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

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 Indiana, Medicare pays $363.68 for 12054 in the office and $183.48 when it’s performed in a hospital or facility.

$363.68Office (non-facility)
$183.48Hospital or facility
−7.1%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 Indiana
  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 Indiana 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. Indiana pays $363.68. The RVUs are the same everywhere; the geographic indexes change the dollars.

12054 in Indiana vs other payment areas
  1. Indiana · this page$363.68
  2. Los Angeles, CA · California$438.08+$74.40
  3. Washington, DC area · District of Columbia$445.91+$82.23
  4. Miami, FL · Florida$428.19+$64.51
  5. Chicago, IL · Illinois$415.62+$51.94
  6. Manhattan, NY · New York$450.94+$87.26
  7. Alaska · Alaska$457.69+$94.01

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

Every other payment area

12054 in every other Medicare payment locality
Payment localityOfficeFacility
AlabamaAlabama$351.50$181.41
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

12054 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.

$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 Indiana 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

52

Locality
Indiana
Physician work
1.000
Practice expense
0.927
Malpractice
0.486
Office calculation for 12054 in Indiana
ComponentRVULocality factorAdjusted
Physician work3.41× 1.0003.4100
Practice expense7.80× 0.9277.2306
Malpractice0.51× 0.4860.2479
Total RVUs10.8885
Conversion factor× 33.4009

Office rate, Indiana$363.68

Office: (3.41 × 1 + 7.8 × 0.927 + 0.51 × 0.486) × $33.4009 = $363.68

Facility: (3.41 × 1 + 1.98 × 0.927 + 0.51 × 0.486) × $33.4009 = $183.48

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

How 12054 has changed in Indiana

12054 · Office / nonfacility

$363.68

Effective 2026-10-01

The base rate is $22.07 higher than on 2025-10-01, moving from $341.61 to $363.68 (6.5%).

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

    $341.61changed to$363.68

    • 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
    • Practice expense GPCI 0.922 changed to 0.927
    • Malpractice GPCI 0.485 changed to 0.486

    Held through RVU26B, RVU26C, RVU26D.

  2. January 1, 2025

    RVU25A

    $354.78changed to$341.61

    • 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

    $348.99changed to$354.78

    • Conversion factor 32.7442 changed to 33.2875

    Held through RVU24B, RVU24C, RVU24D.

  4. January 1, 2024

    RVU24A

    $360.38changed to$348.99

    • 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
    • Practice expense GPCI 0.911 changed to 0.922
    • Malpractice GPCI 0.475 changed to 0.485
  5. January 1, 2023

    RVU23A

    $363.73changed to$360.38

    • 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
    • Practice expense GPCI 0.900 changed to 0.911
    • Malpractice GPCI 0.465 changed to 0.475

    Held through RVU23B, RVU23C, RVU23D.

  6. January 1, 2022

    RVU22A

    $364.85changed to$363.73

    • 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

    $353.92changed to$364.85

    • Conversion factor 36.0896 changed to 34.8931
    • Practice expense RVU 6.68 changed to 7.45
    • Practice expense GPCI 0.910 changed to 0.900
    • Malpractice GPCI 0.422 changed to 0.465

    Held through RVU21B, RVU21C, RVU21D.

  8. January 1, 2020

    RVU20A

    $346.53changed to$353.92

    • 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
    • Practice expense GPCI 0.919 changed to 0.910
    • Malpractice GPCI 0.379 changed to 0.422

    Held through RVU20B, RVU20C, RVU20D.

  9. January 1, 2019

    RVU19A

    $339.87changed to$346.53

    • 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

    $339.46changed to$339.87

    • 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
    • Practice expense GPCI 0.920 changed to 0.919
    • Malpractice GPCI 0.498 changed to 0.379

    Held through RVU18B, RVU18C, RVU18D.

  11. January 1, 2017

    RVU17A

    $340.81changed to$339.46

    • Conversion factor 35.8043 changed to 35.8887
    • Practice expense RVU 6.18 changed to 6.19
    • Practice expense GPCI 0.921 changed to 0.920
    • Malpractice GPCI 0.617 changed to 0.498

    Held through RVU17B, RVU17C, RVU17D.

  12. January 1, 2016

    RVU16A

    $347.78changed to$340.81

    • 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

    $346.05changed to$347.78

    • Conversion factor 35.7547 changed to 35.9335

    Held through RVU15D.

  14. January 1, 2015

    RVU15A

    $343.82changed to$346.05

    • 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
    • Practice expense GPCI 0.922 changed to 0.921
    • Malpractice GPCI 0.615 changed to 0.617

    Held through RVU15B.

  15. January 1, 2014

    RVU14A

    $352.46changed to$343.82

    • 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
    • Practice expense GPCI 0.923 changed to 0.922
    • Malpractice GPCI 0.613 changed to 0.615

    Held through RVU14B, RVU14C, RVU14D.

  16. January 1, 2013

    RVU13AR

    Earliest loaded release: $352.46

    Held through RVU13B, RVU13C, RVU13D.

Rates in every CMS release
Effective fromOfficeFacilityCMS release
2026-10-01$363.68$183.48RVU26D
2026-07-01$363.68$183.48RVU26C
2026-04-01$363.68$183.48RVU26B
2026-01-01$363.68$183.48RVU26A
2025-10-01$341.61$199.35RVU25D
2025-07-01$341.61$199.35RVU25C
2025-04-01$341.61$199.35RVU25B
2025-01-01$341.61$199.35RVU25A
2024-10-01$354.78$203.78RVU24D
2024-07-01$354.78$203.78RVU24C
2024-04-01$354.78$203.78RVU24B
2024-03-09$354.78$203.78RVU24AR
2024-01-01$348.99$200.45RVU24A
2023-10-01$360.38$204.48RVU23D
2023-07-01$360.38$204.48RVU23C
2023-04-01$360.38$204.48RVU23B
2023-01-01$360.38$204.48RVU23A
2022-10-01$363.73$203.33RVU22D
2022-07-01$363.73$203.33RVU22C
2022-04-01$363.73$203.33RVU22B
2022-01-01$363.73$203.33RVU22A
2021-10-01$364.85$203.74RVU21D
2021-07-01$364.85$203.74RVU21C
2021-04-01$364.85$203.74RVU21B
2021-01-01$364.85$203.74RVU21A
2020-10-01$353.92$210.40RVU20D
2020-07-01$353.92$210.40RVU20C
2020-04-01$353.92$210.40RVU20B
2020-01-01$353.92$210.40RVU20A
2019-10-01$346.53$211.07RVU19D
2019-07-01$346.53$211.07RVU19C
2019-04-01$346.53$211.07RVU19B
2019-01-01$346.53$211.07RVU19A
2018-10-01$339.87$212.16RVU18D
2018-07-01$339.87$212.16RVU18C
2018-04-01$339.87$212.16RVU18B
2018-01-01$339.87$212.16RVU18AR1
2017-10-01$339.46$213.66RVU17D
2017-07-01$339.46$213.66RVU17C
2017-04-01$339.46$213.66RVU17B
2017-01-01$339.46$213.66RVU17A
2016-10-01$340.81$215.18RVU16D
2016-07-01$340.81$215.18RVU16C
2016-04-01$340.81$215.18RVU16B
2016-01-01$340.81$215.18RVU16A
2015-10-01$347.78$220.36RVU15D
2015-07-01$347.78$220.36RVU15C
2015-04-01$346.05$219.27RVU15B
2015-01-01$346.05$219.27RVU15A
2014-10-01$343.82$219.30RVU14D
2014-07-01$343.82$219.30RVU14C
2014-04-01$343.82$219.30RVU14B
2014-01-01$343.82$219.30RVU14A
2013-10-01$352.46$217.43RVU13D
2013-07-01$352.46$217.43RVU13C
2013-04-01$352.46$217.43RVU13B
2013-01-01$352.46$217.43RVU13AR

Price 12054 for an earlier date of service

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

Browse all communities in Indiana

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 IndianaGPCI2026.csv, line 52 (RVU26D)

Open CMS sourceHow we calculate rates

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