$335.86–$351.76
This code applies to a repaired length of 5.1 to 7.5 cm; 12052 is for the shorter range in the same facial and mucous membrane anatomic group.
On this page
CMS RVU26D · Effective 2026-10-01
12053 Wound repair Medicare reimbursement rates in New Jersey
Report this code for intermediate layered repair of qualifying facial or mucous membrane wounds when the total repaired length is 5.1 to 7.5 cm. Compare 12053 office and facility rates across CMS payment localities in New Jersey.
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 12053 in New Jersey?
New Jersey 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
$388.98–$407.62
2 of 2 localities have a supported rate.
Facility setting
$198.95–$205.76
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 12053: Intermediate facial wound repair, 5.1 to 7.5 cm
Report this code for intermediate layered repair of qualifying facial or mucous membrane wounds when the total repaired length is 5.1 to 7.5 cm.
This code covers intermediate repair of wounds involving the face, ears, eyelids, nose, lips, or mucous membranes, with a total repaired length of 5.1 to 7.5 cm. The closure involves layered repair, such as closing deeper tissue and the skin, or a single-layer closure of a heavily contaminated wound that requires extensive cleaning. Physicians and other qualified practitioners commonly perform these repairs in emergency departments, offices, and outpatient settings after injuries such as facial lacerations.
Select the code based on the documented repair method, eligible anatomic group, and measured length of the repaired wound or wounds. For multiple qualifying wounds in the same anatomic group, report the code level supported by their combined repaired length. The note should identify the sites, lengths, and layered or contamination-related work supporting an intermediate repair. Medicare includes related postoperative visits during the 10-day global period. When multiple procedures are performed in the same session, the highest-valued procedure is paid in full and other procedures are subject to the standard multiple-procedure reduction. Assistant-at-surgery payment is restricted; co-surgeons and team surgery are not permitted.
CMS billing rules for 12053
- 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 RVU3.09 · 29%
- Practice expense (office) RVU7.33 · 68%
- Malpractice RVU0.39 · 4%
16.8K
Medicare services in 2024 · #1214 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.
12053 compared with similar codes
Office rates for New Jersey, from the same CMS release.
$421.64–$441.48
Both are intermediate repairs in the same anatomic group, but 12054 applies when the repaired length falls in the next longer range.
$323.31–$339.16
12032 is intermediate repair for a different anatomic group, including scalp, axillae, trunk, and extremities; this code is for facial and mucous membrane sites.
$226.87–$236.88
12015 is a simple repair code for a longer facial-region wound. Choose based on the closure's complexity as well as its length; this code requires an intermediate repair.
Compare 12053 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
Northern Nj →
Office / nonfacility
$407.62
Facility
$205.76
Rest Of New Jersey →
Office / nonfacility
$388.98
Facility
$198.95
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12053 billing questions
How does this differ from 12052?
Both cover intermediate repair in the same anatomic group. Use 12053 when the qualifying repaired length is 5.1 to 7.5 cm; 12052 covers the shorter length range.
Can separate facial wounds be combined to select the length level?
Qualifying wounds in the same anatomic group may be combined when determining total repaired length. Document each wound's site and length, and do not combine repairs from different anatomic groups.
What documentation supports intermediate repair?
Record the wound sites and lengths, the closure method and layers, and, for a single-layer closure, the heavy contamination and extensive cleaning that support intermediate repair.
Are related postoperative visits separately payable during the global period?
Related postoperative visits during the 10-day global period are included in this procedure's payment.
How are other procedures performed in the same session paid?
The highest-valued procedure is paid in full, and other procedures are subject to the standard multiple-procedure reduction.
Can an assistant surgeon or co-surgeon be reported?
Medicare payment for an assistant at surgery is restricted 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.
1,42312047,,Intmd rpr n-hf/genit >30.0cm,A,,4.83,12.15,,4.23,,1.29,18.27,10.35,0,010,0.10,0.80,0.10,2,0,2,1,0,9,,33.4009,09,0,99,0.00,0.00,0.00
1,42412051,,Intmd rpr face/mm 2.5 cm/<,A,,2.27,5.91,,1.91,,0.29,8.47,4.47,0,010,0.10,0.80,0.10,2,0,1,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
1,42512052,,Intmd rpr face/mm 2.6-5.0 cm,A,,2.80,6.20,,2.03,,0.34,9.34,5.17,0,010,0.10,0.80,0.10,2,0,1,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
1,42612053,,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