CPT code 12056: Wound repair, face, 20.1–30 cm2026 Medicare rate & RVUs in New Mexico
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.
In New Mexico, Medicare pays $595.28 for 12056 in the office and $343.20 when it’s performed in a hospital or facility.
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.
On this page 11 sections
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 New Mexico 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. New Mexico pays $595.28. The RVUs are the same everywhere; the geographic indexes change the dollars.
- New Mexico · this page$595.28
- Los Angeles, CA · California$696.55+$101.27
- Washington, DC area · District of Columbia$711.10+$115.82
- Miami, FL · Florida$689.79+$94.51
- Chicago, IL · Illinois$668.42+$73.14
- Manhattan, NY · New York$721.29+$126.01
- Alaska · Alaska$722.76+$127.48
Other areas in New Mexico first, then benchmark localities. Bars start at $0.
Every other payment area
| Payment locality | Office | Facility |
|---|---|---|
| AlabamaAlabama | $557.32 | $316.79 |
| 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 |
| Merced, CACalifornia | $651.86 | $350.58 |
| Modesto, CACalifornia | $651.86 | $350.58 |
| Napa, CACalifornia | $751.89 | $389.59 |
| Oxnard, CACalifornia | $692.57 | $367.65 |
| Redding, CACalifornia | $651.86 | $350.58 |
| Rest of CaliforniaCalifornia | $651.86 | $350.58 |
| Riverside, CACalifornia | $662.20 | $360.92 |
| Sacramento, CACalifornia | $683.21 | $363.51 |
| Salinas, CACalifornia | $680.67 | $362.07 |
| San Diego, CACalifornia | $696.18 | $367.42 |
| Marin County, CACalifornia | $794.38 | $406.79 |
| San Francisco, CACalifornia | $793.29 | $405.70 |
| San Benito County, CACalifornia | $812.84 | $416.45 |
| Santa Clara County, CACalifornia | $808.39 | $411.99 |
| San Luis Obispo, CACalifornia | $669.87 | $356.77 |
| Santa Cruz, CACalifornia | $702.40 | $368.40 |
| Santa Maria, CACalifornia | $683.08 | $362.56 |
| Santa Rosa, CACalifornia | $709.39 | $371.83 |
| Stockton, CACalifornia | $651.86 | $350.58 |
| Vallejo, CACalifornia | $750.32 | $388.02 |
| Visalia, CACalifornia | $651.86 | $350.58 |
| Yuba City, CACalifornia | $651.86 | $350.58 |
| ColoradoColorado | $645.45 | $352.97 |
| ConnecticutConnecticut | $666.03 | $369.98 |
| DelawareDelaware | $616.19 | $344.60 |
| Fort Lauderdale, FLFlorida | $654.95 | $376.49 |
| Rest of FloridaFlorida | $621.29 | $358.50 |
| Atlanta, GAGeorgia | $637.26 | $357.97 |
| Rest of GeorgiaGeorgia | $584.52 | $339.31 |
| Hawaii, Guam, HIHawaii | $667.48 | $354.93 |
| IowaIowa | $568.66 | $317.13 |
| IdahoIdaho | $573.19 | $320.29 |
| East St. Louis, ILIllinois | $622.60 | $369.70 |
| Rest of IllinoisIllinois | $605.21 | $354.23 |
| Suburban Chicago, ILIllinois | $660.87 | $378.56 |
| IndianaIndiana | $576.54 | $321.72 |
| KansasKansas | $567.48 | $318.98 |
| KentuckyKentucky | $574.38 | $330.00 |
| New Orleans, LALouisiana | $603.24 | $344.57 |
| Rest of LouisianaLouisiana | $574.08 | $330.80 |
| Metropolitan Boston, MAMassachusetts | $708.40 | $380.19 |
| Rest of MassachusettsMassachusetts | $642.05 | $352.59 |
| Baltimore area, MDMaryland | $664.53 | $369.58 |
| Rest of MarylandMaryland | $627.72 | $349.53 |
| Rest of MaineMaine | $577.97 | $325.07 |
| Southern Maine, MEMaine | $607.99 | $335.58 |
| Detroit, MIMichigan | $630.93 | $365.66 |
| Rest of MichiganMichigan | $591.29 | $340.32 |
| MinnesotaMinnesota | $613.17 | $330.31 |
| Metropolitan Kansas City, MOMissouri | $597.31 | $339.19 |
| Metropolitan St. Louis, MOMissouri | $603.55 | $341.86 |
| Rest of MissouriMissouri | $564.96 | $328.01 |
| MississippiMississippi | $557.01 | $320.33 |
| MontanaMontana | $623.53 | $348.64 |
| North CarolinaNorth Carolina | $583.96 | $327.48 |
| North DakotaNorth Dakota | $604.55 | $329.66 |
| NebraskaNebraska | $571.40 | $317.68 |
| New HampshireNew Hampshire | $636.76 | $350.60 |
| Northern New JerseyNew Jersey | $703.67 | $384.80 |
| Rest of New JerseyNew Jersey | $672.15 | $371.97 |
| NevadaNevada | $618.66 | $343.49 |
| NYC suburbs and Long Island, NYNew York | $741.29 | $414.44 |
| Poughkeepsie and northern NYC suburbs, NYNew York | $677.89 | $376.89 |
| Queens, NYNew York | $725.05 | $400.13 |
| Rest of New YorkNew York | $593.13 | $331.98 |
| OhioOhio | $587.41 | $336.44 |
| OklahomaOklahoma | $571.63 | $326.15 |
| Portland, OROregon | $664.64 | $359.24 |
| Rest of OregonOregon | $612.40 | $338.61 |
| Metropolitan Philadelphia, PAPennsylvania | $650.06 | $363.90 |
| Rest of PennsylvaniaPennsylvania | $587.49 | $335.14 |
| Puerto RicoPuerto Rico | $627.72 | $349.81 |
| Rhode IslandRhode Island | $637.23 | $353.27 |
| South CarolinaSouth Carolina | $586.95 | $332.95 |
| South DakotaSouth Dakota | $602.30 | $327.41 |
| TennesseeTennessee | $570.63 | $320.76 |
| Austin, TXTexas | $644.58 | $353.74 |
| Beaumont, TXTexas | $583.62 | $333.47 |
| Brazoria, TXTexas | $614.15 | $341.74 |
| Dallas, TXTexas | $618.92 | $345.13 |
| Fort Worth, TXTexas | $615.15 | $344.11 |
| Galveston, TXTexas | $616.53 | $343.56 |
| Houston, TXTexas | $634.10 | $361.14 |
| Rest of TexasTexas | $599.12 | $338.25 |
| UtahUtah | $595.19 | $336.80 |
| VirginiaVirginia | $607.05 | $336.83 |
| Virgin Islands, VIUnited States Virgin Islands | $627.72 | $349.81 |
| VermontVermont | $603.57 | $331.43 |
| Rest of WashingtonWashington | $640.38 | $350.92 |
| King County, WAWashington | $721.44 | $384.15 |
| WisconsinWisconsin | $583.81 | $320.47 |
| West VirginiaWest Virginia | $582.55 | $343.67 |
| WyomingWyoming | $615.26 | $340.37 |
12056 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.
$548.99
$732.35
Color shows the midpoint of each state’s locality range.
View every state and territory as a table
| State / territory | Office rate range | Localities |
|---|---|---|
| AK | $722.76 | 1 |
| AL | $557.32 | 1 |
| AR | $548.99 | 1 |
| AZ | $605.99 | 1 |
| CA | $651.86–$812.84 | 29 |
| CO | $645.45 | 1 |
| CT | $666.03 | 1 |
| DC | $711.10 | 1 |
| DE | $616.19 | 1 |
| FL | $621.29–$689.79 | 3 |
| GA | $584.52–$637.26 | 2 |
| GU | $667.48 | 1 |
| HI | $667.48 | 1 |
| IA | $568.66 | 1 |
| ID | $573.19 | 1 |
| IL | $605.21–$668.42 | 4 |
| IN | $576.54 | 1 |
| KS | $567.48 | 1 |
| KY | $574.38 | 1 |
| LA | $574.08–$603.24 | 2 |
| MA | $642.05–$708.40 | 2 |
| MD | $627.72–$711.10 | 3 |
| ME | $577.97–$607.99 | 2 |
| MI | $591.29–$630.93 | 2 |
| MN | $613.17 | 1 |
| MO | $564.96–$603.55 | 3 |
| MS | $557.01 | 1 |
| MT | $623.53 | 1 |
| NC | $583.96 | 1 |
| ND | $604.55 | 1 |
| NE | $571.40 | 1 |
| NH | $636.76 | 1 |
| NJ | $672.15–$703.67 | 2 |
| NM | $595.28 | 1 |
| NV | $618.66 | 1 |
| NY | $593.13–$741.29 | 5 |
| OH | $587.41 | 1 |
| OK | $571.63 | 1 |
| OR | $612.40–$664.64 | 2 |
| PA | $587.49–$650.06 | 2 |
| PR | $627.72 | 1 |
| RI | $637.23 | 1 |
| SC | $586.95 | 1 |
| SD | $602.30 | 1 |
| TN | $570.63 | 1 |
| TX | $583.62–$644.58 | 8 |
| UT | $595.19 | 1 |
| VA | $607.05–$711.10 | 2 |
| VI | $627.72 | 1 |
| VT | $603.57 | 1 |
| WA | $640.38–$721.44 | 2 |
| WI | $583.81 | 1 |
| WV | $582.55 | 1 |
| WY | $615.26 | 1 |
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
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 New Mexico 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
77
- Locality
- New Mexico
- Physician work
- 1.000
- Practice expense
- 0.917
- Malpractice
- 1.201
| Component | RVU | Locality factor | Adjusted |
|---|---|---|---|
| Physician work | 5.17 | × 1.000 | 5.1700 |
| Practice expense | 12.54 | × 0.917 | 11.4992 |
| Malpractice | 0.96 | × 1.201 | 1.1530 |
| Total RVUs | 17.8221 | ||
| Conversion factor | × 33.4009 | ||
Office rate, New Mexico$595.28
Office: (5.17 × 1 + 12.54 × 0.917 + 0.96 × 1.201) × $33.4009 = $595.28
Facility: (5.17 × 1 + 4.31 × 0.917 + 0.96 × 1.201) × $33.4009 = $343.20
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
| Rule | CMS value | What it means |
|---|---|---|
| Global period | 010 | Minor procedure: the day of the procedure plus 10 days after are included. |
| Multiple procedures | 2 | Standard reduction: highest-valued procedure at 100%, others at 50%. |
| Bilateral (modifier 50) | 0 | The 150% bilateral adjustment doesn’t apply. |
| Assistant at surgery (80/81/82/AS) | 0 | Not paid without supporting documentation. |
| Co-surgeons (62) | 0 | Not permitted. |
| Team surgery (66) | 0 | Not permitted. |
| Professional/technical | 0 | Physician service: no professional/technical split. |
| Split (54/55/56) | 0.10/0.80/0.10 | Share 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.
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%).
How 12056 has changed in New Mexico
12056 · Office / nonfacility
$595.28
Effective 2026-10-01
The base rate is $60.68 higher than on 2025-10-01, moving from $534.60 to $595.28 (11.4%).
It is unchanged from the immediately preceding available release, effective 2026-07-01.
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
January 1, 2026
RVU26A
$534.60changed to$595.28
- 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
- Practice expense GPCI 0.908 changed to 0.917
- Malpractice GPCI 1.172 changed to 1.201
Held through RVU26B, RVU26C, RVU26D.
January 1, 2025
RVU25A
$551.36changed to$534.60
- Conversion factor 33.2875 changed to 32.3465
- Practice expense RVU 11.14 changed to 11.10
Held through RVU25B, RVU25C, RVU25D.
March 9, 2024
RVU24AR
$542.36changed to$551.36
- Conversion factor 32.7442 changed to 33.2875
Held through RVU24B, RVU24C, RVU24D.
January 1, 2024
RVU24A
$559.88changed to$542.36
- 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
- Practice expense GPCI 0.902 changed to 0.908
- Malpractice GPCI 1.169 changed to 1.172
January 1, 2023
RVU23A
$566.64changed to$559.88
- 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
- Practice expense GPCI 0.896 changed to 0.902
- Malpractice GPCI 1.166 changed to 1.169
Held through RVU23B, RVU23C, RVU23D.
January 1, 2022
RVU22A
$568.65changed to$566.64
- 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.
January 1, 2021
RVU21A
$562.98changed to$568.65
- 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
- Practice expense GPCI 0.908 changed to 0.896
- Malpractice GPCI 1.207 changed to 1.166
Held through RVU21B, RVU21C, RVU21D.
January 1, 2020
RVU20A
$557.73changed to$562.98
- 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
- Practice expense GPCI 0.921 changed to 0.908
- Malpractice GPCI 1.247 changed to 1.207
Held through RVU20B, RVU20C, RVU20D.
July 1, 2019
RVU19C
$555.48changed to$557.73
- Malpractice RVU 0.85 changed to 0.90
Held through RVU19D.
January 1, 2019
RVU19A
$551.37changed to$555.48
- 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.
January 1, 2018
RVU18AR1
$481.85changed to$551.37
- 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
- Practice expense GPCI 0.920 changed to 0.921
- Malpractice GPCI 1.204 changed to 1.247
Held through RVU18B, RVU18C, RVU18D.
January 1, 2017
RVU17A
$532.68changed to$481.85
- 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
- Practice expense GPCI 0.919 changed to 0.920
- Malpractice GPCI 1.161 changed to 1.204
Held through RVU17B, RVU17C, RVU17D.
January 1, 2016
RVU16A
$489.03changed to$532.68
- Conversion factor 35.9335 changed to 35.8043
- Practice expense RVU 7.93 changed to 9.31
Held through RVU16B, RVU16C, RVU16D.
July 1, 2015
RVU15C
$486.60changed to$489.03
- Conversion factor 35.7547 changed to 35.9335
Held through RVU15D.
January 1, 2015
RVU15A
$525.37changed to$486.60
- 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
- Practice expense GPCI 0.918 changed to 0.919
- Malpractice GPCI 1.079 changed to 1.161
Held through RVU15B.
January 1, 2014
RVU14A
$529.04changed to$525.37
- 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
- Practice expense GPCI 0.916 changed to 0.918
- Malpractice GPCI 0.997 changed to 1.079
Held through RVU14B, RVU14C, RVU14D.
January 1, 2013
RVU13AR
Earliest loaded release: $529.04
Held through RVU13B, RVU13C, RVU13D.
| Effective from | Office | Facility | CMS release |
|---|---|---|---|
| 2026-10-01 | $595.28 | $343.20 | RVU26D |
| 2026-07-01 | $595.28 | $343.20 | RVU26C |
| 2026-04-01 | $595.28 | $343.20 | RVU26B |
| 2026-01-01 | $595.28 | $343.20 | RVU26A |
| 2025-10-01 | $534.60 | $366.01 | RVU25D |
| 2025-07-01 | $534.60 | $366.01 | RVU25C |
| 2025-04-01 | $534.60 | $366.01 | RVU25B |
| 2025-01-01 | $534.60 | $366.01 | RVU25A |
| 2024-10-01 | $551.36 | $373.04 | RVU24D |
| 2024-07-01 | $551.36 | $373.04 | RVU24C |
| 2024-04-01 | $551.36 | $373.04 | RVU24B |
| 2024-03-09 | $551.36 | $373.04 | RVU24AR |
| 2024-01-01 | $542.36 | $366.95 | RVU24A |
| 2023-10-01 | $559.88 | $376.79 | RVU23D |
| 2023-07-01 | $559.88 | $376.79 | RVU23C |
| 2023-04-01 | $559.88 | $376.79 | RVU23B |
| 2023-01-01 | $559.88 | $376.79 | RVU23A |
| 2022-10-01 | $566.64 | $379.05 | RVU22D |
| 2022-07-01 | $566.64 | $379.05 | RVU22C |
| 2022-04-01 | $566.64 | $379.05 | RVU22B |
| 2022-01-01 | $566.64 | $379.05 | RVU22A |
| 2021-10-01 | $568.65 | $380.44 | RVU21D |
| 2021-07-01 | $568.65 | $380.44 | RVU21C |
| 2021-04-01 | $568.65 | $380.44 | RVU21B |
| 2021-01-01 | $568.65 | $380.44 | RVU21A |
| 2020-10-01 | $562.98 | $391.26 | RVU20D |
| 2020-07-01 | $562.98 | $391.26 | RVU20C |
| 2020-04-01 | $562.98 | $391.26 | RVU20B |
| 2020-01-01 | $562.98 | $391.26 | RVU20A |
| 2019-10-01 | $557.73 | $392.44 | RVU19D |
| 2019-07-01 | $557.73 | $392.44 | RVU19C |
| 2019-04-01 | $555.48 | $390.19 | RVU19B |
| 2019-01-01 | $555.48 | $390.19 | RVU19A |
| 2018-10-01 | $551.37 | $392.55 | RVU18D |
| 2018-07-01 | $551.37 | $392.55 | RVU18C |
| 2018-04-01 | $551.37 | $392.55 | RVU18B |
| 2018-01-01 | $551.37 | $392.55 | RVU18AR1 |
| 2017-10-01 | $481.85 | $347.47 | RVU17D |
| 2017-07-01 | $481.85 | $347.47 | RVU17C |
| 2017-04-01 | $481.85 | $347.47 | RVU17B |
| 2017-01-01 | $481.85 | $347.47 | RVU17A |
| 2016-10-01 | $532.68 | $380.66 | RVU16D |
| 2016-07-01 | $532.68 | $380.66 | RVU16C |
| 2016-04-01 | $532.68 | $380.66 | RVU16B |
| 2016-01-01 | $532.68 | $380.66 | RVU16A |
| 2015-10-01 | $489.03 | $353.64 | RVU15D |
| 2015-07-01 | $489.03 | $353.64 | RVU15C |
| 2015-04-01 | $486.60 | $351.88 | RVU15B |
| 2015-01-01 | $486.60 | $351.88 | RVU15A |
| 2014-10-01 | $525.37 | $373.43 | RVU14D |
| 2014-07-01 | $525.37 | $373.43 | RVU14C |
| 2014-04-01 | $525.37 | $373.43 | RVU14B |
| 2014-01-01 | $525.37 | $373.43 | RVU14A |
| 2013-10-01 | $529.04 | $366.67 | RVU13D |
| 2013-07-01 | $529.04 | $366.67 | RVU13C |
| 2013-04-01 | $529.04 | $366.67 | RVU13B |
| 2013-01-01 | $529.04 | $366.67 | RVU13AR |
Where the New Mexico rate applies
New Mexico is a Medicare payment area, not a city. Our Census mapping connects it to 528 cities and communities in New Mexico. Some span more than one payment area; confirm with the service ZIP.
- Abeytas
- Abiquiu
- Acomita Lake
- Adelino
- Agua Fria
- Alamillo
- Alamo
- Alamogordo
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
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