Layered wound repair, face or mucous membrane, 5.1-7.5 cm

Hospitals report these codes with terse, inconsistent chargemaster text. This plain-English title was written by an AI model from that text and has not been reviewed by a person, so it can be wrong. The prices on this page come straight from hospital filings and do not depend on it.

Model: claude-sonnet-5-5
Provider: anthropic
API: message_batches
Reasoning effort: model default
Max output tokens: 4096
Prompt version (hash): 444523875572
Generated: October 20, 2026

Original text from hospital filings

HC INT RPR F/E/EY/NO/L/M 5.1-7.5

Payers reporting CPT 12053

Payer pricing summary

Low

$258

Average

$957

Median

$669

High

$4.5k

Payer rate distribution

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#
1	UnitedHealthcare fee schedule · outpatient · +42 other terms	633	$421	$878	$1.9k	218%	8–80	$1 – $28.5k
2	Humana fee schedule · outpatient · +32 other terms	420	$398	$508	$741	146%	7–70	$1 – $12.8k
3	Molina fee schedule · outpatient · +31 other terms	258	$333	$320	$255	80%	3–30	$1 – $2.2k
4	Kaiser fee schedule · outpatient · +24 other terms	107	$525	$685	$695	102%	3–30	$16 – $4.3k
5	First Health fee schedule · outpatient · +23 other terms	48	$425	$1.1k	$1.9k	167%	2–20	$143 – $7.2k
6	Premera fee schedule · outpatient · +15 other terms	14	$1.3k	$1.2k	$410	33%	2–20	$241 – $1.8k
7	Bcbs Al facility · other · outpatient · +5 other terms	6	$508	$452	$154	34%	2–20	$203 – $648
8	Aetna fee schedule · outpatient · +40 other terms	569	$442	$1.2k	$2.0k	172%	1–10	$1 – $21.3k
9	Cigna fee schedule · outpatient · +35 other terms	266	$437	$1.1k	$1.9k	176%	1–10	$45 – $15.8k
10	Blue Cross Blue Shield fee schedule · outpatient · +38 other terms	456	$595	$1.4k	$1.9k	137%	—	$0 – $18.0k
11	WellCare fee schedule · outpatient · +24 other terms	184	$417	$479	$479	100%	—	$133 – $4.3k
12	Anthem fee schedule · outpatient · +29 other terms	147	$402	$607	$805	133%	—	$40 – $6.3k
13	Oscar case rate · outpatient · +23 other terms	136	$2.6k	$2.6k	$727	28%	—	$625 – $7.5k
14	MultiPlan fee schedule · outpatient · +22 other terms	101	$693	$741	$364	49%	—	$132 – $2.7k
15	Ambetter fee schedule · outpatient · +21 other terms	97	$702	$649	$339	52%	—	$121 – $2.3k
16	Aetna Better Health fee schedule · outpatient · +25 other terms	85	$181	$225	$149	66%	—	$154 – $1.4k
17	Devoted facility · fee schedule · outpatient · +16 other terms	80	$385	$523	$765	146%	—	$149 – $4.9k
18	Caresource fee schedule · outpatient · +17 other terms	74	$397	$516	$637	123%	—	$1 – $4.3k
19	Optum fee schedule · outpatient · +27 other terms	73	$367	$608	$625	103%	—	$141 – $3.0k
20	Highmark facility · fee schedule · outpatient · +19 other terms	68	$468	$541	$454	84%	—	$50 – $2.0k
21	Tricare fee schedule · outpatient · +22 other terms	68	$405	$659	$1.1k	165%	—	$165 – $5.1k
22	Amerihealth Caritas facility · fee schedule · outpatient · +14 other terms	47	$223	$373	$1.1k	289%	—	$48 – $9.5k
23	Medica fee schedule · outpatient · +24 other terms	45	$499	$547	$255	47%	—	$89 – $1.2k
24	Medicare facility · fee schedule · outpatient · +18 other terms	40	$421	$982	$2.6k	266%	—	$123 – $22k
25	Healthcare Highways case rate · outpatient · +4 other terms	39	$5.8k	$6.7k	$5.2k	77%	—	$2.1k – $14.6k

Page 1 of 3 · 68 payers