Billing code 12057: Wound repairMedicare rate & RVUs

Medicare pays $648.65 for 12057 nationally in the office and $382.44 in a hospital or facility. Local office rates run $572.21–$837.49.

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

What 12057 covers

This code covers intermediate repair of wounds on the face, ears, eyelids, nose, lips, or mucous membranes when the total repaired length is more than 30.0 cm. Intermediate complexity generally involves layered closure, including closure of deeper tissue beneath the skin, or single-layer closure of a heavily contaminated wound requiring extensive cleaning. Emergency physicians, plastic surgeons, dermatologists, and other clinicians who repair traumatic lacerations may perform this service in an emergency department, outpatient facility, or operating room.

Select the code based on the repair method, anatomic group, and documented final length; combine lengths of wounds repaired at the same complexity in the same anatomic group. The record should identify wound sites, lengths, tissue layers closed, and any extensive cleaning that supports intermediate complexity. Medicare assigns a 10-day global period, including related postoperative visits during that period. When multiple procedures occur in one session, the highest-valued procedure is paid in full and other procedures are subject to the standard 50% reduction. Bilateral adjustment is inappropriate. Assistant-at-surgery payment may be made; co-surgeon payment requires supporting documentation, and team surgery is 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 12057 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

12057 rates by state

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

How the 12057 rate is calculated

Each of 12057’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 12057

12057 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

12057 compared with similar codes

How to choose

12056Wound repair

Both are intermediate repairs in the same anatomic group; choose 12057 only when the combined repaired length exceeds 30.0 cm.

12018Wound repair

This code is for simple repair over 30.0 cm at these sites. Choose 12057 when the documented repair meets intermediate-complexity criteria.

12037Intermediate repair

Both describe intermediate repair over 30.0 cm, but 12037 applies to scalp, trunk, or extremity sites rather than the face-related group.

Codes related to 12057

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