Billing code 12053: Wound repairMedicare rate & RVUs in Washington
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.
Medicare pays $372.27–$419.42 for 12053 in the office in Washington, from Rest Of Washington to Seattle (King Cnty). Which amount applies depends on the service address.
Medicare allowed amount for participating (non-QP) physicians, before deductible, coinsurance and claim adjustments. Not a patient’s bill or a hospital charge.
On this page 9 sections
What 12053 covers
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.
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 12053 pays more and less in Washington
| Payment locality | Office | Facility |
|---|---|---|
| Rest Of Washington | $372.27 | $189.03 |
| Seattle (King Cnty) | $419.42 | $205.90 |
How the 12053 rate is calculated
Each of 12053’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.
How the rate is built · 12053
RVUs × geographic indexes × conversion factor
Swap in your local Medicare rate.
Work 3.09Practice expense 7.33Malpractice 0.39
All indexes start at 1.000 (the national rate). Enter a ZIP or drag a slider.
Payment rules and modifiers for 12053
12053 has a 10-day global period: related visits in that window are included in the surgery payment.
CMS payment indicators · 12053
Wound repair
| Rule | CMS value | What it means |
|---|---|---|
| Global period | 010 | Minor procedure: the day of the procedure plus 10 days after are included. |
| Multiple procedures | 2 | Standard reduction: highest-valued procedure at 100%, others at 50%. |
| Bilateral (modifier 50) | 0 | The 150% bilateral adjustment doesn’t apply. |
| Assistant at surgery (80/81/82/AS) | 1 | Not paid (statutory restriction). |
| Co-surgeons (62) | 0 | Not permitted. |
| Team surgery (66) | 0 | Not permitted. |
| Professional/technical | 0 | Physician service: no professional/technical split. |
| Split (54/55/56) | 0.10/0.80/0.10 | Share of the payment for pre-op, the procedure itself, and post-op care. |
Global surgery period · 12053
Wound repair
10-day global period ends
Oct 11, 2026
Covers Oct 1, 2026 through Oct 11, 2026 (11 days).
Visit on Oct 31, 2026
After the global period ends: visits and procedures are billed normally.
What modifiers do to the payment
Modifier 51 · payment effect
With and without the modifier
12053 without 51 · national office
$361.06
Wound repair
12053-51 · Second procedure: 50%
$180.53
When this isn’t the highest-valued procedure in the session, Medicare pays 50% of its fee schedule amount (the highest is paid at 100%).
12053 compared with similar codes
Compare codes
12053 vs 12052 vs 12054 vs 12032 vs 12015: national Medicare rates
Swap in your local Medicare rate.
How to choose
- 12052Wound repair
- 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.
- 12054Wound repair
- Both are intermediate repairs in the same anatomic group, but 12054 applies when the repaired length falls in the next longer range.
- 12032Intermediate repair
- 12032 is intermediate repair for a different anatomic group, including scalp, axillae, trunk, and extremities; this code is for facial and mucous membrane sites.
- 12015Simple wound repair
- 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.
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 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
Show the CMS file lines behind this rate
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