    Held through RVU17B, RVU17C, RVU17D.

  12. January 1, 2016

    RVU16A

    $431.49changed to$422.63

    • Conversion factor 35.9335 changed to 35.8043
    • Practice expense RVU 6.36 changed to 6.18
    • Malpractice RVU 0.52 changed to 0.53

    Held through RVU16B, RVU16C, RVU16D.

  13. July 1, 2015

    RVU15C

    $429.34changed to$431.49

    • Conversion factor 35.7547 changed to 35.9335

    Held through RVU15D.

  14. January 1, 2015

    RVU15A

    $424.51changed to$429.34

    • Conversion factor 35.8228 changed to 35.7547
    • Practice expense RVU 6.24 changed to 6.36
    • Malpractice RVU 0.56 changed to 0.52
    • Work GPCI 1.050 changed to 1.051
    • Practice expense GPCI 1.202 changed to 1.205
    • Malpractice GPCI 1.205 changed to 1.280

    Held through RVU15B.

  15. January 1, 2014

    RVU14A

    $434.55changed to$424.51

    • Conversion factor 34.0230 changed to 35.8228
    • Practice expense RVU 7.04 changed to 6.24
    • Malpractice RVU 0.59 changed to 0.56
    • Work GPCI 1.049 changed to 1.050
    • Practice expense GPCI 1.198 changed to 1.202
    • Malpractice GPCI 1.130 changed to 1.205

    Held through RVU14B, RVU14C, RVU14D.

  16. January 1, 2013

    RVU13AR

    Earliest loaded release: $434.55

    Held through RVU13B, RVU13C, RVU13D.

Rates in every CMS release
Effective fromOfficeFacilityCMS release
2026-10-01$445.91$216.91RVU26D
2026-07-01$445.91$216.91RVU26C
2026-04-01$445.91$216.91RVU26B
2026-01-01$445.91$216.91RVU26A
2025-10-01$423.87$239.95RVU25D
2025-07-01$423.87$239.95RVU25C
2025-04-01$423.87$239.95RVU25B
2025-01-01$423.87$239.95RVU25A
2024-10-01$440.56$245.34RVU24D
2024-07-01$440.56$245.34RVU24C
2024-04-01$440.56$245.34RVU24B
2024-03-09$440.56$245.34RVU24AR
2024-01-01$433.37$241.33RVU24A
2023-10-01$458.37$250.62RVU23D
2023-07-01$458.37$250.62RVU23C
2023-04-01$458.37$250.62RVU23B
2023-01-01$458.37$250.62RVU23A
2022-10-01$473.54$253.26RVU22D
2022-07-01$473.54$253.26RVU22C
2022-04-01$473.54$253.26RVU22B
2022-01-01$473.54$253.26RVU22A
2021-10-01$474.41$253.16RVU21D
2021-07-01$474.41$253.16RVU21C
2021-04-01$474.41$253.16RVU21B
2021-01-01$474.41$253.16RVU21A
2020-10-01$451.75$259.18RVU20D
2020-07-01$451.75$259.18RVU20C
2020-04-01$451.75$259.18RVU20B
2020-01-01$451.75$259.18RVU20A
2019-10-01$435.12$257.50RVU19D
2019-07-01$435.12$257.50RVU19C
2019-04-01$435.12$257.50RVU19B
2019-01-01$435.12$257.50RVU19A
2018-10-01$426.40$258.95RVU18D
2018-07-01$426.40$258.95RVU18C
2018-04-01$426.40$258.95RVU18B
2018-01-01$426.40$258.95RVU18AR1
2017-10-01$423.51$258.74RVU17D
2017-07-01$423.51$258.74RVU17C
2017-04-01$423.51$258.74RVU17B
2017-01-01$423.51$258.74RVU17A
2016-10-01$422.63$258.25RVU16D
2016-07-01$422.63$258.25RVU16C
2016-04-01$422.63$258.25RVU16B
2016-01-01$422.63$258.25RVU16A
2015-10-01$431.49$264.78RVU15D
2015-07-01$431.49$264.78RVU15C
2015-04-01$429.34$263.46RVU15B
2015-01-01$429.34$263.46RVU15A
2014-10-01$424.51$262.18RVU14D
2014-07-01$424.51$262.18RVU14C
2014-04-01$424.51$262.18RVU14B
2014-01-01$424.51$262.18RVU14A
2013-10-01$434.55$259.28RVU13D
2013-07-01$434.55$259.28RVU13C
2013-04-01$434.55$259.28RVU13B
2013-01-01$434.55$259.28RVU13AR

Price 12054 for an earlier date of service

Where the Washington, DC area rate applies

Washington, DC area is a Medicare payment area, not a city. Our Census mapping connects it to 1 cities and communities in District of Columbia. Some span more than one payment area; confirm with the service ZIP.

  • Washington

Browse all communities in District of Columbia

12054 billing questions

How is the length selected when there are multiple facial wounds?

Add the lengths of wounds that share the same repair classification and anatomic grouping. Use the resulting total to select the applicable length range.

What documentation supports intermediate rather than simple repair?

Document the wound sites and lengths, the tissue layers closed, and the closure technique. For single-layer closure, record the heavy contamination and extensive cleaning that support intermediate classification.

Can the repair layers be billed separately?

No. The layered closure is part of the repair service; do not report a separate charge for each layer.

Is modifier 50 appropriate for repairs on both sides of the face?

No. Bilateral adjustment does not apply to this code, and modifier 50 is inappropriate.

Are related postoperative visits separately payable during the global period?

Related postoperative visits during the 10-day global period are included in the procedure.

Can an assistant or co-surgeon be reported?

Medicare does not pay an assistant at surgery 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 12054PPRRVU2026_Oct_nonQPP.csv, line 1,427 (RVU26D)
Geographic factors for Washington, DC areaGPCI2026.csv, line 39 (RVU26D)

Open CMS sourceHow we calculate rates

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