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See a sample rate comparisonCPT 12053 Fee Schedule
Last Verified: October 2026
Healthcare providers use this code to document and receive reimbursement for visits that address moderate-level medical decision-making, often including multiple diagnoses or prescription management.
Intmd Rpr Face Mm 5 1 7 5 Cm, Repair Intermediate Wounds Of Face Ears Eyelids Nose Lips And Or Mucous Membranes 5 1 Cm To 7 5 Cm
| Key Fact | Detail |
|---|---|
| Service Type | Surgery Surgical Procedures on the Integumentary System |
| Common Place of Service | 11 - Office 23 - Emergency Room |
| Common Modifiers | None 59 - Distinct Procedural Service 51 - Multiple procedures |
| Complexity Level | Moderate |
| Medicare Fee Schedule | View Medicare rates for 12053 |
| Medicaid Fee Schedule | View Medicaid rates for 12053 |
National average reimbursement for CPT 12053 by major payers:
$402.31
$432.56
$459.19
$551.84
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CPT 12053
5 of 25 sample ratesHigher to lower in this preview
Drexel Town Square Surgery Center, LLC, Drexel Town Square Surgery Center
Drexel Town Square Surgery Center LLC
$1,160.00Published rateVictoria Laine
Deaconess Hospital Inc
$612.91Published rateEl Paso Asc Lp, Endoscopy Center Of El Paso
El Paso Asc Lp
$267.00Published ratePremier-Covenant Astc LLC, Premier Ambulatory Surgery Center
Premiercovenant Astc LLC
$107.00Published rateDermatology & Cosmetic Surgery Center PC
Dermatology Cosmetic Surgery Center PC
$60.00Published rate
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See a sample payer proposalCPT 12053 vs. Other Surgical Procedures on the Integumentary System Codes
The CPT 12053 code is part of the Surgery services used for Surgical Procedures on the Integumentary System. It represents a moderate-complexity encounter and is one of several codes that vary based on time spent, level of medical decision-making, and documentation requirements.
The CPT 12053 code involves more provider time and moderate medical decision-making, unlike lower-level codes that require less time and simpler assessments. It typically includes multiple diagnoses, medication management, or test interpretation, leading to higher reimbursement and more detailed documentation requirements.
| Code | Complexity | Description |
|---|---|---|
| 12052-CPT | Moderate | Intmd Rpr Face Mm 2 6 5 0 Cm, Repair Intermediate Wounds Of Face Ears Eyelids Nose Lips And Or Mucous Membranes 2 6 Cm To 5 0 Cm |
| 12053-CPT | Moderate | Intmd Rpr Face Mm 5 1 7 5 Cm, Repair Intermediate Wounds Of Face Ears Eyelids Nose Lips And Or Mucous Membranes 5 1 Cm To 7 5 Cm |
| 12054-CPT | Moderate | Intmd Rpr Face Mm 7 6 12 5cm, Repair Intermediate Wounds Of Face Ears Eyelids Nose Lips And Or Mucous Membranes 7 6 Cm To 12 5 Cm |
| 12055-CPT | Moderate | Intmd Rpr Face Mm 12 6 20 Cm, Repair Intermediate Wounds Of Face Ears Eyelids Nose Lips And Or Mucous Membranes 12 6 Cm To 20 0 Cm |
What is a fee schedule?
A fee schedule is a list of fixed prices that healthcare providers charge for specific services, including CPT 12053. These prices vary depending on payer type (Medicare, Medicaid, private insurance), geographic location, and provider contracts.
Understanding the 12053 fee schedule helps patients estimate costs and providers optimize billing for accurate reimbursements.
Factors that affect fee schedules
Medicare & Medicaid Rates
Government-set reimbursement amounts
Private Insurance Rates
Negotiated rates between providers and insurance companies
Geographic Location
Costs may be higher in urban areas.
Provider Type
Hospital providers may have different rates than private practice.
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