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

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 Virgin Islands, VI, Medicare pays $549.40 for 12055 in the office and $295.12 when it’s performed in a hospital or facility.

$549.40Office (non-facility)
$295.12Hospital or facility
+0.7%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 Virgin Islands, VI
  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 Virgin Islands, VI 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. Virgin Islands, VI pays $549.40. The RVUs are the same everywhere; the geographic indexes change the dollars.

12055 in Virgin Islands, VI vs other payment areas
  1. Virgin Islands, VI · this page$549.40
  2. Los Angeles, CA · California$609.57+$60.17
  3. Washington, DC area · District of Columbia$622.83+$73.43
  4. Miami, FL · Florida$605.87+$56.47
  5. Chicago, IL · Illinois$586.71+$37.31
  6. Manhattan, NY · New York$632.28+$82.88
  7. Alaska · Alaska$629.92+$80.52

Other areas in United States Virgin Islands 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.

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 Virgin Islands, VI 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

107

Locality
Virgin Islands, VI
Physician work
1.000
Practice expense
1.011
Malpractice
0.985
Office calculation for 12055 in Virgin Islands, VI
ComponentRVULocality factorAdjusted
Physician work4.39× 1.0004.3900
Practice expense11.07× 1.01111.1918
Malpractice0.88× 0.9850.8668
Total RVUs16.4486
Conversion factor× 33.4009

Office rate, Virgin Islands, VI$549.40

Office: (4.39 × 1 + 11.07 × 1.011 + 0.88 × 0.985) × $33.4009 = $549.40

Facility: (4.39 × 1 + 3.54 × 1.011 + 0.88 × 0.985) × $33.4009 = $295.12

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

How 12055 has changed in Virgin Islands, VI

12055 · Office / nonfacility

$549.40

Effective 2026-10-01

The base rate is $62.16 higher than on 2025-10-01, moving from $487.24 to $549.40 (12.8%).

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

    $487.24changed to$549.40

    • 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
    • Practice expense GPCI 1.007 changed to 1.011
    • Malpractice GPCI 0.982 changed to 0.985

    Held through RVU26B, RVU26C, RVU26D.

  2. January 1, 2025

    RVU25A

    $505.44changed to$487.24

    • 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

    $497.19changed to$505.44

    • Conversion factor 32.7442 changed to 33.2875

    Held through RVU24B, RVU24C, RVU24D.

  4. January 1, 2024

    RVU24A

    $520.39changed to$497.19

    • 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
    • Practice expense GPCI 1.008 changed to 1.007
    • Malpractice GPCI 0.984 changed to 0.982
  5. October 1, 2023

    RVU23D

    $518.14changed to$520.39

    • Practice expense GPCI 1.000 changed to 1.008
    • Malpractice GPCI 1.000 changed to 0.984
  6. January 1, 2023

    RVU23A

    $525.24changed to$518.14

    • 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
    • Practice expense GPCI 1.008 changed to 1.000
    • Malpractice GPCI 0.986 changed to 1.000

    Held through RVU23B, RVU23C.

  7. January 1, 2022

    RVU22A

    $526.07changed to$525.24

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

    Held through RVU22B, RVU22C, RVU22D.

  8. January 1, 2021

    RVU21A

    $504.52changed to$526.07

    • Conversion factor 36.0896 changed to 34.8931
    • Practice expense RVU 8.63 changed to 9.72
    • Malpractice GPCI 0.988 changed to 0.986

    Held through RVU21B, RVU21C, RVU21D.

  9. January 1, 2020

    RVU20A

    $490.91changed to$504.52

    • 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
    • Practice expense GPCI 1.007 changed to 1.008
    • Malpractice GPCI 0.990 changed to 0.988

    Held through RVU20B, RVU20C, RVU20D.

  10. January 1, 2019

    RVU19A

    $479.50changed to$490.91

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

    Held through RVU19B, RVU19C, RVU19D.

  11. January 1, 2018

    RVU18AR1

    $476.73changed to$479.50

    • 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
    • Practice expense GPCI 1.006 changed to 1.007
    • Malpractice GPCI 0.993 changed to 0.990

    Held through RVU18B, RVU18C, RVU18D.

  12. January 1, 2017

    RVU17A

    $463.13changed to$476.73

    • Conversion factor 35.8043 changed to 35.8887
    • Malpractice RVU 0.71 changed to 0.69
    • Practice expense GPCI 0.960 changed to 1.006
    • Malpractice GPCI 0.996 changed to 0.993

    Held through RVU17B, RVU17C, RVU17D.

  13. January 1, 2016

    RVU16A

    $471.70changed to$463.13

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

    Held through RVU16B, RVU16C, RVU16D.

  14. July 1, 2015

    RVU15C

    $469.36changed to$471.70

    • Conversion factor 35.7547 changed to 35.9335

    Held through RVU15D.

  15. January 1, 2015

    RVU15A

    $479.84changed to$469.36

    • 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 1.004 changed to 0.960
    • Malpractice GPCI 1.003 changed to 0.996

    Held through RVU15B.

  16. January 1, 2014

    RVU14A

    $484.67changed to$479.84

    • 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 1.002 changed to 1.004
    • Malpractice GPCI 1.010 changed to 1.003

    Held through RVU14B, RVU14C, RVU14D.

  17. January 1, 2013

    RVU13AR

    Earliest loaded release: $484.67

    Held through RVU13B, RVU13C, RVU13D.

Rates in every CMS release
Effective fromOfficeFacilityCMS release
2026-10-01$549.40$295.12RVU26D
2026-07-01$549.40$295.12RVU26C
2026-04-01$549.40$295.12RVU26B
2026-01-01$549.40$295.12RVU26A
2025-10-01$487.24$294.41RVU25D
2025-07-01$487.24$294.41RVU25C
2025-04-01$487.24$294.41RVU25B
2025-01-01$487.24$294.41RVU25A
2024-10-01$505.44$301.64RVU24D
2024-07-01$505.44$301.64RVU24C
2024-04-01$505.44$301.64RVU24B
2024-03-09$505.44$301.64RVU24AR
2024-01-01$497.19$296.71RVU24A
2023-10-01$520.39$303.49RVU23D
2023-07-01$518.14$302.95RVU23C
2023-04-01$518.14$302.95RVU23B
2023-01-01$518.14$302.95RVU23A
2022-10-01$525.24$304.08RVU22D
2022-07-01$525.24$304.08RVU22C
2022-04-01$525.24$304.08RVU22B
2022-01-01$525.24$304.08RVU22A
2021-10-01$526.07$304.84RVU21D
2021-07-01$526.07$304.84RVU21C
2021-04-01$526.07$304.84RVU21B
2021-01-01$526.07$304.84RVU21A
2020-10-01$504.52$313.17RVU20D
2020-07-01$504.52$313.17RVU20C
2020-04-01$504.52$313.17RVU20B
2020-01-01$504.52$313.17RVU20A
2019-10-01$490.91$313.08RVU19D
2019-07-01$490.91$313.08RVU19C
2019-04-01$490.91$313.08RVU19B
2019-01-01$490.91$313.08RVU19A
2018-10-01$479.50$316.00RVU18D
2018-07-01$479.50$316.00RVU18C
2018-04-01$479.50$316.00RVU18B
2018-01-01$479.50$316.00RVU18AR1
2017-10-01$476.73$316.06RVU17D
2017-07-01$476.73$316.06RVU17C
2017-04-01$476.73$316.06RVU17B
2017-01-01$476.73$316.06RVU17A
2016-10-01$463.13$310.18RVU16D
2016-07-01$463.13$310.18RVU16C
2016-04-01$463.13$310.18RVU16B
2016-01-01$463.13$310.18RVU16A
2015-10-01$471.70$306.12RVU15D
2015-07-01$471.70$306.12RVU15C
2015-04-01$469.36$304.60RVU15B
2015-01-01$469.36$304.60RVU15A
2014-10-01$479.84$311.16RVU14D
2014-07-01$479.84$311.16RVU14C
2014-04-01$479.84$311.16RVU14B
2014-01-01$479.84$311.16RVU14A
2013-10-01$484.67$305.35RVU13D
2013-07-01$484.67$305.35RVU13C
2013-04-01$484.67$305.35RVU13B
2013-01-01$484.67$305.35RVU13AR

Price 12055 for an earlier date of service

Where the Virgin Islands, VI rate applies

Virgin Islands, VI is a Medicare payment area, not a city. Our Census mapping connects it to 10 cities and communities in United States Virgin Islands. Some span more than one payment area; confirm with the service ZIP.

  • Charlotte Amalie
  • Charlotte Amalie East
  • Charlotte Amalie West
  • Christiansted
  • Coral Bay
  • Cruz Bay
  • Frederiksted
  • Frederiksted Southeast

Browse all communities in United States Virgin Islands

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 Virgin Islands, VIGPCI2026.csv, line 107 (RVU26D)

Open CMS sourceHow we calculate rates

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