🪡 CPT 12052 — Repair, Intermediate, Wounds of Face, Ears, Eyelids, Nose, Lips and/or Mucous Membranes; 2.6 Cm to 5.0 Cm
Quick Reference
wRVU: 2.80 | Global Period: 010 | Assistant Payable: Yes | Bilateral Indicator: 0
Rule: CPT 12052 requires the summation of all intermediate repair lengths on the face, ears, eyelids, nose, lips, and mucous membranes.1 The bilateral indicator of 0 means the 150% payment adjustment for bilateral procedures does not apply, and bilateral modifiers should not be used; instead, lengths are summed. Assistant surgeon services are subject to statutory restrictions.2
📋 Clinical Description
CPT 12052 describes the intermediate repair of wounds located on the face, ears, eyelids, nose, lips, and/or mucous membranes, where the cumulative length of the repair is between 2.6 cm and 5.0 cm.1 This code is utilized when the wound requires a layered closure of one or more of the deeper layers of subcutaneous tissue and superficial (non-muscle) fascia, in addition to the epidermal and dermal skin closure.1 It may also be applied to a single-layer closure of a heavily contaminated wound that necessitates extensive cleaning or removal of particulate matter prior to closure.1
When calculating the appropriate code for wound repair, lengths of multiple lacerations belonging to the same classification (e.g., intermediate) and the same anatomic grouping (e.g., face, ears, eyelids, nose, lips, mucous membranes) must be added together.1 You should not use multiple codes from this specific subcategory unless there are wounds of varying complexities or distinct anatomic groupings involved.1 Do not combine lengths of repairs from different anatomical categories, such as combining a facial repair with a trunk repair.1
This procedure may be performed in the following clinical contexts:
- A patient presents to the emergency department after a fall, sustaining a 3.5 cm jagged laceration to the forehead requiring deep suture placement before closing the skin.1
- Excision of a 3.0 cm basal cell carcinoma on the cheek where the resulting defect requires a layered intermediate closure to minimize tension and prevent scarring.1
- A dog bite to the lip measuring 4.0 cm that is heavily contaminated, requiring extensive debridement and cleansing prior to a single-layer closure.1
- Reconstruction following a traumatic injury to the ear cartilage and overlying skin, totaling 4.5 cm, requiring deep dermal suturing.1
🔬 Anatomical & Procedural Considerations
| Variant | Mechanism | Key Notes |
|---|---|---|
| Facial Lacerations | Involves disruption of the dermis and underlying subcutaneous fat due to blunt or sharp trauma.1 | Requires careful approximation of tissue layers to avoid dog-ear deformities and ensure optimal cosmetic outcomes. Meticulous alignment of the vermilion border or hairline is critical.1 |
| Mucous Membrane | Often involves the inner lip or buccal mucosa where tissue is highly vascular and friable.1 | Absorbable sutures are typically preferred, and meticulous hemostasis is required to prevent hematoma formation. Extensive cleansing is standard due to high bacterial loads.1 |
| Heavily Contaminated Wounds | Wound is impregnated with debris (e.g., gravel, glass) necessitating aggressive scrubbing and irrigation.1 | May qualify for intermediate repair even if closed in a single layer, provided the extensive cleansing and debris removal is thoroughly documented in the operative note.1 |
Clinical Pearl
Always verify the total length of all intermediate repairs on the face, ears, eyelids, nose, lips, and mucous membranes. If a patient has a 2.0 cm intermediate repair on the nose and a 1.5 cm intermediate repair on the cheek, sum them together (3.5 cm) and report 12052 once, rather than coding 12051 twice. Accurate measurement of the final defect size, rather than the initial lesion size, is crucial for compliant coding.1,2
✅ Procedure Includes
- Local infiltration of anesthesia (e.g., lidocaine injection) directly into the wound margins.1
- Thorough cleansing, irrigation, and preparation of the wound bed.1
- Layered closure using absorbable sutures for the deeper subcutaneous and fascial layers.1
- Epidermal approximation using sutures, staples, or tissue adhesives.1
- Application of standard sterile dressings and post-operative instructions.1
- Routine removal of sutures during the standard 10-day global period.1,2
❌ Excludes / Do Not Report Together
| Code | Description | Relationship |
|---|---|---|
| 12011 | Simple repair of superficial wounds of face, ears, eyelids, nose, lips and/or mucous membranes; 2.5 cm or less | Simple repairs involve only a single-layer closure of the epidermis/dermis without deep layer involvement. Do not report simple and intermediate repair codes for the exact same laceration.1 |
| 13152 | Repair, complex, eyelids, nose, ears and/or lips; 2.6 cm to 7.5 cm | Complex repairs require more than layered closure, such as scar revision, debridement of traumatic lacerations, or extensive undermining. You cannot bill complex and intermediate repairs for the same wound.1 |
| 11442 | Excision, other benign lesion including margins, except skin tag (unless listed elsewhere), face, ears, eyelids, nose, lips, mucous membrane; excised diameter 1.1 to 2.0 cm | Excision codes inherently include simple closure. If the excision requires an intermediate repair, 12052 may be reported in addition to the excision code, but it must be distinctly documented.1 |
| 12051 | Repair, intermediate, wounds of face, ears, eyelids, nose, lips and/or mucous membranes; 2.5 cm or less | Do not bill multiple intermediate repair codes for the same anatomical grouping. Lengths must be summed and billed as a single code.1 |
Bundling Alert
Intermediate repairs include the administration of local anesthesia and routine wound cleansing. Do not report local anesthesia blocks separately unless performed by a different provider for a distinct reason. Medicare and NCCI edits consider simple closure bundled into all excision codes; however, if the operative report explicitly details a layered closure, 12052 can be billed separately using modifier -51. The 10-day global period dictates that any routine suture removal or wound check within 10 days is bundled into the reimbursement for this code and should not be billed as a separate E/M visit.1,2
🌳 Code Tree — Surgery: Integumentary System
CPT 10021-19499 Surgery: Integumentary System
│
├── 12001-12021 Repair-Simple
│ ├── 12011 Simple repair of superficial wounds of face, ears, eyelids, nose, lips and/or mucous membranes; 2.5 cm or less
│ └── 12013 Simple repair of superficial wounds of face, ears, eyelids, nose, lips and/or mucous membranes; 2.6 cm to 5.0 cm
│
├── 12031-12057 Repair-Intermediate
│ ├── 12042 Repair, intermediate, wounds of neck, axillae, genitalia and/or hands; 2.6 cm to 7.5 cm (Global: 010)
│ ├── 12051 Repair, intermediate, wounds of face, ears, eyelids, nose, lips and/or mucous membranes; 2.5 cm or less (Global: 010)
│ ├── ▶▶ 12052 ◀◀ Repair, intermediate, wounds of face, ears, eyelids, nose, lips and/or mucous membranes; 2.6 cm to 5.0 cm ← YOU ARE HERE (Global: 010)
│ ├── 12053 Repair, intermediate, wounds of face, ears, eyelids, nose, lips and/or mucous membranes; 5.1 cm to 7.5 cm (Global: 010)
│ └── 12054 Repair, intermediate, wounds of face, ears, eyelids, nose, lips and/or mucous membranes; 7.6 cm to 12.5 cm (Global: 010)
│
└── 13100-13160 Repair-Complex
├── 13151 Repair, complex, eyelids, nose, ears and/or lips; 1.1 cm to 2.5 cm
└── 13152 Repair, complex, eyelids, nose, ears and/or lips; 2.6 cm to 7.5 cm
💰 RVU & Reimbursement Profile
| Component | Value |
|---|---|
| Work RVU | 2.80 |
| Global Period | 010 |
| Bilateral Indicator | 0 |
| Assistant Surgeon | 1 |
| Co‑Surgeon | 0 |
| Team Surgery | 0 |
| PC/TC Split | 0 |
| Modifier -51 Exempt | No |
| Anesthesia | Included |
Bilateral Billing Rules
The bilateral modifier -50 is typically not appropriate for wound repair codes because the bilateral indicator is 0. If a patient has multiple intermediate lacerations on both the right and left sides of the face, you must add the lengths of the lacerations together to determine the total length. Do not report the repair code twice with right and left modifiers.1,2
🏷️ Modifier Reference
| Modifier | Name | When to Apply |
|---|---|---|
| -RT | Right Side | Not applicable for wound repair codes, as lengths are summed across bilateral anatomical regions.1 |
| -LT | Left Side | Not applicable for wound repair codes, as lengths are summed across bilateral anatomical regions.1 |
| -50 | Bilateral | Not applicable due to the bilateral indicator of 0; sum the lengths instead.1,2 |
| -E1 | Upper Left Eyelid | Can be used to specify location if only one eyelid is repaired, though summing is standard.1 |
| -E2 | Lower Left Eyelid | Can be used to specify location if only one eyelid is repaired.1 |
| -E3 | Upper Right Eyelid | Can be used to specify location if only one eyelid is repaired.1 |
| -E4 | Lower Right Eyelid | Can be used to specify location if only one eyelid is repaired.1 |
| -25 | Significant E/M | Apply when a significant, separately identifiable E/M service is performed on the same day, such as evaluating a concussion after a fall that also caused the facial laceration.1,5 |
| -24 | Unrelated E/M | Apply if an unrelated E/M service is provided during the 10-day global period of this procedure.1,5 |
| -51 | Multiple Procedures | Apply when multiple distinct procedures are performed during the same session, such as excising a lesion on the arm and repairing a laceration on the face.1 |
| -59 | Distinct Service | Apply to designate a distinct procedural service, such as when repairs are performed on different anatomic sites not grouped together in the CPT descriptors.1 |
| -52 | Reduced Services | Apply if the physician elected to reduce or eliminate a portion of the intermediate repair.1 |
| -53 | Discontinued | Apply if the repair was started but discontinued due to extenuating circumstances or patient instability.1 |
| -58 | Staged | Apply if the intermediate repair was planned prospectively during the global period of a previous, related surgical procedure.1,2 |
| -78 | Return to OR | Apply when the patient has an unplanned return to the operating/procedure room for a related procedure during the 10-day global period.1,2 |
| -79 | Unrelated Procedure | Apply if an unrelated procedure or service is performed by the same physician during the postoperative period of a previous surgery.1,2 |
🩺 Common ICD‑10‑CM Pairings
Primary Diagnosis Group
| ICD‑10 | Description | HCC? | Notes |
|---|---|---|---|
| S01.111A | Laceration without foreign body of right eyelid and periocular area, initial encounter | No | Indicates acute trauma requiring repair on the right side.3 |
| S01.112A | Laceration without foreign body of left eyelid and periocular area, initial encounter | No | Specifies left eye injury for lateralized tracking and medical necessity.3 |
| S01.21XA | Laceration without foreign body of nose, initial encounter | No | Common diagnosis for intermediate repair on nasal cartilage and surrounding tissue.3 |
| S01.311A | Laceration without foreign body of right ear, initial encounter | No | Used for auricular trauma necessitating layered suturing to prevent deformity.3 |
| S01.511A | Laceration without foreign body of lip, initial encounter | No | Frequent site for layered mucous membrane and dermal closures to align the vermilion border.3 |
Secondary Group
| ICD‑10 | Description | HCC? | Notes |
|---|---|---|---|
| W54.0XXA | Bitten by dog, initial encounter | No | Identifies the external cause of the facial injury, often requiring extensive cleaning.3 |
| W20.8XXA | Striking against glass, initial encounter | No | Useful for explaining deep lacerations requiring extensive debris removal and layered closure.3 |
Etiology / Complication
| ICD‑10 | Description | HCC? | Notes |
|---|---|---|---|
| C44.311 | Basal cell carcinoma of skin of nose | Yes | Used when an intermediate repair is required to close the defect after a malignancy excision.2,3 |
| L72.0 | Epidermal cyst | No | May require intermediate closure if the cyst is large and deep upon removal, leaving a significant defect.3 |
Coding Specificity Reminder
Ensure that all laceration diagnoses such as S01.111A, S01.21XA, or S01.511A include the appropriate 7th character (A, D, or S) to denote the encounter type.,6 External cause codes should always be appended to clarify how the trauma occurred. If the intermediate repair follows an excision of a lesion, sequence the diagnosis for the excised lesion (e.g., C44.311) as the primary diagnosis.
🏥 MS‑DRG Considerations
As CPT 12052 is a minor integumentary procedure, it does not function as an operating room (OR) procedure that would group to a surgical MS-DRG on its own in the inpatient setting. If performed during an inpatient stay, the DRG will primarily be driven by the principal diagnosis and any major surgical interventions performed. There are no specific National Coverage Determinations (NCDs) restricting this code, though Local Coverage Determinations (LCDs) frequently require strict documentation of the layered closure technique or extensive cleaning to justify billing an intermediate repair instead of a simple repair.
🔧 ICD‑10‑PCS Equivalents
| PCS Code | Full Description | Modality |
|---|---|---|
| 0HQ1XZZ | Repair Face Skin, External Approach | Open |
| 0HQ2XZZ | Repair Right Ear Skin, External Approach | Open |
| 0HQ3XZZ | Repair Left Ear Skin, External Approach | Open |
| 0CQQXZZ | Repair Lip, External Approach | Open |
PCS Character Analysis
| Position | Character | Value | Definition |
|---|---|---|---|
| 1 | Section | 0 | Defines the Medical and Surgical section for all surgical interventions.4,6 |
| 2 | Body System | H | Identifies the Skin and Breast body system where the facial or ear skin is located.4,6 |
| 3 | Root Operation | Q | Specifies the root operation Repair, used for restoring the anatomical structure of a body part without replacing it.4,6 |
| 4 | Body Part | 1 | Specifies the Face Skin as the anatomical region repaired.4,6 |
| 5 | Approach | X | Indicates an External approach, meaning the procedure is performed directly on the skin or mucous membrane from the outside.4,6 |
| 6 | Device | Z | Indicates No Device, meaning no implants or devices remain after the repair.4,6 |
| 7 | Qualifier | Z | Indicates No Qualifier, meaning no additional qualifications apply to this closure.4,6 |
Root Operation Comparison
Repair (Q) is used when the wound is simply sutured together in layers, restoring anatomical continuity.4,6
Excision (B) would be used if a portion of tissue is cut out, which is not the primary objective of this code unless repairing a defect from a separate excision procedure.4,6
Control (3) is used strictly for stopping post-procedural or acute hemorrhage, not for standard laceration closure.4,6
📝 Coding Examples
Example 1
Clinical Scenario: A patient presents to the urgent care clinic with a 4.0 cm deep laceration to the right cheek after falling off a bicycle. The physician administers local anesthesia, thoroughly cleanses the wound, and performs a layered closure, placing deep subcutaneous sutures followed by epidermal sutures.
| Field | Code | Rationale |
|---|---|---|
| CPT | 12052 | The total length is 4.0 cm, located on the face, and required a layered (intermediate) closure. |
| PDx | S01.411A | Laceration without foreign body of right cheek and temporomandibular area, initial encounter. |
Note
Ensure the procedure note explicitly details the deep subcutaneous closure; otherwise, the service defaults to a simple repair code.1,2
Example 2
Clinical Scenario: A dermatologist excises a 2.0 cm squamous cell carcinoma from a patient’s nose (margins included). The resulting defect measures 3.0 cm in total length and requires an intermediate, layered closure to secure the tissue and prevent excessive scarring.
| Field | Code | Rationale |
|---|---|---|
| CPT 1 | 11642 | Excision of malignant lesion on the nose, excised diameter 1.1 to 2.0 cm.1 |
| CPT 2 | 12052--51 | Intermediate repair of the 3.0 cm defect on the nose. The -51 modifier denotes a multiple procedure.1,2 |
| PDx | C44.321 | Squamous cell carcinoma of skin of nose.3 |
Warning
While simple closures are bundled into excision codes, intermediate and complex repairs are separately reportable. The excision defect size dictates the repair length, which is often larger than the excised lesion.1,2
Example 3
Clinical Scenario: A patient sustains two separate lacerations during a bar fight: a 1.5 cm laceration on the left ear and a 1.5 cm laceration on the upper lip. Both wounds are deep, reaching the fascia, and the physician performs layered intermediate closures on both.1
| Field | Code | Rationale |
|---|---|---|
| CPT | 12052 | The lengths of both intermediate repairs (1.5 cm + 1.5 cm = 3.0 cm) within the same anatomic grouping are summed. |
| PDx | S01.312A | Laceration without foreign body of left ear, initial encounter. |
Note
Routine suture removal for these lacerations within the next 10 days is bundled into the global period and is not separately billable as an E/M visit.1,2
⚠️ Common Coding Pitfalls
- Pitfall 1: Billing multiple repair codes for the same anatomical grouping. If a patient has a 2.0 cm and a 1.0 cm intermediate repair on the face, they must be summed to 3.0 cm and billed as 12052, rather than billing 12051 twice.1,2
- Pitfall 2: Selecting an intermediate repair code when only a single-layer closure was performed on a non-contaminated wound. Without documented layered closure or extensive cleaning of a contaminated wound, the repair must be coded as simple (12011-12018).1,2
- Pitfall 3: Using bilateral modifiers for lacerations on both sides of the face. CPT guidelines require summing the lengths of repairs of the same complexity in the same anatomical group, avoiding the use of modifiers -50, -LT, or -RT.1,2
- Pitfall 4: Failing to append modifier -59 when an intermediate repair is performed on a completely different anatomical group (e.g., face and trunk) on the same day, which may result in inappropriate bundling.1,2
- Pitfall 5: Billing intermediate repair for the closure of a simple benign lesion excision. Simple closure is always bundled into the excision code; intermediate closure can only be billed if the layered technique is explicitly documented in the operative note.1,2
- Pitfall 6: Choosing the repair code based on the size of the lesion removed rather than the length of the resulting defect. The repair length will often be larger than the lesion itself and should be documented separately. Surgeons must accurately record the final margin-to-margin defect measurement prior to closure, as billing based solely on the lesion diameter will lead to undercoding and revenue loss.1,2
📎 Sources
1. AMA CPT Professional Edition, 2026. 2. ICD-10-CM Official Guidelines for Coding and Reporting, 2026. 3. CMS Medicare Physician Fee Schedule, 2026. 4. ICD-10-CM Index to Diseases and Injuries, 2026. 5. Centers for Medicare & Medicaid Services, Evaluation and Management Services Guide, MLN Booklet, 2024. 6. ICD-10-PCS Official Guidelines for Coding and Reporting, 2026.Sources listed above correspond to superscript citations throughout this note. Verify all Medicare payment figures against your current CMS PFS Lookup tool and applicable MAC LCD prior to claim submission. Please use the latest AAPC/AHIMA Coding Books to verify each code within this note.