Billing code 12052: Wound repairMedicare rate & RVUs

Medicare pays $311.96 for 12052 nationally in the office and $172.68 in a hospital or facility. Local office rates run $277.26–$408.51.

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

What 12052 covers

This code covers intermediate repair of wounds involving the face, ears, eyelids, nose, lips, or mucous membranes. A typical case is a facial laceration closed in layers, with repair of deeper tissue as well as the skin. A single-layer closure can also qualify when a heavily contaminated wound requires extensive cleaning or removal of particulate matter. Physicians and other qualified practitioners commonly perform these repairs in emergency departments, offices, and operating rooms.

Select the code by the repair’s complexity, anatomic group, and total length. Add together the lengths of wounds in the same anatomic and repair classification, and document the sites, measured lengths, and closure technique or qualifying wound cleaning. Medicare assigns a 10-day global period, which includes related postoperative visits during that period. When multiple procedures are performed in the same session, the highest-valued procedure is paid in full and the others at 50%. Modifier 50 is inappropriate for this code. Medicare does not pay an assistant at surgery for this service, and co-surgeon and team-surgery billing 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 12052 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

12052 rates by state

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

How the 12052 rate is calculated

Each of 12052’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 12052

12052 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

12052 compared with similar codes

How to choose

12051Facial repair

This code covers intermediate repair of facial and related-site wounds measuring 2.6–5.0 cm; 12051 is the shorter-length tier, at 2.5 cm or less.

12053Wound repair

Use 12053 when the intermediate repair’s total length is 5.1–7.5 cm. This code is for 2.6–5.0 cm.

12013Wound repair

Both codes cover facial wounds in the 2.6–5.0 cm length range, but 12013 is for simple repair; this code requires intermediate repair.

Codes related to 12052

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