$577.97–$607.99
Both are intermediate repairs in the same anatomic group; choose 12057 only when the combined repaired length exceeds 30.0 cm.
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CMS RVU26D · Effective 2026-10-01
12057 Wound repair Medicare reimbursement rates in Maine
Reports intermediate-complexity repair of wounds on the face or related sites when the combined repaired length exceeds 30.0 cm. Compare 12057 office and facility rates across CMS payment localities in Maine.
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.
What does Medicare pay for 12057 in Maine?
Maine has 2 payment localities in this comparison. Use the service location to choose the applicable amount. These are the supported base rates for the 2 payment areas shown below, using the same CMS release.
Office / nonfacility
$601.54–$631.46
2 of 2 localities have a supported rate.
Facility setting
$356.63–$367.65
2 of 2 localities have a supported rate.
These are locality ranges, not averages or address-specific quotes. A facility-setting amount covers the physician service; it does not include a hospital’s separate bill. Choose a locality below to inspect its calculation, compare other payment areas, or price a percentage of Medicare.
Wound repair
About 12057: Extensive intermediate facial wound repair
Reports intermediate-complexity repair of wounds on the face or related sites when the combined repaired length exceeds 30.0 cm.
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.
CMS billing rules for 12057
- 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
- Assistant at surgery may be paid.
- Co-surgeons
- Co-surgeons paid only with supporting documentation.
- Team surgery
- Team surgery not permitted.
Where the value comes from
- Work RVU5.85 · 30%
- Practice expense (office) RVU12.48 · 64%
- Malpractice RVU1.09 · 6%
11
Medicare services in 2024 · #6156 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.
12057 compared with similar codes
Office rates for Maine, from the same CMS release.
No office rate
This code is for simple repair over 30.0 cm at these sites. Choose 12057 when the documented repair meets intermediate-complexity criteria.
$495.59–$519.86
Both describe intermediate repair over 30.0 cm, but 12037 applies to scalp, trunk, or extremity sites rather than the face-related group.
Compare 12057 by payment locality
Find the payment area for your service address, then open its rate page for calculation inputs, release history and the percentage-of-Medicare tool. A city may cross payment-area boundaries; the ZIP lookup above helps resolve the location.
2 of 2 payment localities
Rest Of Maine →
Office / nonfacility
$601.54
Facility
$356.63
Southern Maine →
Office / nonfacility
$631.46
Facility
$367.65
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12057 billing questions
How is 12057 distinguished from 12056?
Both cover intermediate repair in the same anatomic group. Use 12057 when the combined repaired length exceeds 30.0 cm; 12056 covers 20.1 to 30.0 cm.
Can lengths from multiple facial wounds be combined?
Yes. Combine lengths for wounds repaired at the same complexity within the same anatomic group, and report the applicable code for the resulting total.
When is 12018 a better choice?
Use 12018 for a simple repair of these anatomic sites when the total length exceeds 30.0 cm. 12057 requires intermediate repair complexity.
What documentation supports intermediate complexity?
Document the wound locations and lengths, the closure method and tissue layers closed, and extensive cleaning when a single-layer closure of a heavily contaminated wound supports intermediate repair.
Should modifier 50 be reported?
No. CMS identifies bilateral adjustment as inappropriate for this code.
How does Medicare treat other procedures performed in the same session?
The highest-valued procedure is paid in full, and other procedures are subject to the standard 50% multiple-procedure reduction. Related postoperative visits are included for 10 days.
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.
1,42712054,,Intmd rpr face/mm 7.6-12.5cm,A,,3.41,7.80,,1.98,,0.51,11.72,5.90,0,010,0.10,0.80,0.10,2,0,1,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
1,42812055,,Intmd rpr face/mm 12.6-20 cm,A,,4.39,11.07,,3.54,,0.88,16.34,8.81,0,010,0.10,0.80,0.10,2,0,1,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
1,42912056,,Intmd rpr face/mm 20.1-30.0,A,,5.17,12.54,,4.31,,0.96,18.67,10.44,0,010,0.10,0.80,0.10,2,0,0,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
1,43012057,,Intmd rpr face/mm >30.0 cm,A,,5.85,12.48,,4.51,,1.09,19.42,11.45,0,010,0.10,0.80,0.10,2,0,2,1,0,9,,33.4009,09,0,99,0.00,0.00,0.00
1,4311205F,,Epi etiol synd rvwd and docd,I,,0.00,0.00,,0.00,,0.00,0.00,0.00,9,XXX,0.00,0.00,0.00,9,9,9,9,9,9,,33.4009,09,0,99,0.00,0.00,0.00
1,4321220F,,Pt screened for depression,I,,0.00,0.00,,0.00,,0.00,0.00,0.00,9,XXX,0.00,0.00,0.00,9,9,9,9,9,9,,33.4009,09,0,99,0.00,0.00,0.00
1,43313100,,Cmplx rpr trunk 1.1-2.5 cm,A,,2.93,6.83,,1.84,,0.36,10.12,5.13,0,010,0.10,0.80,0.10,2,0,1,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00