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CMS RVU26D · Effective 2026-10-01

12054 in Merced

Office / nonfacility

$410.50

Base rate per service

Facility setting

$197.45

Base rate per service

Amounts below use the non-QP conversion factor for participating physicians. These are base physician payments before claim-level adjustments, not patient costs or total hospital charges.

Wound repair

About 12054: Intermediate facial wound repair

Report this code for intermediate repair of qualifying facial or mucosal wounds when the combined repaired length falls within the 7.6–12.5 cm range.

This code covers an intermediate repair on the face or mucous membranes, including sites such as the eyelid, nose, lip, or ear. The repair involves layered closure, including deeper tissue beneath the skin, or a single-layer closure when a heavily contaminated wound requires extensive cleaning. Physicians and other qualified clinicians commonly perform these repairs in emergency departments, offices, and outpatient surgical settings.

Select the code using the total repaired length of qualifying wounds in the same anatomic grouping and repair classification; documentation should identify the sites, measurements, wound characteristics, and closure performed. The code has a 10-day global period, so related postoperative visits during that period are included. When multiple procedures occur in the same session, the highest-valued procedure is paid in full and other procedures are subject to the standard 50% multiple-procedure reduction. Modifier 50 is inappropriate for this code. Medicare does not pay an assistant at surgery, and co-surgeons and team surgery are not permitted.

CMS billing rules for 12054

Global period
Minor procedure with a 10-day global period: related postoperative visits for 10 days are included.
Multiple procedures
Standard multiple procedure reduction: the highest-valued procedure is paid in full and others at 50% when performed in the same session.
Bilateral procedures
Bilateral adjustment does not apply; the descriptor or anatomy makes modifier 50 inappropriate.
Assistant at surgery
Statutory restriction: assistant at surgery is not paid.
Co-surgeons
Co-surgeons not permitted.
Team surgery
Team surgery not permitted.

Where the value comes from

  • Work RVU3.41 · 29%
  • Practice expense (office) RVU7.80 · 67%
  • Malpractice RVU0.51 · 4%

3.9K

Medicare services in 2024 · #2021 by national volume

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.

12054 compared with similar codes

Office rates for Merced, from the same CMS release.

12053

Wound repair

Face and mucous membranes

$380.28

Use 12053 when the total qualifying intermediate facial repair length is 5.1–7.5 cm; use this code for 7.6–12.5 cm.

12055

Wound repair

Face and mucous membranes

$570.12

Use 12055 when the total qualifying intermediate facial repair length is 12.6–20 cm; this code covers 7.6–12.5 cm.

12015

Simple wound repair

Face and related sites, 7.6-12.5 cm

$217.67

12015 is for simple facial repair in this length range. Choose this code when the repair meets intermediate criteria, such as layered closure.

12034

Wound repair

Intermediate, 7.6–12.5 cm

$351.86

Both codes cover intermediate repair in the 7.6–12.5 cm range, but 12034 is for a different anatomic grouping, including scalp, trunk, or extremities.

The same code, a different location

How does Merced compare?

In Bakersfield, the office rate for 12054 is $411.97—$1.47 higher than the $410.50 rate in Merced. Both use the same code, release and participation basis.

12054 across payment areas

Same release and payment basis · bars start at $0

  1. Merced · This locality

    $410.50

  2. Bakersfield

    $411.97

    $1.47 higher than Merced

  3. Chico

    $410.50

    The same base rate than Merced

  4. El Centro

    $410.59

    $0.09 higher than Merced

  5. Fresno

    $410.50

    The same base rate than Merced

  6. Hanford-Corcoran

    $410.50

    The same base rate than Merced

  7. Los Angeles-Long Beach-Anaheim (Los Angeles/Orange Cnty)

    $438.08

    $27.58 higher than Merced

Other payment areas listed in California appear first, followed by selected cross-country examples. The chart compares amounts, not distance.

Across 109 of 109 CMS payment localities with a supported office rate, 12054 ranges from $346.46 in Arkansas to $511.24 in San Jose-Sunnyvale-Santa Clara (San Benito Cnty). This is a geographic range, not an average.

The code’s RVUs stay the same in these comparisons. Geographic adjustments to work, practice expense and malpractice change the dollar amount. A city name alone may not identify the payment area for a service address.

Compare all 108 other payment areas

  • Madera

    California · 12054

    Office

    $410.50

    Facility

    $197.45

    The same base rate than Merced for the office setting.

  • Modesto

    California · 12054

    Office

    $410.50

    Facility

    $197.45

    The same base rate than Merced for the office setting.

  • Napa

    California · 12054

    Office

    $473.10

    Facility

    $216.89

    $62.60 higher than Merced for the office setting.

  • Oxnard-Thousand Oaks-Ventura

    California · 12054

    Office

    $435.64

    Facility

    $205.87

    $25.14 higher than Merced for the office setting.

  • Redding

    California · 12054

    Office

    $410.50

    Facility

    $197.45

    The same base rate than Merced for the office setting.

  • Rest Of California

    California · 12054

    Office

    $410.50

    Facility

    $197.45

    The same base rate than Merced for the office setting.

  • Riverside-San Bernardino-Ontario

    California · 12054

    Office

    $416.02

    Facility

    $202.96

    $5.52 higher than Merced for the office setting.

  • Sacramento-Roseville-Folsom

    California · 12054

    Office

    $430.12

    Facility

    $204.04

    $19.62 higher than Merced for the office setting.

  • Salinas

    California · 12054

    Office

    $428.51

    Facility

    $203.21

    $18.01 higher than Merced for the office setting.

  • San Diego-Chula Vista-Carlsbad

    California · 12054

    Office

    $438.14

    Facility

    $205.64

    $27.64 higher than Merced for the office setting.

  • San Francisco-Oakland-Berkeley (Marin Cnty)

    California · 12054

    Office

    $499.88

    Facility

    $225.78

    $89.38 higher than Merced for the office setting.

  • San Francisco-Oakland-Berkeley (San Francisco/San Mateo/Alameda/Contra Costa Cnty)

    California · 12054

    Office

    $499.30

    Facility

    $225.21

    $88.80 higher than Merced for the office setting.

  • San Jose-Sunnyvale-Santa Clara (San Benito Cnty)

    California · 12054

    Office

    $511.24

    Facility

    $230.92

    $100.74 higher than Merced for the office setting.

  • San Jose-Sunnyvale-Santa Clara (Santa Clara Cnty)

    California · 12054

    Office

    $508.87

    Facility

    $228.55

    $98.37 higher than Merced for the office setting.

  • San Luis Obispo-Paso Robles

    California · 12054

    Office

    $421.70

    Facility

    $200.29

    $11.20 higher than Merced for the office setting.

  • Santa Cruz-Watsonville

    California · 12054

    Office

    $441.96

    Facility

    $205.77

    $31.46 higher than Merced for the office setting.

  • Santa Maria-Santa Barbara

    California · 12054

    Office

    $429.99

    Facility

    $203.33

    $19.49 higher than Merced for the office setting.

  • Santa Rosa-Petaluma

    California · 12054

    Office

    $446.37

    Facility

    $207.66

    $35.87 higher than Merced for the office setting.

  • Stockton

    California · 12054

    Office

    $410.50

    Facility

    $197.45

    The same base rate than Merced for the office setting.

  • Vallejo

    California · 12054

    Office

    $472.27

    Facility

    $216.06

    $61.77 higher than Merced for the office setting.

  • Visalia

    California · 12054

    Office

    $410.50

    Facility

    $197.45

    The same base rate than Merced for the office setting.

  • Yuba City

    California · 12054

    Office

    $410.50

    Facility

    $197.45

    The same base rate than Merced for the office setting.

  • Dc + Md/Va Suburbs

    District of Columbia · 12054

    Office

    $445.91

    Facility

    $216.91

    $35.41 higher than Merced for the office setting.

  • Miami

    Florida · 12054

    Office

    $428.19

    Facility

    $225.82

    $17.69 higher than Merced for the office setting.

  • Chicago

    Illinois · 12054

    Office

    $415.62

    Facility

    $220.25

    $5.12 higher than Merced for the office setting.

  • Manhattan

    New York · 12054

    Office

    $450.94

    Facility

    $225.05

    $40.44 higher than Merced for the office setting.

  • Alaska*

    Alaska · 12054

    Office

    $457.69

    Facility

    $250.66

    $47.19 higher than Merced for the office setting.

  • Alabama

    Alabama · 12054

    Office

    $351.50

    Facility

    $181.41

    $59.00 lower than Merced for the office setting.

  • Arkansas

    Arkansas · 12054

    Office

    $346.46

    Facility

    $179.48

    $64.04 lower than Merced for the office setting.

  • Arizona

    Arizona · 12054

    Office

    $380.93

    Facility

    $192.56

    $29.57 lower than Merced for the office setting.

  • Colorado

    Colorado · 12054

    Office

    $405.77

    Facility

    $198.93

    $4.73 lower than Merced for the office setting.

  • Connecticut

    Connecticut · 12054

    Office

    $417.37

    Facility

    $208.01

    $6.87 higher than Merced for the office setting.

  • Delaware

    Delaware · 12054

    Office

    $387.18

    Facility

    $195.12

    $23.32 lower than Merced for the office setting.

  • Fort Lauderdale

    Florida · 12054

    Office

    $408.61

    Facility

    $211.69

    $1.89 lower than Merced for the office setting.

  • Rest Of Florida

    Florida · 12054

    Office

    $388.56

    Facility

    $202.72

    $21.94 lower than Merced for the office setting.

  • Atlanta

    Georgia · 12054

    Office

    $399.39

    Facility

    $201.89

    $11.11 lower than Merced for the office setting.

  • Rest Of Georgia

    Georgia · 12054

    Office

    $366.59

    Facility

    $193.19

    $43.91 lower than Merced for the office setting.

  • Hawaii, Guam

    Hawaii · 12054

    Office

    $419.98

    Facility

    $198.95

    $9.48 higher than Merced for the office setting.

  • Iowa

    Iowa · 12054

    Office

    $359.04

    Facility

    $181.17

    $51.46 lower than Merced for the office setting.

  • Idaho

    Idaho · 12054

    Office

    $361.64

    Facility

    $182.80

    $48.86 lower than Merced for the office setting.

  • East St. Louis

    Illinois · 12054

    Office

    $387.89

    Facility

    $209.05

    $22.61 lower than Merced for the office setting.

  • Rest Of Illinois

    Illinois · 12054

    Office

    $378.38

    Facility

    $200.90

    $32.12 lower than Merced for the office setting.

  • Suburban Chicago

    Illinois · 12054

    Office

    $412.44

    Facility

    $212.80

    $1.94 higher than Merced for the office setting.

  • Indiana

    Indiana · 12054

    Office

    $363.68

    Facility

    $183.48

    $46.82 lower than Merced for the office setting.

  • Kansas

    Kansas · 12054

    Office

    $358.00

    Facility

    $182.27

    $52.50 lower than Merced for the office setting.

  • Kentucky

    Kentucky · 12054

    Office

    $361.09

    Facility

    $188.28

    $49.41 lower than Merced for the office setting.

  • New Orleans

    Louisiana · 12054

    Office

    $378.40

    Facility

    $195.48

    $32.10 lower than Merced for the office setting.

  • Rest Of Louisiana

    Louisiana · 12054

    Office

    $360.78

    Facility

    $188.74

    $49.72 lower than Merced for the office setting.

  • Metropolitan Boston

    Massachusetts · 12054

    Office

    $444.80

    Facility

    $212.69

    $34.30 higher than Merced for the office setting.

  • Rest Of Massachusetts

    Massachusetts · 12054

    Office

    $403.63

    Facility

    $198.93

    $6.87 lower than Merced for the office setting.

  • Baltimore/Surr. Cntys

    Maryland · 12054

    Office

    $416.34

    Facility

    $207.75

    $5.84 higher than Merced for the office setting.

  • Rest Of Maryland

    Maryland · 12054

    Office

    $394.33

    Facility

    $197.60

    $16.17 lower than Merced for the office setting.

  • Rest Of Maine

    Maine · 12054

    Office

    $364.18

    Facility

    $185.34

    $46.32 lower than Merced for the office setting.

  • Southern Maine

    Maine · 12054

    Office

    $382.83

    Facility

    $190.18

    $27.67 lower than Merced for the office setting.

  • Detroit

    Michigan · 12054

    Office

    $394.03

    Facility

    $206.44

    $16.47 lower than Merced for the office setting.

  • Rest Of Michigan

    Michigan · 12054

    Office

    $370.99

    Facility

    $193.51

    $39.51 lower than Merced for the office setting.

  • Minnesota

    Minnesota · 12054

    Office

    $387.02

    Facility

    $186.99

    $23.48 lower than Merced for the office setting.

  • Metropolitan Kansas City

    Missouri · 12054

    Office

    $375.17

    Facility

    $192.64

    $35.33 lower than Merced for the office setting.

  • Metropolitan St. Louis

    Missouri · 12054

    Office

    $378.99

    Facility

    $193.92

    $31.51 lower than Merced for the office setting.

  • Rest Of Missouri

    Missouri · 12054

    Office

    $355.06

    Facility

    $187.50

    $55.44 lower than Merced for the office setting.

  • Mississippi

    Mississippi · 12054

    Office

    $350.80

    Facility

    $183.43

    $59.70 lower than Merced for the office setting.

  • Montana**

    Montana · 12054

    Office

    $391.42

    Facility

    $197.03

    $19.08 lower than Merced for the office setting.

  • North Carolina

    North Carolina · 12054

    Office

    $367.85

    Facility

    $186.48

    $42.65 lower than Merced for the office setting.

  • North Dakota**

    North Dakota · 12054

    Office

    $381.34

    Facility

    $186.95

    $29.16 lower than Merced for the office setting.

  • Nebraska

    Nebraska · 12054

    Office

    $360.80

    Facility

    $181.38

    $49.70 lower than Merced for the office setting.

  • New Hampshire

    New Hampshire · 12054

    Office

    $400.01

    Facility

    $197.65

    $10.49 lower than Merced for the office setting.

  • Northern Nj

    New Jersey · 12054

    Office

    $441.48

    Facility

    $215.98

    $30.98 higher than Merced for the office setting.

  • Rest Of New Jersey

    New Jersey · 12054

    Office

    $421.64

    Facility

    $209.36

    $11.14 higher than Merced for the office setting.

  • New Mexico

    New Mexico · 12054

    Office

    $373.26

    Facility

    $195.00

    $37.24 lower than Merced for the office setting.

  • Nevada**

    Nevada · 12054

    Office

    $388.87

    Facility

    $194.29

    $21.63 lower than Merced for the office setting.

  • Nyc Suburbs/Long Island

    New York · 12054

    Office

    $462.59

    Facility

    $231.45

    $52.09 higher than Merced for the office setting.

  • Poughkpsie/N Nyc Suburbs

    New York · 12054

    Office

    $424.91

    Facility

    $212.05

    $14.41 higher than Merced for the office setting.

  • Queens

    New York · 12054

    Office

    $453.69

    Facility

    $223.92

    $43.19 higher than Merced for the office setting.

  • Rest Of New York

    New York · 12054

    Office

    $373.37

    Facility

    $188.70

    $37.13 lower than Merced for the office setting.

  • Ohio

    Ohio · 12054

    Office

    $368.93

    Facility

    $191.45

    $41.57 lower than Merced for the office setting.

  • Oklahoma

    Oklahoma · 12054

    Office

    $359.78

    Facility

    $186.19

    $50.72 lower than Merced for the office setting.

  • Portland

    Oregon · 12054

    Office

    $417.84

    Facility

    $201.87

    $7.34 higher than Merced for the office setting.

  • Rest Of Oregon

    Oregon · 12054

    Office

    $385.36

    Facility

    $191.74

    $25.14 lower than Merced for the office setting.

  • Metropolitan Philadelphia

    Pennsylvania · 12054

    Office

    $407.48

    Facility

    $205.11

    $3.02 lower than Merced for the office setting.

  • Rest Of Pennsylvania

    Pennsylvania · 12054

    Office

    $369.16

    Facility

    $190.71

    $41.34 lower than Merced for the office setting.

  • Puerto Rico

    Puerto Rico · 12054

    Office

    $394.07

    Facility

    $197.54

    $16.43 lower than Merced for the office setting.

  • Rhode Island

    Rhode Island · 12054

    Office

    $400.38

    Facility

    $199.57

    $10.12 lower than Merced for the office setting.

  • South Carolina

    South Carolina · 12054

    Office

    $369.10

    Facility

    $189.48

    $41.40 lower than Merced for the office setting.

  • South Dakota**

    South Dakota · 12054

    Office

    $380.15

    Facility

    $185.75

    $30.35 lower than Merced for the office setting.

  • Tennessee

    Tennessee · 12054

    Office

    $359.86

    Facility

    $183.16

    $50.64 lower than Merced for the office setting.

  • Austin

    Texas · 12054

    Office

    $404.85

    Facility

    $199.19

    $5.65 lower than Merced for the office setting.

  • Beaumont

    Texas · 12054

    Office

    $366.80

    Facility

    $189.90

    $43.70 lower than Merced for the office setting.

  • Brazoria

    Texas · 12054

    Office

    $386.28

    Facility

    $193.63

    $24.22 lower than Merced for the office setting.

  • Dallas

    Texas · 12054

    Office

    $389.02

    Facility

    $195.41

    $21.48 lower than Merced for the office setting.

  • Fort Worth

    Texas · 12054

    Office

    $386.64

    Facility

    $194.97

    $23.86 lower than Merced for the office setting.

  • Galveston

    Texas · 12054

    Office

    $387.62

    Facility

    $194.58

    $22.88 lower than Merced for the office setting.

  • Houston

    Texas · 12054

    Office

    $396.95

    Facility

    $203.92

    $13.55 lower than Merced for the office setting.

  • Rest Of Texas

    Texas · 12054

    Office

    $376.52

    Facility

    $192.04

    $33.98 lower than Merced for the office setting.

  • Utah

    Utah · 12054

    Office

    $374.09

    Facility

    $191.36

    $36.41 lower than Merced for the office setting.

  • Virginia

    Virginia · 12054

    Office

    $382.02

    Facility

    $190.93

    $28.48 lower than Merced for the office setting.

  • Virgin Islands

    United States Virgin Islands · 12054

    Office

    $394.07

    Facility

    $197.54

    $16.43 lower than Merced for the office setting.

  • Vermont

    Vermont · 12054

    Office

    $380.44

    Facility

    $187.99

    $30.06 lower than Merced for the office setting.

  • Rest Of Washington

    Washington · 12054

    Office

    $402.68

    Facility

    $197.98

    $7.82 lower than Merced for the office setting.

  • Seattle (King Cnty)

    Washington · 12054

    Office

    $453.18

    Facility

    $214.66

    $42.68 higher than Merced for the office setting.

  • Wisconsin

    Wisconsin · 12054

    Office

    $368.73

    Facility

    $182.50

    $41.77 lower than Merced for the office setting.

  • West Virginia

    West Virginia · 12054

    Office

    $364.67

    Facility

    $195.74

    $45.83 lower than Merced for the office setting.

  • Wyoming**

    Wyoming · 12054

    Office

    $387.03

    Facility

    $192.64

    $23.47 lower than Merced for the office setting.

See how rates vary across the country

12054 · Office / nonfacility · Non-QP. Choose a state to explore its payment localities. A range means the amount varies within that state.

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.

$346.46

$460.87

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

View all state and territory rates as a table
State / territoryRate rangeLocalities
AK$457.691
AL$351.501
AR$346.461
AZ$380.931
CA$410.50–$511.2429
CO$405.771
CT$417.371
DC$445.911
DE$387.181
FL$388.56–$428.193
GA$366.59–$399.392
GU$419.981
HI$419.981
IA$359.041
ID$361.641
IL$378.38–$415.624
IN$363.681
KS$358.001
KY$361.091
LA$360.78–$378.402
MA$403.63–$444.802
MD$394.33–$445.913
ME$364.18–$382.832
MI$370.99–$394.032
MN$387.021
MO$355.06–$378.993
MS$350.801
MT$391.421
NC$367.851
ND$381.341
NE$360.801
NH$400.011
NJ$421.64–$441.482
NM$373.261
NV$388.871
NY$373.37–$462.595
OH$368.931
OK$359.781
OR$385.36–$417.842
PA$369.16–$407.482
PR$394.071
RI$400.381
SC$369.101
SD$380.151
TN$359.861
TX$366.80–$404.858
UT$374.091
VA$382.02–$445.912
VI$394.071
VT$380.441
WA$402.68–$453.182
WI$368.731
WV$364.671
WY$387.031

Explore 12054 on the national rate map →

Where does this rate apply?

Merced is a Medicare payment area. Our Census mapping connects it to 24 cities and communities in California, including the examples shown here.

Some communities span more than one payment area. Follow a city link to compare all of its mapped areas, or check the service-location ZIP above for an address-level starting point.

Browse all communities in California →

Why are the office and facility amounts different?

For 12054 in Merced, the physician’s office rate is $410.50 and the facility-setting rate is $197.45: a difference of $213.05.

The calculation uses a different practice-expense RVU for each setting. Both amounts here are physician fee-schedule amounts. The facility figure does not include a hospital’s separate charges, so this comparison does not tell you the total cost of receiving care in each setting.

See the inputs behind this difference →

Use this rate

What is a percentage of Medicare worth?

Turn a percentage into dollars for 12054 in Merced. This uses the base rate on this page, so the locality and release stay consistent.

Reference amount per service

$451.55

$410.50 × 110% = $451.55

A contract may specify another Medicare year or additional adjustments. This is percentage arithmetic on the displayed base rate, not a claim adjudication.

Working with a whole code list?

Compare an offer across your annual code mix, including an older Medicare schedule or flat per-code rates.

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How this local rate is calculated

Each RVU component is multiplied by its own geographic practice cost index (GPCI). The three adjusted components are added, then multiplied by the conversion factor. These are the inputs used for 12054 in Merced.

PPRRVU2026_Oct_nonQPP.csv

1,427

Code
12054
Physician work
3.41
Practice expense
7.80
Malpractice
0.51

GPCI2026.csv

15

Locality
Merced
Physician work
1.017
Practice expense
1.096
Malpractice
0.536
Office / nonfacility calculation for 12054 in Merced
ComponentRVULocality factorAdjusted
Physician work3.41× 1.0173.4680
Practice expense7.80× 1.0968.5488
Malpractice0.51× 0.5360.2734
Total RVUs12.2901
Conversion factor× 33.4009

Office / nonfacility rate, Merced$410.50

Values as parsed from CMS release RVU26D, effective 2026-10-01. The amount is rounded to the nearest cent only at the end.

Open 12054 in the RVU calculator →

Explore RVUs, geographic factors and the full formula

Office / nonfacility

Office / nonfacility calculation inputs
ComponentRVULocal GPCI
Work3.411.017
Practice expense7.81.096
Malpractice0.510.536

(3.41 × 1.017 + 7.8 × 1.096 + 0.51 × 0.536) × $33.4009 = $410.50

Facility

Facility calculation inputs
ComponentRVULocal GPCI
Work3.411.017
Practice expense1.981.096
Malpractice0.510.536

(3.41 × 1.017 + 1.98 × 1.096 + 0.51 × 0.536) × $33.4009 = $197.45

The office and facility calculations use their respective practice-expense RVUs. The facility amount here is the physician fee, not a separate hospital or facility bill.

How this rate has changed

12054 · Office / nonfacility

$410.50

Effective 2026-10-01

The base rate is $25.19 higher than on 2025-10-01, moving from $385.31 to $410.50 (6.5%).

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

    $385.31changed to$410.50

    • Conversion factor 32.3465 changed to 33.4009
    • Work RVU 3.50 changed to 3.41
    • Practice expense RVU 7.39 changed to 7.80
    • Work GPCI 1.014 changed to 1.017
    • Practice expense GPCI 1.093 changed to 1.096
    • Malpractice GPCI 0.560 changed to 0.536

    Held through RVU26B, RVU26C, RVU26D.

  2. January 1, 2025

    RVU25A

    Earliest loaded release: $385.31

    Held through RVU25B, RVU25C, RVU25D.

Explore release dates and calculate this code in an earlier period →

Each row uses the accepted CMS release effective on that date and the same contractor and locality identifiers. Missing rates stay visible. Historical boundaries may differ; verify the service address for an older claim.

Inspect every release and its CMS source
Effective fromOffice / nonfacilityFacilityCMS release
2026-10-01$410.50$197.45RVU26D
2026-07-01$410.50$197.45RVU26C
2026-04-01$410.50$197.45RVU26B
2026-01-01$410.50$197.45RVU26A
2025-10-01$385.31$216.67RVU25D
2025-07-01$385.31$216.67RVU25C
2025-04-01$385.31$216.67RVU25B
2025-01-01$385.31$216.67RVU25A

12054 billing questions

How is the length selected when there are multiple facial wounds?

Add the lengths of wounds that share the same repair classification and anatomic grouping. Use the resulting total to select the applicable length range.

What documentation supports intermediate rather than simple repair?

Document the wound sites and lengths, the tissue layers closed, and the closure technique. For single-layer closure, record the heavy contamination and extensive cleaning that support intermediate classification.

Can the repair layers be billed separately?

No. The layered closure is part of the repair service; do not report a separate charge for each layer.

Is modifier 50 appropriate for repairs on both sides of the face?

No. Bilateral adjustment does not apply to this code, and modifier 50 is inappropriate.

Are related postoperative visits separately payable during the global period?

Related postoperative visits during the 10-day global period are included in the procedure.

Can an assistant or co-surgeon be reported?

Medicare does not pay an assistant at surgery for this code. Co-surgeons and team surgery are not permitted.

Where these rates come from

FeeBase calculates base physician payments from CMS work, practice-expense, and malpractice RVUs, adjusted by each locality’s geographic indices and the applicable conversion factor. Unavailable or separately priced services are labeled rather than assigned a made-up amount.

Source: RVU26D. Effective 2026-10-01 through the day before 2027-01-01.

RVUs for 12054PPRRVU2026_Oct_nonQPP.csv, line 1,427 (RVU26D)
Geographic factors for MercedGPCI2026.csv, line 15 (RVU26D)
Open CMS sourceHow this rate is calculatedBuild a fee sheet