$499.02
Use 12055 for the shorter adjacent facial intermediate-repair length range; 12056 is for a total of 20.1–30 cm.
On this page
CMS RVU26D · Effective 2026-10-01
12056 Wound repair Medicare reimbursement rates in Nebraska
Reports layered intermediate repair of a wound in the facial, ear, eyelid, nose, lip, or mucous membrane group when total repaired length is 20.1–30 cm. Compare 12056 office and facility rates across CMS payment localities in Nebraska.
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 12056 in Nebraska?
Nebraska has 1 payment locality in this comparison. Use the service location to choose the applicable amount. These are the supported base rates for the payment area shown below, using the same CMS release.
Office / nonfacility
$571.40
1 of 1 localities have a supported rate.
Payment area: Nebraska
One mapped payment locality.
Facility setting
$317.68
1 of 1 localities have a supported rate.
Payment area: Nebraska
One mapped payment locality.
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 12056: Intermediate facial wound repair, 20.1–30 cm
Reports layered intermediate repair of a wound in the facial, ear, eyelid, nose, lip, or mucous membrane group when total repaired length is 20.1–30 cm.
This service closes a wound in layers when repair involves more than a single-layer skin closure, typically bringing deeper tissue together before closing the skin. Common situations include traumatic lacerations of the cheek, lip, eyelid, ear, or nose, as well as wounds involving mucous membrane sites in this anatomic group. Emergency physicians, plastic surgeons, dermatologic surgeons, and other clinicians who perform wound repair may report it in emergency, office, or facility settings.
Select the code based on intermediate repair complexity, the anatomic group, and a total repaired length of 20.1–30 cm. For multiple qualifying wounds in the same group, combine their repaired lengths. Document each wound’s location and length, the layered technique, and any extensive cleaning that supports intermediate-level work. CMS assigns a 10-day global period, which includes related postoperative visits during that period. For multiple procedures in one session, the highest-valued procedure is paid in full and others at 50%. Modifier 50 is inappropriate for this code. Assistant-at-surgery payment requires documented medical necessity; co-surgeons and team surgery are not permitted.
CMS billing rules for 12056
- 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 is paid only with documentation of medical necessity.
- Co-surgeons
- Co-surgeons not permitted.
- Team surgery
- Team surgery not permitted.
Where the value comes from
- Work RVU5.17 · 28%
- Practice expense (office) RVU12.54 · 67%
- Malpractice RVU0.96 · 5%
19
Medicare services in 2024 · #5935 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.
12056 compared with similar codes
Office rates for Nebraska, from the same CMS release.
$593.90
Use 12057 when the total facial intermediate-repair length exceeds 30 cm. A total of 20.1–30 cm falls under 12056.
$437.23
Both codes cover intermediate repair in the 20.1–30 cm range, but 12036 is for its own anatomic group rather than the face, ears, eyelids, nose, lips, or mucous membranes.
No office rate
This is a complex repair code for the facial anatomic group and length range. Choose based on whether the documented repair meets complex rather than intermediate repair criteria.
Compare 12056 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.
1 of 1 payment localities
Nebraska →
Office / nonfacility
$571.40
Facility
$317.68
Need rates for a whole code list?
Fee-sheet and API access are in early access. Tell us which codes and locations your team needs.
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 12056 in Nebraska.
PPRRVU2026_Oct_nonQPP.csv
1,429
- Code
- 12056
- Physician work
- 5.17
- Practice expense
- 12.54
- Malpractice
- 0.96
GPCI2026.csv
72
- Locality
- Nebraska
- Physician work
- 1.000
- Practice expense
- 0.923
- Malpractice
- 0.378
| Component | RVU | Locality factor | Adjusted |
|---|---|---|---|
| Physician work | 5.17 | × 1.000 | 5.1700 |
| Practice expense | 12.54 | × 0.923 | 11.5744 |
| Malpractice | 0.96 | × 0.378 | 0.3629 |
| Total RVUs | 17.1073 | ||
| Conversion factor | × 33.4009 | ||
Office / nonfacility rate, Nebraska$571.40
Explore RVUs, geographic factors and the full formula
Office / nonfacility
| Component | RVU | Local GPCI |
|---|---|---|
| Work | 5.17 | 1 |
| Practice expense | 12.54 | 0.923 |
| Malpractice | 0.96 | 0.378 |
(5.17 × 1 + 12.54 × 0.923 + 0.96 × 0.378) × $33.4009 = $571.40
Facility
| Component | RVU | Local GPCI |
|---|---|---|
| Work | 5.17 | 1 |
| Practice expense | 4.31 | 0.923 |
| Malpractice | 0.96 | 0.378 |
(5.17 × 1 + 4.31 × 0.923 + 0.96 × 0.378) × $33.4009 = $317.68
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.
12056 billing questions
How is 12056 distinguished from 12055 or 12057?
Choose by total repaired length in the facial anatomic group: 12056 covers 20.1–30 cm. Code 12055 covers the shorter adjacent range, while 12057 is for lengths over 30 cm.
What documentation supports intermediate repair?
Record the wound site and repaired length, along with the layered closure technique. Describe extensive cleaning when it is part of the work supporting intermediate-level repair.
Can the lengths of multiple wounds be combined?
Combine lengths for qualifying wounds in the same anatomic and repair category when selecting the length range. Keep the location and repaired length of each wound in the record.
Should modifier 50 be appended for wounds on both sides of the face?
No. CMS identifies bilateral adjustment as inappropriate for this code; report based on the qualifying repair length and circumstances.
How are multiple procedures and postoperative visits handled?
CMS includes related postoperative visits for 10 days in the global period. In a same-session multiple-procedure situation, the highest-valued procedure is paid in full and others at 50%.
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.
1,42612053,,Intmd rpr face/mm 5.1-7.5 cm,A,,3.09,7.33,,2.12,,0.39,10.81,5.60,0,010,0.10,0.80,0.10,2,0,1,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
1,42712054,,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
6905302,MO,01,METROPOLITAN ST. LOUIS,1.000,0.952,1.002
7005302,MO,99,REST OF MISSOURI,1.000,0.862,0.974
7103202,MT,01,MONTANA**,1.000,1.000,0.998
7205402,NE,00,NEBRASKA,1.000,0.923,0.378
7301312,NV,00,NEVADA**,1.000,1.001,0.833
7414312,NH,40,NEW HAMPSHIRE,1.000,1.041,0.875
7512402,NJ,01,NORTHERN NJ,1.063,1.160,1.068