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See a sample rate comparisonHealthcare 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.
| Key Fact | Detail |
|---|---|
| Service Type | Surgery Surgical Procedures on the Integumentary System |
| Common Place of Service | 22 - On Campus Outpatient Hospital 21 - Inpatient Hospital |
| Common Modifiers | None AG - Primary physician 59 - Distinct Procedural Service |
| Complexity Level | Moderate |
| Medicare Fee Schedule | View Medicare rates for 12057 |
| Medicaid Fee Schedule | View Medicaid rates for 12057 |
National average reimbursement for CPT 12057 by major payers:

$686.08

$741.98

$751.94

$693.82
Choose a payer to see a sample of rates for CPT 12057.
Sjv Management, LLC
Osu Wexner Medical Center Ambulatory Surgery Center
Alderwood Surgical Center
Orthopaedic Institute For Children Ambulatory Surgery Center LLC
Mississippi Urology Clinic, PLLC
Choose your state and specialty to build a report from payer-published rates.
Rate Benchmarking
Select a published rate, define comparable providers, and see where that rate falls in your market.
See a sample rate comparisonPayer Contract Negotiation
Use your fee schedule and market benchmarks to set target rates and draft a letter for your payer.
See a sample payer proposalCPT 12057 vs. Other Surgical Procedures on the Integumentary System Codes
The CPT 12057 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 12057 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 |
|---|---|---|
| 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 |
| 12056-CPT | Moderate | Intmd Rpr Face Mm 20 1 30 0, Repair Intermediate Wounds Of Face Ears Eyelids Nose Lips And Or Mucous Membranes 20 1 Cm To 30 0 Cm |
| 12057-CPT | Moderate | Intmd Rpr Face Mm 30 0 Cm, Repair Intermediate Wounds Of Face Ears Eyelids Nose Lips And Or Mucous Membranes Over 30 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 12057. These prices vary depending on payer type (Medicare, Medicaid, private insurance), geographic location, and provider contracts.
Understanding the 12057 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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