Summary & Overview
CPT 12057: Intermediate Repair of Facial and Mucosal Wounds >30.0 cm
CPT code 12057 designates the intermediate repair of wounds to the face, ears, eyelids, nose, lips, and/or mucous membranes when the aggregated repair length exceeds 30.0 cm. This code is used for layered closures that require deeper suturing and more time and technical skill than simple repairs but do not meet the criteria for complex reconstruction. Nationally, accurate use of this code affects surgical billing, quality reporting, and appropriate reimbursement for common facial trauma and laceration repairs performed in outpatient and emergency settings.
Key payers discussed include Aetna, Blue Cross Blue Shield, Cigna Health, UnitedHealthcare, and Medicare. Readers will find a clinical and billing-focused overview of the code’s intent and typical sites of service, plus guidance on common documentation elements and modifier contexts (listed separately). The publication provides benchmarks where available, policy and coverage considerations, and clinical context to help billing professionals and clinicians align documentation with payer expectations. Data not available in the input for payer-specific rates or utilization metrics is noted as such. This summary is intended for a national audience and focuses on code definition, clinical application, and the administrative implications of correct coding for facial and mucosal intermediate wound repairs.
Billing Code Overview
CPT code 12057 describes the intermediate repair of wounds to the face, ears, eyelids, nose, lips, and/or mucous membranes when the repair length is greater than 30.0 cm. This procedure typically involves layered closure techniques such as deep sutures and superficial skin closure requiring more than simple approximation but less than complex repair.
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Service type: Surgical wound repair (intermediate repair)
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Typical site of service: Outpatient surgical settings, ambulatory surgery centers, emergency departments, or office-based procedure rooms where facial and mucosal wound repairs are performed
Data not available in the input for payers, associated taxonomies, ICD-10 diagnoses, related codes, and service line.
Clinical & Coding Specifications
Clinical Context
A typical patient scenario involves an adult who presents to an outpatient surgical clinic or emergency department after sustaining a large facial laceration from blunt trauma or a dog bite. The wound is an intermediate-depth injury involving dermis and subcutaneous tissue and measures 30.0 cm or greater in total length across the face, ear, eyelid, nose, lip and/or mucous membranes. The clinical workflow begins with triage and wound assessment, including history, tetanus status, allergy review, and neurovascular and ocular evaluation as appropriate. Wound cleaning, irrigation, and local anesthesia or monitored anesthesia care are provided based on patient comfort and complexity. The provider performs layered closure using intermediate techniques (deep dermal sutures, buried absorbable sutures, and fine epidermal closure) with attention to cosmetic subunits and functional structures (eyelid margin, lip vermilion, nasal framework). Documentation includes wound length, depth, anatomical subsite(s), anesthesia type, hemostasis, suture materials, any debridement performed, and postoperative instructions. Typical sites of service are outpatient surgical centers, ambulatory care clinics, and emergency departments. Patient follow-up includes suture removal, wound check for infection, and scar management as indicated.
Coding Specifications
| Modifier | Description | When to Use |
|---|---|---|
11 | Physician or other qualified health care professional service | When reporting the usual, deemed-as-normal service provided by the surgeon without unusual circumstances |