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CPT code 12056: Wound repair, face, 20.1–30 cm2026 Medicare rate & RVUs in Washington, DC area

Reports layered intermediate repair of a wound in the facial, ear, eyelid, nose, lip, or mucous membrane group when total repaired length is 20.1–30 cm.

CMS RVU26DEffective Oct 1, 2026One payment locality19 Medicare services in 2024

In Washington, DC area, Medicare pays $711.10 for 12056 in the office and $387.28 when it’s performed in a hospital or facility.

$711.10Office (non-facility)
$387.28Hospital or facility
+14.0%vs the national office rate ($623.59)

Check a contract rate as a % of Medicare · 12056 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 12056 for the payment locality that covers the ZIP.

On this page 11 sections
  1. Rate in Washington, DC area
  2. What 12056 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 12056 covers

This service closes a wound in layers when repair involves more than a single-layer skin closure, typically bringing deeper tissue together before closing the skin. Common situations include traumatic lacerations of the cheek, lip, eyelid, ear, or nose, as well as wounds involving mucous membrane sites in this anatomic group. Emergency physicians, plastic surgeons, dermatologic surgeons, and other clinicians who perform wound repair may report it in emergency, office, or facility settings.

Select the code based on intermediate repair complexity, the anatomic group, and a total repaired length of 20.1–30 cm. For multiple qualifying wounds in the same group, combine their repaired lengths. Document each wound’s location and length, the layered technique, and any extensive cleaning that supports intermediate-level work. CMS assigns a 10-day global period, which includes related postoperative visits during that period. For multiple procedures in one session, the highest-valued procedure is paid in full and others at 50%. Modifier 50 is inappropriate for this code. Assistant-at-surgery payment requires documented medical necessity; 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 12056

Across 109 of 109 payment localities, the office rate for 12056 runs from $548.99 in Arkansas to $812.84 in San Benito County, CA. Washington, DC area pays $711.10. The RVUs are the same everywhere; the geographic indexes change the dollars.

12056 in Washington, DC area vs other payment areas
  1. Washington, DC area · this page$711.10
  2. Los Angeles, CA · California$696.55−$14.55
  3. Miami, FL · Florida$689.79−$21.31
  4. Chicago, IL · Illinois$668.42−$42.68
  5. Manhattan, NY · New York$721.29+$10.19
  6. Alaska · Alaska$722.76+$11.66
  7. Alabama · Alabama$557.32−$153.78

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

Every other payment area

12056 in every other Medicare payment locality
Payment localityOfficeFacility
ArkansasArkansas$548.99$312.86
ArizonaArizona$605.99$339.63
Bakersfield, CACalifornia$654.55$353.27
Chico, CACalifornia$651.86$350.58
El Centro, CACalifornia$652.02$350.74
Fresno, CACalifornia$651.86$350.58
Hanford, CACalifornia$651.86$350.58
Madera, CACalifornia$651.86$350.58

12056 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.

$548.99

$732.35

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

View every state and territory as a table
12056 office rate range by state
State / territoryOffice rate rangeLocalities
AK$722.761
AL$557.321
AR$548.991
AZ$605.991
CA$651.86–$812.8429
CO$645.451
CT$666.031
DC$711.101
DE$616.191
FL$621.29–$689.793
GA$584.52–$637.262
GU$667.481
HI$667.481
IA$568.661
ID$573.191
IL$605.21–$668.424
IN$576.541
KS$567.481
KY$574.381
LA$574.08–$603.242
MA$642.05–$708.402
MD$627.72–$711.103
ME$577.97–$607.992
MI$591.29–$630.932
MN$613.171
MO$564.96–$603.553
MS$557.011
MT$623.531
NC$583.961
ND$604.551
NE$571.401
NH$636.761
NJ$672.15–$703.672
NM$595.281
NV$618.661
NY$593.13–$741.295
OH$587.411
OK$571.631
OR$612.40–$664.642
PA$587.49–$650.062
PR$627.721
RI$637.231
SC$586.951
SD$602.301
TN$570.631
TX$583.62–$644.588
UT$595.191
VA$607.05–$711.102
VI$627.721
VT$603.571
WA$640.38–$721.442
WI$583.811
WV$582.551
WY$615.261

See 12056 in every payment locality

How the 12056 rate is calculated

Each of 12056’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 · 12056

RVUs × geographic indexes × conversion factor

Office or facility?

Work5.17

5.17 RVUs× 1.000 GPCI

Practice expense12.54

12.54 RVUs× 1.000 GPCI

Malpractice0.96

0.96 RVUs× 1.000 GPCI

Adjusted RVUs

18.6700

Conversion factor

$33.4009

Medicare rate

$623.59

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

1,429

Code
12056
Physician work
5.17
Practice expense
12.54
Malpractice
0.96

GPCI2026.csv

39

Locality
Washington, DC area
Physician work
1.054
Practice expense
1.178
Malpractice
1.113
Office calculation for 12056 in Washington, DC area
ComponentRVULocality factorAdjusted
Physician work5.17× 1.0545.4492
Practice expense12.54× 1.17814.7721
Malpractice0.96× 1.1131.0685
Total RVUs21.2898
Conversion factor× 33.4009

Office rate, Washington, DC area$711.10

Office: (5.17 × 1.054 + 12.54 × 1.178 + 0.96 × 1.113) × $33.4009 = $711.10

Facility: (5.17 × 1.054 + 4.31 × 1.178 + 0.96 × 1.113) × $33.4009 = $387.28

Open 12056 in the RVU calculator

Payment rules and modifiers for 12056

12056 has a 10-day global period: related visits in that window are included in the surgery payment.

CMS payment indicators · 12056

Wound repair, face, 20.1–30 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)0Not paid without supporting documentation.
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 · 12056

Wound repair, face, 20.1–30 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

12056 without 51 · national office

$623.59

Wound repair, face, 20.1–30 cm

12056-51 · Second procedure: 50%

$311.80

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 12056

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

Codes related to 12056
CodeHow it relatesOffice range, Washington, DC area
Same family
12054Wound repair, face, 7.6–12.5 cmSame facial intermediate-repair group, for a shorter repaired-length range.$445.91
12055Wound repair, face and mucous membranesAdjacent shorter-length level in the facial intermediate-repair group.$622.83
12057Wound repair, face and related sites, over 30 cmAdjacent longer-length level in the facial intermediate-repair group.$737.51
Used instead
12036Wound repair, intermediate, 20.1–30 cmIntermediate repair at the same length range for a different anatomic group.$546.39
12046Intermediate repair, 20.1–30 cm, specified sitesIntermediate repair at the same length range for the non-hair-bearing or genital group.$636.51

How 12056 has changed in Washington, DC area

12056 · Office / nonfacility

$711.10

Effective 2026-10-01

The base rate is $64.88 higher than on 2025-10-01, moving from $646.22 to $711.10 (10.0%).

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

    $646.22changed to$711.10

    • Conversion factor 32.3465 changed to 33.4009
    • Work RVU 5.30 changed to 5.17
    • Practice expense RVU 11.10 changed to 12.54
    • Malpractice RVU 0.98 changed to 0.96
    • 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

    $666.60changed to$646.22

    • Conversion factor 33.2875 changed to 32.3465
    • Practice expense RVU 11.14 changed to 11.10

    Held through RVU25B, RVU25C, RVU25D.

  3. March 9, 2024

    RVU24AR

    $655.72changed to$666.60

    • Conversion factor 32.7442 changed to 33.2875

    Held through RVU24B, RVU24C, RVU24D.

  4. January 1, 2024

    RVU24A

    $690.46changed to$655.72

    • Conversion factor 33.8872 changed to 32.7442
    • Practice expense RVU 11.21 changed to 11.14
    • Malpractice RVU 0.95 changed to 0.98
    • 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

    $711.52changed to$690.46

    • Conversion factor 34.6062 changed to 33.8872
    • Practice expense RVU 11.11 changed to 11.21
    • Malpractice RVU 0.96 changed to 0.95
    • 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

    $713.93changed to$711.52

    • Conversion factor 34.8931 changed to 34.6062
    • Practice expense RVU 11.05 changed to 11.11
    • Malpractice RVU 0.94 changed to 0.96

    Held through RVU22B, RVU22C, RVU22D.

  7. January 1, 2021

    RVU21A

    $688.99changed to$713.93

    • Conversion factor 36.0896 changed to 34.8931
    • Practice expense RVU 10.12 changed to 11.05
    • Malpractice RVU 0.92 changed to 0.94
    • 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

    $667.39changed to$688.99

    • Conversion factor 36.0391 changed to 36.0896
    • Practice expense RVU 9.83 changed to 10.12
    • Malpractice RVU 0.90 changed to 0.92
    • 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. July 1, 2019

    RVU19C

    $665.12changed to$667.39

    • Malpractice RVU 0.85 changed to 0.90

    Held through RVU19D.

  10. January 1, 2019

    RVU19A

    $659.27changed to$665.12

    • Conversion factor 35.9996 changed to 36.0391
    • Practice expense RVU 9.67 changed to 9.83
    • Malpractice RVU 0.89 changed to 0.85

    Held through RVU19B.

  11. January 1, 2018

    RVU18AR1

    $573.75changed to$659.27

    • Conversion factor 35.8887 changed to 35.9996
    • Practice expense RVU 7.93 changed to 9.67
    • Malpractice RVU 0.69 changed to 0.89
    • Work GPCI 1.048 changed to 1.045
    • Malpractice GPCI 1.271 changed to 1.261

    Held through RVU18B, RVU18C, RVU18D.

  12. January 1, 2017

    RVU17A

    $641.44changed to$573.75

    • Conversion factor 35.8043 changed to 35.8887
    • Practice expense RVU 9.31 changed to 7.93
    • Malpractice RVU 0.88 changed to 0.69
    • Work GPCI 1.051 changed to 1.048
    • Malpractice GPCI 1.280 changed to 1.271

    Held through RVU17B, RVU17C, RVU17D.

  13. January 1, 2016

    RVU16A

    $584.00changed to$641.44

    • Conversion factor 35.9335 changed to 35.8043
    • Practice expense RVU 7.93 changed to 9.31

    Held through RVU16B, RVU16C, RVU16D.

  14. July 1, 2015

    RVU15C

    $581.10changed to$584.00

    • Conversion factor 35.7547 changed to 35.9335

    Held through RVU15D.

  15. January 1, 2015

    RVU15A

    $633.89changed to$581.10

    • Conversion factor 35.8228 changed to 35.7547
    • Practice expense RVU 9.45 changed to 7.93
    • Malpractice RVU 0.64 changed to 0.88
    • 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.

  16. January 1, 2014

    RVU14A

    $641.26changed to$633.89

    • Conversion factor 34.0230 changed to 35.8228
    • Practice expense RVU 10.46 changed to 9.45
    • Malpractice RVU 0.67 changed to 0.64
    • 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.

  17. January 1, 2013

    RVU13AR

    Earliest loaded release: $641.26

    Held through RVU13B, RVU13C, RVU13D.

Rates in every CMS release
Effective fromOfficeFacilityCMS release
2026-10-01$711.10$387.28RVU26D
2026-07-01$711.10$387.28RVU26C
2026-04-01$711.10$387.28RVU26B
2026-01-01$711.10$387.28RVU26A
2025-10-01$646.22$424.90RVU25D
2025-07-01$646.22$424.90RVU25C
2025-04-01$646.22$424.90RVU25B
2025-01-01$646.22$424.90RVU25A
2024-10-01$666.60$432.50RVU24D
2024-07-01$666.60$432.50RVU24C
2024-04-01$666.60$432.50RVU24B
2024-03-09$666.60$432.50RVU24AR
2024-01-01$655.72$425.44RVU24A
2023-10-01$690.46$444.04RVU23D
2023-07-01$690.46$444.04RVU23C
2023-04-01$690.46$444.04RVU23B
2023-01-01$690.46$444.04RVU23A
2022-10-01$711.52$452.74RVU22D
2022-07-01$711.52$452.74RVU22C
2022-04-01$711.52$452.74RVU22B
2022-01-01$711.52$452.74RVU22A
2021-10-01$713.93$454.30RVU21D
2021-07-01$713.93$454.30RVU21C
2021-04-01$713.93$454.30RVU21B
2021-01-01$713.93$454.30RVU21A
2020-10-01$688.99$458.09RVU20D
2020-07-01$688.99$458.09RVU20C
2020-04-01$688.99$458.09RVU20B
2020-01-01$688.99$458.09RVU20A
2019-10-01$667.39$451.12RVU19D
2019-07-01$667.39$451.12RVU19C
2019-04-01$665.12$448.85RVU19B
2019-01-01$665.12$448.85RVU19A
2018-10-01$659.27$451.48RVU18D
2018-07-01$659.27$451.48RVU18C
2018-04-01$659.27$451.48RVU18B
2018-01-01$659.27$451.48RVU18AR1
2017-10-01$573.75$397.74RVU17D
2017-07-01$573.75$397.74RVU17C
2017-04-01$573.75$397.74RVU17B
2017-01-01$573.75$397.74RVU17A
2016-10-01$641.44$442.12RVU16D
2016-07-01$641.44$442.12RVU16C
2016-04-01$641.44$442.12RVU16B
2016-01-01$641.44$442.12RVU16A
2015-10-01$584.00$406.47RVU15D
2015-07-01$584.00$406.47RVU15C
2015-04-01$581.10$404.45RVU15B
2015-01-01$581.10$404.45RVU15A
2014-10-01$633.89$434.96RVU14D
2014-07-01$633.89$434.96RVU14C
2014-04-01$633.89$434.96RVU14B
2014-01-01$633.89$434.96RVU14A
2013-10-01$641.26$428.90RVU13D
2013-07-01$641.26$428.90RVU13C
2013-04-01$641.26$428.90RVU13B
2013-01-01$641.26$428.90RVU13AR

Price 12056 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

12056 billing questions

How is 12056 distinguished from 12055 or 12057?

Choose by total repaired length in the facial anatomic group: 12056 covers 20.1–30 cm. Code 12055 covers the shorter adjacent range, while 12057 is for lengths over 30 cm.

What documentation supports intermediate repair?

Record the wound site and repaired length, along with the layered closure technique. Describe extensive cleaning when it is part of the work supporting intermediate-level repair.

Can the lengths of multiple wounds be combined?

Combine lengths for qualifying wounds in the same anatomic and repair category when selecting the length range. Keep the location and repaired length of each wound in the record.

Should modifier 50 be appended for wounds on both sides of the face?

No. CMS identifies bilateral adjustment as inappropriate for this code; report based on the qualifying repair length and circumstances.

How are multiple procedures and postoperative visits handled?

CMS includes related postoperative visits for 10 days in the global period. In a same-session multiple-procedure situation, the highest-valued procedure is paid in full and others at 50%.

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 12056PPRRVU2026_Oct_nonQPP.csv, line 1,429 (RVU26D)
Geographic factors for Washington, DC areaGPCI2026.csv, line 39 (RVU26D)

Open CMS sourceHow we calculate rates

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