Billing code 12051: Facial repairMedicare rate & RVUs

Medicare pays $282.91 for 12051 nationally in the office and $149.30 in a hospital or facility. Local office rates run $250.37–$374.00.

Medicare allowed amount for participating (non-QP) physicians, before deductible, coinsurance and claim adjustments. Not a patient’s bill or a hospital charge.

What 12051 covers

This service covers repair of a wound involving the face, ears, eyelids, nose, lips, or mucous membranes when the work requires closure of deeper tissue as well as the skin. It can also apply to a heavily contaminated wound closed in one layer after extensive cleaning or removal of embedded material. Emergency physicians, surgeons, dermatologists, and other qualified clinicians commonly perform these repairs in emergency departments, offices, and outpatient settings.

Select the code by repair class, applicable anatomic grouping, and documented total repaired length. For multiple eligible wounds, apply billing code aggregation rules within the appropriate site grouping and repair class rather than choosing by the longest wound alone. The record should describe the site, length, tissue layers repaired, and any extensive cleaning that supports intermediate classification. Medicare includes related postoperative visits during the 10-day global period. When multiple procedures are performed in the same session, the highest-valued procedure is paid in full and other procedures are subject to the standard 50% reduction. Modifier 50 is inappropriate; assistant-at-surgery payment is restricted, 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.

Where 12051 pays more and less

The same RVUs, adjusted for each area’s costs. Open a locality for its calculation, history and nearby areas.

109 of 109 payment localities

12051 rates by state

Office rate range in each state. Select a state to see its payment localities.

How the 12051 rate is calculated

Each of 12051’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.

Payment rules and modifiers for 12051

12051 has a 10-day global period: related visits in that window are included in the surgery payment.

What modifiers do to the payment

When to use modifier 51

12051 compared with similar codes

How to choose

12052Wound repair

Use 12052 when the intermediate repair in the same facial site group totals 2.6–5.0 cm; 12051 is for 2.5 cm or less.

12011Wound repair

Both cover short wounds in the facial site group, but 12011 is for simple repair; 12051 requires intermediate repair criteria.

12031Wound repair

Both are intermediate repairs at the shortest length level. 12031 is for its designated nonfacial site group, while 12051 is for the face and related structures.

Codes related to 12051

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

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

Open CMS sourceHow we calculate rates