CPT code 13133: Complex repair, each additional 5 cm or less2026 Medicare rate & RVUs in Queens, NY

Reports each additional 5 cm or less of qualifying complex repair on the forehead, cheek, chin, mouth, neck, axilla, genitalia, hand, or foot beyond the primary repair length.

CMS RVU26DEffective Oct 1, 2026One payment locality13.1K Medicare services in 2024

In Queens, NY, Medicare pays $192.49 for 13133 in the office and $114.72 when it’s performed in a hospital or facility.

$192.49Office (non-facility)
$114.72Hospital or facility
+14.6%vs the national office rate ($168.01)

Check a contract rate as a % of Medicare · 13133 nationwide

Medicare allowed amount for participating (non-QP) physicians, before deductible, coinsurance and claim adjustments. Not a patient’s bill or a hospital charge.

We’ll open 13133 for the payment locality that covers the ZIP.

On this page 11 sections
  1. Rate in Queens, NY
  2. What 13133 covers
  3. Compared with other areas
  4. Rate map
  5. How it’s calculated
  6. Payment rules
  7. Related codes
  8. Rate history
  9. Where it applies
  10. Billing questions
  11. Sources

What 13133 covers

Code 13133 captures additional length when a complex repair involves the forehead, cheek, chin, mouth, neck, axilla, genital region, hand, or foot. The repair must require work beyond routine layered closure, such as extensive undermining or other substantial additional work; wound length alone does not make a repair complex. Plastic surgeons, dermatologic surgeons, and other physicians who perform wound repair may report it in office or facility settings. A long facial laceration repaired with complex techniques is one typical situation.

Report one unit for each additional 5 cm or less beyond the length covered by the primary repair code, 13131 or 13132. Documentation should identify the repair site, measured length, and features that support complex repair. CMS classifies 13133 as an add-on code: report it only with a qualifying primary procedure, and payment falls within that procedure's global period.

This summary was written with AI assistance from CMS physician fee schedule data and checked against the CMS billing rules shown here. Rates on this page come directly from CMS files.

How Queens, NY compares for 13133

Across 109 of 109 payment localities, the office rate for 13133 runs from $151.29 in Arkansas to $210.36 in San Benito County, CA. Queens, NY pays $192.49. The RVUs are the same everywhere; the geographic indexes change the dollars.

13133 in Queens, NY vs other payment areas
  1. Queens, NY · this page$192.49
  2. Manhattan, NY · New York$192.04−$0.45
  3. NYC suburbs and Long Island, NY · New York$196.85+$4.36
  4. Poughkeepsie and northern NYC suburbs, NY · New York$181.43−$11.06
  5. Rest of New York · New York$160.95−$31.54
  6. Los Angeles, CA · California$183.92−$8.57
  7. Washington, DC area · District of Columbia$188.46−$4.03

Other areas in New York first, then benchmark localities. Bars start at $0.

Every other payment area

13133 in every other Medicare payment locality
Payment localityOfficeFacility
Miami, FLFlorida$185.38$116.89
Chicago, ILIllinois$180.62$114.49
AlaskaAlaska$205.38$135.31
AlabamaAlabama$153.15$95.58
ArkansasArkansas$151.29$94.77
ArizonaArizona$164.00$100.24
Bakersfield, CACalifornia$174.24$102.12
Chico, CACalifornia$173.44$101.32

13133 rates by state

Office rate range in each state. Select a state to see its payment localities.

Explore a state

Local rates. Clear comparisons.

Hover or focus a tile to see its rate range. Select it to open the state’s fee schedule.

$151.29

$205.38

Color shows the midpoint of each state’s locality range.

View every state and territory as a table
13133 office rate range by state
State / territoryOffice rate rangeLocalities
AK$205.381
AL$153.151
AR$151.291
AZ$164.001
CA$173.44–$210.3629
CO$172.491
CT$178.071
DC$188.461
DE$166.401
FL$168.69–$185.383
GA$160.29–$171.432
GU$176.201
HI$176.201
IA$155.131
ID$156.251
IL$165.47–$180.624
IN$156.981
KS$155.131
KY$157.531
LA$157.56–$164.072
MA$171.96–$186.922
MD$169.03–$188.463
ME$157.60–$163.892
MI$161.56–$171.132
MN$164.201
MO$155.70–$163.823
MS$153.491
MT$167.991
NC$158.891
ND$162.651
NE$155.661
NH$170.471
NJ$179.79–$187.122
NM$162.561
NV$166.591
NY$160.95–$196.855
OH$160.471
OK$156.631
OR$164.98–$176.562
PA$160.33–$174.622
PR$168.831
RI$171.281
SC$160.001
SD$162.021
TN$155.871
TX$159.49–$172.208
UT$161.841
VA$163.87–$188.462
VI$168.831
VT$162.681
WA$171.42–$189.792
WI$158.091
WV$160.431
WY$165.661

See 13133 in every payment locality

How the 13133 rate is calculated

Each of 13133’s three RVUs is multiplied by a geographic index (GPCI) for the payment locality, added up, and multiplied by the conversion factor. Drag the indexes or enter a ZIP to see what moves the rate.

How the rate is built · 13133

RVUs × geographic indexes × conversion factor

Office or facility?

Work2.14

2.14 RVUs× 1.000 GPCI

Practice expense2.62

2.62 RVUs× 1.000 GPCI

Malpractice0.27

0.27 RVUs× 1.000 GPCI

Adjusted RVUs

5.0300

Conversion factor

$33.4009

Medicare rate

$168.01

Every GPCI starts at 1.000, the national rate. Enter a ZIP or drag a slider.

The exact Queens, NY inputs and CMS source lines

PPRRVU2026_Oct_nonQPP.csv

1,441

Code
13133
Physician work
2.14
Practice expense
2.62
Malpractice
0.27

GPCI2026.csv

81

Locality
Queens, NY
Physician work
1.064
Practice expense
1.182
Malpractice
1.442
Office calculation for 13133 in Queens, NY
ComponentRVULocality factorAdjusted
Physician work2.14× 1.0642.2770
Practice expense2.62× 1.1823.0968
Malpractice0.27× 1.4420.3893
Total RVUs5.7631
Conversion factor× 33.4009

Office rate, Queens, NY$192.49

Office: (2.14 × 1.064 + 2.62 × 1.182 + 0.27 × 1.442) × $33.4009 = $192.49

Facility: (2.14 × 1.064 + 0.65 × 1.182 + 0.27 × 1.442) × $33.4009 = $114.72

Open 13133 in the RVU calculator

Payment rules and modifiers for 13133

The CMS indicators that decide how 13133 is paid alongside other services.

CMS payment indicators · 13133

Complex repair, each additional 5 cm or less

RuleCMS valueWhat it means
Global periodZZZAdd-on code: falls within the primary procedure’s global period.
Multiple procedures0No multiple-procedure reduction.
Bilateral (modifier 50)0The 150% bilateral adjustment doesn’t apply.
Assistant at surgery (80/81/82/AS)1Not paid (statutory restriction).
Co-surgeons (62)0Not permitted.
Team surgery (66)0Not permitted.
Professional/technical0Physician service: no professional/technical split.

How 13133 has changed in Queens, NY

13133 · Office / nonfacility

$192.49

Effective 2026-10-01

The base rate is $4.85 higher than on 2025-10-01, moving from $187.64 to $192.49 (2.6%).

It is unchanged from the immediately preceding available release, effective 2026-07-01.

Base rate by release · bars start at $0 · select a bar to compare

One bar per available release, ordered by effective date. Missing rates remain gaps. These comparisons hold the code, setting and locality identifiers constant; they do not isolate which policy or input caused a change.

What changed, release by release
  1. January 1, 2026

    RVU26A

    $187.64changed to$192.49

    • Conversion factor 32.3465 changed to 33.4009
    • Work RVU 2.19 changed to 2.14
    • Practice expense RVU 2.56 changed to 2.62
    • Malpractice RVU 0.28 changed to 0.27
    • Work GPCI 1.065 changed to 1.064
    • Practice expense GPCI 1.195 changed to 1.182
    • Malpractice GPCI 1.462 changed to 1.442

    Held through RVU26B, RVU26C, RVU26D.

  2. January 1, 2025

    RVU25A

    $193.58changed to$187.64

    • Conversion factor 33.2875 changed to 32.3465
    • Malpractice RVU 0.29 changed to 0.28

    Held through RVU25B, RVU25C, RVU25D.

  3. March 9, 2024

    RVU24AR

    $190.42changed to$193.58

    • Conversion factor 32.7442 changed to 33.2875

    Held through RVU24B, RVU24C, RVU24D.

  4. January 1, 2024

    RVU24A

    $203.15changed to$190.42

    • Conversion factor 33.8872 changed to 32.7442
    • Practice expense RVU 2.57 changed to 2.56
    • Malpractice RVU 0.27 changed to 0.29
    • Work GPCI 1.061 changed to 1.065
    • Practice expense GPCI 1.212 changed to 1.195
    • Malpractice GPCI 2.061 changed to 1.462
  5. January 1, 2023

    RVU23A

    $210.99changed to$203.15

    • Conversion factor 34.6062 changed to 33.8872
    • Practice expense RVU 2.54 changed to 2.57
    • Malpractice RVU 0.25 changed to 0.27
    • Work GPCI 1.056 changed to 1.061
    • Practice expense GPCI 1.228 changed to 1.212
    • Malpractice GPCI 2.661 changed to 2.061

    Held through RVU23B, RVU23C, RVU23D.

  6. January 1, 2022

    RVU22A

    $215.39changed to$210.99

    • Conversion factor 34.8931 changed to 34.6062
    • Practice expense RVU 2.58 changed to 2.54
    • Malpractice RVU 0.26 changed to 0.25

    Held through RVU22B, RVU22C, RVU22D.

  7. January 1, 2021

    RVU21A

    $217.01changed to$215.39

    • Conversion factor 36.0896 changed to 34.8931
    • Practice expense RVU 2.52 changed to 2.58
    • Malpractice RVU 0.27 changed to 0.26
    • Work GPCI 1.054 changed to 1.056
    • Practice expense GPCI 1.214 changed to 1.228
    • Malpractice GPCI 2.391 changed to 2.661

    Held through RVU21B, RVU21C, RVU21D.

  8. January 1, 2020

    RVU20A

    $218.43changed to$217.01

    • Conversion factor 36.0391 changed to 36.0896
    • Practice expense RVU 2.53 changed to 2.52
    • Malpractice RVU 0.34 changed to 0.27
    • Work GPCI 1.052 changed to 1.054
    • Practice expense GPCI 1.200 changed to 1.214
    • Malpractice GPCI 2.121 changed to 2.391

    Held through RVU20B, RVU20C, RVU20D.

  9. January 1, 2019

    RVU19A

    $218.73changed to$218.43

    • Conversion factor 35.9996 changed to 36.0391
    • Practice expense RVU 2.56 changed to 2.53
    • Malpractice RVU 0.33 changed to 0.34

    Held through RVU19B, RVU19C, RVU19D.

  10. January 1, 2018

    RVU18AR1

    $219.18changed to$218.73

    • Conversion factor 35.8887 changed to 35.9996
    • Malpractice RVU 0.34 changed to 0.33
    • Malpractice GPCI 2.151 changed to 2.121

    Held through RVU18B, RVU18C, RVU18D.

  11. January 1, 2017

    RVU17A

    $218.51changed to$219.18

    • Conversion factor 35.8043 changed to 35.8887
    • Practice expense RVU 2.55 changed to 2.56
    • Practice expense GPCI 1.199 changed to 1.200
    • Malpractice GPCI 2.181 changed to 2.151

    Held through RVU17B, RVU17C, RVU17D.

  12. January 1, 2016

    RVU16A

    $217.73changed to$218.51

    • Conversion factor 35.9335 changed to 35.8043
    • Malpractice RVU 0.32 changed to 0.34

    Held through RVU16B, RVU16C, RVU16D.

  13. July 1, 2015

    RVU15C

    $216.65changed to$217.73

    • Conversion factor 35.7547 changed to 35.9335

    Held through RVU15D.

  14. January 1, 2015

    RVU15A

    $211.40changed to$216.65

    • Conversion factor 35.8228 changed to 35.7547
    • Practice expense RVU 2.49 changed to 2.55
    • Malpractice RVU 0.33 changed to 0.32
    • Work GPCI 1.057 changed to 1.052
    • Practice expense GPCI 1.197 changed to 1.199
    • Malpractice GPCI 1.836 changed to 2.181

    Held through RVU15B.

  15. January 1, 2014

    RVU14A

    $209.41changed to$211.40

    • Conversion factor 34.0230 changed to 35.8228
    • Practice expense RVU 2.78 changed to 2.49
    • Malpractice RVU 0.34 changed to 0.33
    • Work GPCI 1.062 changed to 1.057
    • Practice expense GPCI 1.195 changed to 1.197
    • Malpractice GPCI 1.491 changed to 1.836

    Held through RVU14B, RVU14C, RVU14D.

  16. January 1, 2013

    RVU13AR

    Earliest loaded release: $209.41

    Held through RVU13B, RVU13C, RVU13D.

Rates in every CMS release
Effective fromOfficeFacilityCMS release
2026-10-01$192.49$114.72RVU26D
2026-07-01$192.49$114.72RVU26C
2026-04-01$192.49$114.72RVU26B
2026-01-01$192.49$114.72RVU26A
2025-10-01$187.64$137.39RVU25D
2025-07-01$187.64$137.39RVU25C
2025-04-01$187.64$137.39RVU25B
2025-01-01$187.64$137.39RVU25A
2024-10-01$193.58$141.08RVU24D
2024-07-01$193.58$141.08RVU24C
2024-04-01$193.58$141.08RVU24B
2024-03-09$193.58$141.08RVU24AR
2024-01-01$190.42$138.77RVU24A
2023-10-01$203.15$148.11RVU23D
2023-07-01$203.15$148.11RVU23C
2023-04-01$203.15$148.11RVU23B
2023-01-01$203.15$148.11RVU23A
2022-10-01$210.99$154.47RVU22D
2022-07-01$210.99$154.47RVU22C
2022-04-01$210.99$154.47RVU22B
2022-01-01$210.99$154.47RVU22A
2021-10-01$215.39$157.11RVU21D
2021-07-01$215.39$157.11RVU21C
2021-04-01$215.39$157.11RVU21B
2021-01-01$215.39$157.11RVU21A
2020-10-01$217.01$160.49RVU20D
2020-07-01$217.01$160.49RVU20C
2020-04-01$217.01$160.49RVU20B
2020-01-01$217.01$160.49RVU20A
2019-10-01$218.43$162.65RVU19D
2019-07-01$218.43$162.65RVU19C
2019-04-01$218.43$162.65RVU19B
2019-01-01$218.43$162.65RVU19A
2018-10-01$218.73$163.00RVU18D
2018-07-01$218.73$163.00RVU18C
2018-04-01$218.73$163.00RVU18B
2018-01-01$218.73$163.00RVU18AR1
2017-10-01$219.18$164.06RVU17D
2017-07-01$219.18$164.06RVU17C
2017-04-01$219.18$164.06RVU17B
2017-01-01$219.18$164.06RVU17A
2016-10-01$218.51$163.13RVU16D
2016-07-01$218.51$163.13RVU16C
2016-04-01$218.51$163.13RVU16B
2016-01-01$218.51$163.13RVU16A
2015-10-01$217.73$162.15RVU15D
2015-07-01$217.73$162.15RVU15C
2015-04-01$216.65$161.34RVU15B
2015-01-01$216.65$161.34RVU15A
2014-10-01$211.40$157.80RVU14D
2014-07-01$211.40$157.80RVU14C
2014-04-01$211.40$157.80RVU14B
2014-01-01$211.40$157.80RVU14A
2013-10-01$209.41$151.27RVU13D
2013-07-01$209.41$151.27RVU13C
2013-04-01$209.41$151.27RVU13B
2013-01-01$209.41$151.27RVU13AR

Price 13133 for an earlier date of service

Where the Queens, NY rate applies

Queens, NY is a Medicare payment area, not a city. Our Census mapping connects it to 1 cities and communities in New York. Some span more than one payment area; confirm with the service ZIP.

Browse all communities in New York

13133 billing questions

When is 13133 reported with 13131 versus 13132?

Choose the primary code based on the initial length of the complex repair: 13131 covers 1.1–2.5 cm and 13132 covers 2.6–7.5 cm. Report 13133 for each additional 5 cm or less.

Can 13133 be reported by itself?

No. It is an add-on code and must accompany a qualifying primary complex-repair procedure, such as 13131 or 13132.

What documentation supports reporting 13133?

Document the anatomical site, total repaired length, and the work that made the closure complex, such as extensive undermining. The record should make clear which additional length is being reported.

Does 13133 have a separate global period?

No separate period is assigned. It is paid within the global period of the primary procedure.

Does a long wound automatically qualify as complex repair?

No. Length determines the applicable repair code and add-on units, but the operative documentation must also support complex repair rather than routine layered closure.

Where these rates come from

FeeBase calculates base physician payments from CMS work, practice-expense and malpractice RVUs, adjusted by each locality’s geographic indexes and the conversion factor. Services without a published rate are labeled, never given a made-up amount. Amounts are Medicare allowed amounts before claim adjustments: not a patient’s bill or a commercial rate.

CMS RVU26D · effective Oct 1, 2026 through the day before Jan 1, 2027

Show the CMS file lines behind this rate
RVUs for 13133PPRRVU2026_Oct_nonQPP.csv, line 1,441 (RVU26D)
Geographic factors for Queens, NYGPCI2026.csv, line 81 (RVU26D)

Open CMS sourceHow we calculate rates

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