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CPT code 12055: Wound repair, face and mucous membranes2026 Medicare rate & RVUs in Connecticut

Reports intermediate repair of qualifying facial and mucosal wounds when the combined repaired length is 12.6–20 cm.

CMS RVU26DEffective Oct 1, 2026One payment locality303 Medicare services in 2024

In Connecticut, Medicare pays $583.35 for 12055 in the office and $312.47 when it’s performed in a hospital or facility.

$583.35Office (non-facility)
$312.47Hospital or facility
+6.9%vs the national office rate ($545.77)

Check a contract rate as a % of Medicare · 12055 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 12055 for the payment locality that covers the ZIP.

On this page 11 sections
  1. Rate in Connecticut
  2. What 12055 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 12055 covers

Code 12055 represents intermediate closure of one or more wounds in the face, ear, eyelid, nose, lip, or mucous-membrane grouping when the repaired length totals 12.6–20 cm. Intermediate work involves layered closure, typically closing subcutaneous tissue or superficial fascia as well as skin; it can also apply to a heavily contaminated wound closed in one layer after extensive cleaning. Physicians and other qualified practitioners perform these repairs in offices, emergency departments, and hospitals, often after trauma or a procedure leaves a sizable laceration.

Select the code using the completed repaired length, not the wound’s estimated length before repair. Add lengths of repairs within the same anatomic grouping and repair class. Document the site, measured length, tissue layers, and extensive cleaning when contamination supports intermediate classification. CMS assigns a 10-day minor-procedure global period, including related postoperative visits during that period. In a same-session multiple-procedure claim, the highest-valued procedure is paid in full and others at 50%. Modifier 50 is inappropriate. Assistant-at-surgery services are statutorily unpaid; 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 Connecticut compares for 12055

Across 109 of 109 payment localities, the office rate for 12055 runs from $479.38 in Arkansas to $711.69 in San Benito County, CA. Connecticut pays $583.35. The RVUs are the same everywhere; the geographic indexes change the dollars.

12055 in Connecticut vs other payment areas
  1. Connecticut · this page$583.35
  2. Los Angeles, CA · California$609.57+$26.22
  3. Washington, DC area · District of Columbia$622.83+$39.48
  4. Miami, FL · Florida$605.87+$22.52
  5. Chicago, IL · Illinois$586.71+$3.36
  6. Manhattan, NY · New York$632.28+$48.93
  7. Alaska · Alaska$629.92+$46.57

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

Every other payment area

12055 in every other Medicare payment locality
Payment localityOfficeFacility
AlabamaAlabama$486.80$266.73
ArkansasArkansas$479.38$263.33
ArizonaArizona$530.08$286.36
Bakersfield, CACalifornia$572.56$296.91
Chico, CACalifornia$570.12$294.47
El Centro, CACalifornia$570.27$294.61
Fresno, CACalifornia$570.12$294.47
Hanford, CACalifornia$570.12$294.47

12055 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.

$479.38

$640.91

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

View every state and territory as a table
12055 office rate range by state
State / territoryOffice rate rangeLocalities
AK$629.921
AL$486.801
AR$479.381
AZ$530.081
CA$570.12–$711.6929
CO$564.761
CT$583.351
DC$622.831
DE$539.101
FL$544.29–$605.873
GA$511.48–$558.032
GU$584.051
HI$584.051
IA$496.621
ID$500.701
IL$530.15–$586.714
IN$503.671
KS$495.701
KY$502.231
LA$502.02–$527.952
MA$561.75–$620.282
MD$549.26–$622.833
ME$505.08–$531.602
MI$517.39–$552.992
MN$535.801
MO$493.98–$528.083
MS$486.701
MT$545.711
NC$510.391
ND$528.311
NE$499.021
NH$557.261
NJ$588.50–$616.172
NM$520.991
NV$541.231
NY$518.55–$650.235
OH$513.841
OK$499.651
OR$535.56–$581.632
PA$513.83–$569.242
PR$549.401
RI$557.581
SC$513.261
SD$526.251
TN$498.511
TX$510.41–$564.168
UT$520.591
VA$530.84–$622.832
VI$549.401
VT$527.551
WA$560.25–$631.662
WI$509.901
WV$510.001
WY$538.131

See 12055 in every payment locality

How the 12055 rate is calculated

Each of 12055’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 · 12055

RVUs × geographic indexes × conversion factor

Office or facility?

Work4.39

4.39 RVUs× 1.000 GPCI

Practice expense11.07

11.07 RVUs× 1.000 GPCI

Malpractice0.88

0.88 RVUs× 1.000 GPCI

Adjusted RVUs

16.3400

Conversion factor

$33.4009

Medicare rate

$545.77

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

The exact Connecticut inputs and CMS source lines

PPRRVU2026_Oct_nonQPP.csv

1,428

Code
12055
Physician work
4.39
Practice expense
11.07
Malpractice
0.88

GPCI2026.csv

38

Locality
Connecticut
Physician work
1.020
Practice expense
1.077
Malpractice
1.210
Office calculation for 12055 in Connecticut
ComponentRVULocality factorAdjusted
Physician work4.39× 1.0204.4778
Practice expense11.07× 1.07711.9224
Malpractice0.88× 1.2101.0648
Total RVUs17.4650
Conversion factor× 33.4009

Office rate, Connecticut$583.35

Office: (4.39 × 1.02 + 11.07 × 1.077 + 0.88 × 1.21) × $33.4009 = $583.35

Facility: (4.39 × 1.02 + 3.54 × 1.077 + 0.88 × 1.21) × $33.4009 = $312.47

Open 12055 in the RVU calculator

Payment rules and modifiers for 12055

12055 has a 10-day global period: related visits in that window are included in the surgery payment.

CMS payment indicators · 12055

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 · 12055

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

12055 without 51 · national office

$545.77

Wound repair, face and mucous membranes

12055-51 · Second procedure: 50%

$272.89

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 12055

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

Codes related to 12055
CodeHow it relatesOffice range, Connecticut
Same family
12054Wound repair, face, 7.6–12.5 cmSame repair class and anatomic grouping, for a shorter combined repaired length.$417.37
12056Wound repair, face, 20.1–30 cmSame repair class and anatomic grouping, for a longer combined repaired length.$666.03
12057Wound repair, face and related sites, over 30 cmSame repair class and anatomic grouping, for a combined repaired length over 30 cm.$692.30
Used instead
12016Simple wound repair, face group, 12.6–20 cmFacial repair in the same length range when the wound closure is simple rather than intermediate.$285.88
12035Wound repair, intermediate, 12.6–20 cmIntermediate repair in the same length range for a different anatomic grouping.$442.32

How 12055 has changed in Connecticut

12055 · Office / nonfacility

$583.35

Effective 2026-10-01

The base rate is $60.61 higher than on 2025-10-01, moving from $522.74 to $583.35 (11.6%).

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

    $522.74changed to$583.35

    • Conversion factor 32.3465 changed to 33.4009
    • Work RVU 4.50 changed to 4.39
    • Practice expense RVU 9.69 changed to 11.07
    • Malpractice RVU 0.82 changed to 0.88
    • Work GPCI 1.022 changed to 1.020
    • Practice expense GPCI 1.091 changed to 1.077
    • Malpractice GPCI 1.207 changed to 1.210

    Held through RVU26B, RVU26C, RVU26D.

  2. January 1, 2025

    RVU25A

    $542.26changed to$522.74

    • Conversion factor 33.2875 changed to 32.3465
    • Practice expense RVU 9.82 changed to 9.69
    • Malpractice RVU 0.81 changed to 0.82

    Held through RVU25B, RVU25C, RVU25D.

  3. March 9, 2024

    RVU24AR

    $533.41changed to$542.26

    • Conversion factor 32.7442 changed to 33.2875

    Held through RVU24B, RVU24C, RVU24D.

  4. January 1, 2024

    RVU24A

    $559.12changed to$533.41

    • Conversion factor 33.8872 changed to 32.7442
    • Practice expense RVU 9.97 changed to 9.82
    • Malpractice RVU 0.82 changed to 0.81
    • Work GPCI 1.030 changed to 1.022
    • Practice expense GPCI 1.102 changed to 1.091
    • Malpractice GPCI 1.070 changed to 1.207

  5. January 1, 2023

    RVU23A

    $565.60changed to$559.12

    • Conversion factor 34.6062 changed to 33.8872
    • Practice expense RVU 9.82 changed to 9.97
    • Malpractice RVU 0.79 changed to 0.82
    • Work GPCI 1.037 changed to 1.030
    • Practice expense GPCI 1.114 changed to 1.102
    • Malpractice GPCI 0.934 changed to 1.070

    Held through RVU23B, RVU23C, RVU23D.

  6. January 1, 2022

    RVU22A

    $566.40changed to$565.60

    • Conversion factor 34.8931 changed to 34.6062
    • Practice expense RVU 9.72 changed to 9.82

    Held through RVU22B, RVU22C, RVU22D.

  7. January 1, 2021

    RVU21A

    $544.95changed to$566.40

    • Conversion factor 36.0896 changed to 34.8931
    • Practice expense RVU 8.63 changed to 9.72
    • Work GPCI 1.029 changed to 1.037
    • Practice expense GPCI 1.113 changed to 1.114
    • Malpractice GPCI 1.094 changed to 0.934

    Held through RVU21B, RVU21C, RVU21D.

  8. January 1, 2020

    RVU20A

    $532.67changed to$544.95

    • Conversion factor 36.0391 changed to 36.0896
    • Practice expense RVU 8.37 changed to 8.63
    • Malpractice RVU 0.70 changed to 0.79
    • Work GPCI 1.021 changed to 1.029
    • Practice expense GPCI 1.112 changed to 1.113
    • Malpractice GPCI 1.255 changed to 1.094

    Held through RVU20B, RVU20C, RVU20D.

  9. January 1, 2019

    RVU19A

    $520.08changed to$532.67

    • Conversion factor 35.9996 changed to 36.0391
    • Practice expense RVU 8.07 changed to 8.37

    Held through RVU19B, RVU19C, RVU19D.

  10. January 1, 2018

    RVU18AR1

    $518.72changed to$520.08

    • Conversion factor 35.8887 changed to 35.9996
    • Practice expense RVU 8.05 changed to 8.07
    • Malpractice RVU 0.69 changed to 0.70
    • Work GPCI 1.023 changed to 1.021
    • Practice expense GPCI 1.117 changed to 1.112
    • Malpractice GPCI 1.244 changed to 1.255

    Held through RVU18B, RVU18C, RVU18D.

  11. January 1, 2017

    RVU17A

    $519.40changed to$518.72

    • Conversion factor 35.8043 changed to 35.8887
    • Malpractice RVU 0.71 changed to 0.69
    • Work GPCI 1.024 changed to 1.023
    • Practice expense GPCI 1.121 changed to 1.117
    • Malpractice GPCI 1.232 changed to 1.244

    Held through RVU17B, RVU17C, RVU17D.

  12. January 1, 2016

    RVU16A

    $529.34changed to$519.40

    • Conversion factor 35.9335 changed to 35.8043
    • Practice expense RVU 8.25 changed to 8.05

    Held through RVU16B, RVU16C, RVU16D.

  13. July 1, 2015

    RVU15C

    $526.70changed to$529.34

    • Conversion factor 35.7547 changed to 35.9335

    Held through RVU15D.

  14. January 1, 2015

    RVU15A

    $522.24changed to$526.70

    • Conversion factor 35.8228 changed to 35.7547
    • Practice expense RVU 8.16 changed to 8.25
    • Malpractice RVU 0.70 changed to 0.71
    • Practice expense GPCI 1.116 changed to 1.121
    • Malpractice GPCI 1.234 changed to 1.232

    Held through RVU15B.

  15. January 1, 2014

    RVU14A

    $526.96changed to$522.24

    • Conversion factor 34.0230 changed to 35.8228
    • Practice expense RVU 8.99 changed to 8.16
    • Malpractice RVU 0.73 changed to 0.70
    • Practice expense GPCI 1.110 changed to 1.116
    • Malpractice GPCI 1.235 changed to 1.234

    Held through RVU14B, RVU14C, RVU14D.

  16. January 1, 2013

    RVU13AR

    Earliest loaded release: $526.96

    Held through RVU13B, RVU13C, RVU13D.

Rates in every CMS release
Effective fromOfficeFacilityCMS release
2026-10-01$583.35$312.47RVU26D
2026-07-01$583.35$312.47RVU26C
2026-04-01$583.35$312.47RVU26B
2026-01-01$583.35$312.47RVU26A
2025-10-01$522.74$313.82RVU25D
2025-07-01$522.74$313.82RVU25C
2025-04-01$522.74$313.82RVU25B
2025-01-01$522.74$313.82RVU25A
2024-10-01$542.26$321.46RVU24D
2024-07-01$542.26$321.46RVU24C
2024-04-01$542.26$321.46RVU24B
2024-03-09$542.26$321.46RVU24AR
2024-01-01$533.41$316.21RVU24A
2023-10-01$559.12$321.98RVU23D
2023-07-01$559.12$321.98RVU23C
2023-04-01$559.12$321.98RVU23B
2023-01-01$559.12$321.98RVU23A
2022-10-01$565.60$321.18RVU22D
2022-07-01$565.60$321.18RVU22C
2022-04-01$565.60$321.18RVU22B
2022-01-01$565.60$321.18RVU22A
2021-10-01$566.40$321.90RVU21D
2021-07-01$566.40$321.90RVU21C
2021-04-01$566.40$321.90RVU21B
2021-01-01$566.40$321.90RVU21A
2020-10-01$544.95$333.67RVU20D
2020-07-01$544.95$333.67RVU20C
2020-04-01$544.95$333.67RVU20B
2020-01-01$544.95$333.67RVU20A
2019-10-01$532.67$336.30RVU19D
2019-07-01$532.67$336.30RVU19C
2019-04-01$532.67$336.30RVU19B
2019-01-01$532.67$336.30RVU19A
2018-10-01$520.08$339.54RVU18D
2018-07-01$520.08$339.54RVU18C
2018-04-01$520.08$339.54RVU18B
2018-01-01$520.08$339.54RVU18AR1
2017-10-01$518.72$340.33RVU17D
2017-07-01$518.72$340.33RVU17C
2017-04-01$518.72$340.33RVU17B
2017-01-01$518.72$340.33RVU17A
2016-10-01$519.40$340.80RVU16D
2016-07-01$519.40$340.80RVU16C
2016-04-01$519.40$340.80RVU16B
2016-01-01$519.40$340.80RVU16A
2015-10-01$529.34$335.98RVU15D
2015-07-01$529.34$335.98RVU15C
2015-04-01$526.70$334.31RVU15B
2015-01-01$526.70$334.31RVU15A
2014-10-01$522.24$334.74RVU14D
2014-07-01$522.24$334.74RVU14C
2014-04-01$522.24$334.74RVU14B
2014-01-01$522.24$334.74RVU14A
2013-10-01$526.96$328.32RVU13D
2013-07-01$526.96$328.32RVU13C
2013-04-01$526.96$328.32RVU13B
2013-01-01$526.96$328.32RVU13AR

Price 12055 for an earlier date of service

Where the Connecticut rate applies

Connecticut is a Medicare payment area, not a city. Our Census mapping connects it to 215 cities and communities in Connecticut. Some span more than one payment area; confirm with the service ZIP.

  • Ansonia
  • Ball Pond
  • Baltic
  • Bantam
  • Bethel
  • Bethlehem Village
  • Bigelow Corners
  • Blue Hills

Browse all communities in Connecticut

12055 billing questions

When does this repair qualify as intermediate rather than simple?

The repair involves layered closure, such as closing subcutaneous tissue or superficial fascia as well as skin. A heavily contaminated wound may also qualify when extensive cleaning is required, even if closure is in one layer.

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

Add the repaired lengths of wounds in the same anatomic grouping and repair class. The combined length must fall within 12.6–20 cm for this code.

Can modifier 50 be used for repairs on both sides of the face?

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

Are related postoperative visits included?

Yes. The 10-day minor-procedure global period includes related postoperative visits during that period.

How does CMS handle this code when other procedures are performed in the same session?

The highest-valued procedure is paid in full, and other procedures subject to the multiple-procedure reduction are paid at 50%.

Can an assistant surgeon or co-surgeon be reported for this repair?

Assistant-at-surgery services are statutorily unpaid 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 12055PPRRVU2026_Oct_nonQPP.csv, line 1,428 (RVU26D)
Geographic factors for ConnecticutGPCI2026.csv, line 38 (RVU26D)

Open CMS sourceHow we calculate rates

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