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CPT code 13151: Complex repair, eyelid, nose, ear, or lip2026 Medicare rate & RVUs in Montana

Report this service for a complex repair of a wound on an eyelid, nose, ear, or lip when the repaired length is 1.1 to 2.5 cm.

CMS RVU26DEffective Oct 1, 2026One payment locality29.8K Medicare services in 2024

In Montana, Medicare pays $419.15 for 13151 in the office and $233.10 when it’s performed in a hospital or facility.

$419.15Office (non-facility)
$233.10Hospital or facility
−0.0%vs the national office rate ($419.18)

Check a contract rate as a % of Medicare · 13151 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 13151 for the payment locality that covers the ZIP.

On this page 11 sections
  1. Rate in Montana
  2. What 13151 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 13151 covers

This service covers a complex repair of a wound on an eyelid, nose, ear, or lip, with a repaired length of 1.1 to 2.5 cm. It may be performed for a traumatic laceration or another wound requiring work beyond routine layered closure, such as extensive undermining, substantial wound preparation, or scar revision. Surgeons, plastic surgeons, dermatologic surgeons, and emergency clinicians may perform these repairs in office or facility settings.

Choose the code by the wound’s anatomic site, complexity, and repaired length. Document the location, length, wound characteristics, and additional work that supports complex repair. Related postoperative visits during the 10-day global period are included. When multiple procedures are performed in the same session, the highest-valued procedure is paid in full and other procedures are subject to the standard 50% multiple-procedure reduction. Modifier 50 is inappropriate for this code. Medicare does not pay an assistant at surgery, and co-surgery and team surgery are not permitted.

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 Montana compares for 13151

Across 109 of 109 payment localities, the office rate for 13151 runs from $374.25 in Arkansas to $542.42 in San Benito County, CA. Montana pays $419.15. The RVUs are the same everywhere; the geographic indexes change the dollars.

13151 in Montana vs other payment areas
  1. Montana · this page$419.15
  2. Los Angeles, CA · California$467.16+$48.01
  3. Washington, DC area · District of Columbia$475.19+$56.04
  4. Miami, FL · Florida$455.43+$36.28
  5. Chicago, IL · Illinois$443.10+$23.95
  6. Manhattan, NY · New York$480.32+$61.17
  7. Alaska · Alaska$499.30+$80.15

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

Every other payment area

13151 in every other Medicare payment locality
Payment localityOfficeFacility
AlabamaAlabama$379.28$216.50
ArkansasArkansas$374.25$214.44
ArizonaArizona$408.68$228.40
Bakersfield, CACalifornia$440.41$236.51
Chico, CACalifornia$438.91$235.01
El Centro, CACalifornia$438.99$235.09
Fresno, CACalifornia$438.91$235.01
Hanford, CACalifornia$438.91$235.01

13151 rates by state

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

MEWIVTNHMTNDMNMINYMARIWAIDWYSDIAILINOHPANJCTORNVUTCONEMOKYWVVAMDDECAAZNMKSOKARTNNCSCDCTXLAMSALGAFLAKHI

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.

$374.25

$499.30

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

View every state and territory as a table
13151 office rate range by state
State / territoryOffice rate rangeLocalities
AK$499.301
AL$379.281
AR$374.251
AZ$408.681
CA$438.91–$542.4229
CO$433.941
CT$445.631
DC$475.191
DE$415.071
FL$416.09–$455.433
GA$394.18–$427.142
GU$447.931
HI$447.931
IA$386.911
ID$389.481
IL$405.86–$443.104
IN$391.531
KS$385.821
KY$388.771
LA$388.44–$406.042
MA$431.90–$473.812
MD$422.36–$475.193
ME$391.97–$410.672
MI$398.61–$421.502
MN$415.001
MO$382.70–$406.683
MS$378.521
MT$419.151
NC$395.651
ND$409.261
NE$388.681
NH$427.801
NJ$450.48–$471.012
NM$400.861
NV$416.651
NY$401.16–$491.905
OH$396.591
OK$387.511
OR$413.18–$446.162
PA$396.84–$435.662
PR$421.801
RI$428.681
SC$396.831
SD$408.091
TN$387.681
TX$394.49–$432.718
UT$401.811
VA$409.83–$475.192
VI$421.801
VT$408.321
WA$430.87–$482.482
WI$396.651
WV$392.161
WY$414.841

See 13151 in every payment locality

How the 13151 rate is calculated

Each of 13151’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 · 13151

RVUs × geographic indexes × conversion factor

Office or facility?

Work4.23

4.23 RVUs× 1.000 GPCI

Practice expense7.82

7.82 RVUs× 1.000 GPCI

Malpractice0.50

0.50 RVUs× 1.000 GPCI

Adjusted RVUs

12.5500

Conversion factor

$33.4009

Medicare rate

$419.18

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

The exact Montana inputs and CMS source lines

PPRRVU2026_Oct_nonQPP.csv

1,442

Code
13151
Physician work
4.23
Practice expense
7.82
Malpractice
0.50

GPCI2026.csv

71

Locality
Montana
Physician work
1.000
Practice expense
1.000
Malpractice
0.998
Office calculation for 13151 in Montana
ComponentRVULocality factorAdjusted
Physician work4.23× 1.0004.2300
Practice expense7.82× 1.0007.8200
Malpractice0.50× 0.9980.4990
Total RVUs12.5490
Conversion factor× 33.4009

Office rate, Montana$419.15

Office: (4.23 × 1 + 7.82 × 1 + 0.5 × 0.998) × $33.4009 = $419.15

Facility: (4.23 × 1 + 2.25 × 1 + 0.5 × 0.998) × $33.4009 = $233.10

Open 13151 in the RVU calculator

Payment rules and modifiers for 13151

13151 has a 10-day global period: related visits in that window are included in the surgery payment.

CMS payment indicators · 13151

Complex repair, eyelid, nose, ear, or lip

RuleCMS valueWhat it means
Global period010Minor procedure: the day of the procedure plus 10 days after are included.
Multiple procedures2Standard reduction: highest-valued procedure at 100%, others at 50%.
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.
Split (54/55/56)0.10/0.80/0.10Share of the payment for pre-op, the procedure itself, and post-op care.

Global surgery period · 13151

Complex repair, eyelid, nose, ear, or lip

10-day global period ends

Oct 11, 2026

Covers Oct 1, 2026 through Oct 11, 2026 (11 days).

Visit on Oct 31, 2026

After the global period ends: visits and procedures are billed normally.

SurgeryVisit
Sep 28, 2026Oct 14, 2026

What modifiers do to the payment

Modifier 51 · payment effect

With and without the modifier

13151 without 51 · national office

$419.18

Complex repair, eyelid, nose, ear, or lip

13151-51 · Second procedure: 50%

$209.59

When this isn’t the highest-valued procedure in the session, Medicare pays 50% of its fee schedule amount (the highest is paid at 100%).

When to use modifier 51

Codes related to 13151

Related codes aren’t interchangeable: bill the code that matches the service performed.

Codes related to 13151
CodeHow it relatesOffice range, Montana
Same family
13152Complex repair, eyelid, nose, ear, or lipComplex repair in the same anatomic group for a longer repaired length.$490.62
13131Complex repair, face and related sites, 1.1–2.5 cmComplex repair code for a different group of anatomic sites.$384.42
Add-on codes
13153Complex repair, additional 5 cm or lessAdd-on code for additional repaired length beyond the primary-code range.$189.03
Used instead
12051Facial repair, intermediate, 2.5 cm or lessIntermediate repair for the same general anatomic group when complexity is lower.$282.89
12011Wound repair, face, 2.5 cm or lessSimple repair for a short wound in the same general anatomic group.$139.60

How 13151 has changed in Montana

13151 · Office / nonfacility

$419.15

Effective 2026-10-01

The base rate is $11.33 higher than on 2025-10-01, moving from $407.82 to $419.15 (2.8%).

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

    $407.82changed to$419.15

    • Conversion factor 32.3465 changed to 33.4009
    • Work RVU 4.34 changed to 4.23
    • Practice expense RVU 7.73 changed to 7.82
    • Malpractice RVU 0.55 changed to 0.50
    • Malpractice GPCI 0.978 changed to 0.998

    Held through RVU26B, RVU26C, RVU26D.

  2. January 1, 2025

    RVU25A

    $422.02changed to$407.82

    • Conversion factor 33.2875 changed to 32.3465
    • Practice expense RVU 7.81 changed to 7.73
    • Malpractice RVU 0.54 changed to 0.55

    Held through RVU25B, RVU25C, RVU25D.

  3. March 9, 2024

    RVU24AR

    $415.13changed to$422.02

    • Conversion factor 32.7442 changed to 33.2875

    Held through RVU24B, RVU24C, RVU24D.

  4. January 1, 2024

    RVU24A

    $430.98changed to$415.13

    • Conversion factor 33.8872 changed to 32.7442
    • Practice expense RVU 7.85 changed to 7.81

  5. January 1, 2023

    RVU23A

    $436.66changed to$430.98

    • Conversion factor 34.6062 changed to 33.8872
    • Practice expense RVU 7.77 changed to 7.85
    • Malpractice RVU 0.52 changed to 0.54
    • Malpractice GPCI 0.977 changed to 0.978

    Held through RVU23B, RVU23C, RVU23D.

  6. January 1, 2022

    RVU22A

    $440.64changed to$436.66

    • Conversion factor 34.8931 changed to 34.6062
    • Practice expense RVU 7.79 changed to 7.77
    • Malpractice RVU 0.51 changed to 0.52

    Held through RVU22B, RVU22C, RVU22D.

  7. January 1, 2021

    RVU21A

    $443.36changed to$440.64

    • Conversion factor 36.0896 changed to 34.8931
    • Practice expense RVU 7.28 changed to 7.79
    • Malpractice GPCI 1.304 changed to 0.977

    Held through RVU21B, RVU21C, RVU21D.

  8. January 1, 2020

    RVU20A

    $451.94changed to$443.36

    • Conversion factor 36.0391 changed to 36.0896
    • Practice expense RVU 7.14 changed to 7.28
    • Malpractice RVU 0.65 changed to 0.51
    • Malpractice GPCI 1.631 changed to 1.304

    Held through RVU20B, RVU20C, RVU20D.

  9. January 1, 2019

    RVU19A

    $447.12changed to$451.94

    • Conversion factor 35.9996 changed to 36.0391
    • Practice expense RVU 7.02 changed to 7.14

    Held through RVU19B, RVU19C, RVU19D.

  10. January 1, 2018

    RVU18AR1

    $440.83changed to$447.12

    • Conversion factor 35.8887 changed to 35.9996
    • Practice expense RVU 7.00 changed to 7.02
    • Malpractice RVU 0.66 changed to 0.65
    • Malpractice GPCI 1.429 changed to 1.631

    Held through RVU18B, RVU18C, RVU18D.

  11. January 1, 2017

    RVU17A

    $433.56changed to$440.83

    • Conversion factor 35.8043 changed to 35.8887
    • Practice expense RVU 6.96 changed to 7.00
    • Malpractice GPCI 1.226 changed to 1.429

    Held through RVU17B, RVU17C, RVU17D.

  12. January 1, 2016

    RVU16A

    $433.72changed to$433.56

    • Conversion factor 35.9335 changed to 35.8043
    • Practice expense RVU 6.97 changed to 6.96
    • Malpractice RVU 0.62 changed to 0.66

    Held through RVU16B, RVU16C, RVU16D.

  13. July 1, 2015

    RVU15C

    $431.56changed to$433.72

    • Conversion factor 35.7547 changed to 35.9335

    Held through RVU15D.

  14. January 1, 2015

    RVU15A

    $426.02changed to$431.56

    • Conversion factor 35.8228 changed to 35.7547
    • Practice expense RVU 6.83 changed to 6.97
    • Malpractice GPCI 1.165 changed to 1.226

    Held through RVU15B.

  15. January 1, 2014

    RVU14A

    $432.67changed to$426.02

    • Conversion factor 34.0230 changed to 35.8228
    • Practice expense RVU 7.66 changed to 6.83
    • Malpractice RVU 0.65 changed to 0.62
    • Malpractice GPCI 1.103 changed to 1.165

    Held through RVU14B, RVU14C, RVU14D.

  16. January 1, 2013

    RVU13AR

    Earliest loaded release: $432.67

    Held through RVU13B, RVU13C, RVU13D.

Rates in every CMS release
Effective fromOfficeFacilityCMS release
2026-10-01$419.15$233.10RVU26D
2026-07-01$419.15$233.10RVU26C
2026-04-01$419.15$233.10RVU26B
2026-01-01$419.15$233.10RVU26A
2025-10-01$407.82$269.70RVU25D
2025-07-01$407.82$269.70RVU25C
2025-04-01$407.82$269.70RVU25B
2025-01-01$407.82$269.70RVU25A
2024-10-01$422.02$275.23RVU24D
2024-07-01$422.02$275.23RVU24C
2024-04-01$422.02$275.23RVU24B
2024-03-09$422.02$275.23RVU24AR
2024-01-01$415.13$270.73RVU24A
2023-10-01$430.98$279.17RVU23D
2023-07-01$430.98$279.17RVU23C
2023-04-01$430.98$279.17RVU23B
2023-01-01$430.98$279.17RVU23A
2022-10-01$436.66$280.93RVU22D
2022-07-01$436.66$280.93RVU22C
2022-04-01$436.66$280.93RVU22B
2022-01-01$436.66$280.93RVU22A
2021-10-01$440.64$282.57RVU21D
2021-07-01$440.64$282.57RVU21C
2021-04-01$440.64$282.57RVU21B
2021-01-01$440.64$282.57RVU21A
2020-10-01$443.36$297.56RVU20D
2020-07-01$443.36$297.56RVU20C
2020-04-01$443.36$297.56RVU20B
2020-01-01$443.36$297.56RVU20A
2019-10-01$451.94$312.10RVU19D
2019-07-01$451.94$312.10RVU19C
2019-04-01$451.94$312.10RVU19B
2019-01-01$451.94$312.10RVU19A
2018-10-01$447.12$312.84RVU18D
2018-07-01$447.12$312.84RVU18C
2018-04-01$447.12$312.84RVU18B
2018-01-01$447.12$312.84RVU18AR1
2017-10-01$440.83$308.40RVU17D
2017-07-01$440.83$308.40RVU17C
2017-04-01$440.83$308.40RVU17B
2017-01-01$440.83$308.40RVU17A
2016-10-01$433.56$301.80RVU16D
2016-07-01$433.56$301.80RVU16C
2016-04-01$433.56$301.80RVU16B
2016-01-01$433.56$301.80RVU16A
2015-10-01$433.72$300.77RVU15D
2015-07-01$433.72$300.77RVU15C
2015-04-01$431.56$299.27RVU15B
2015-01-01$431.56$299.27RVU15A
2014-10-01$426.02$297.05RVU14D
2014-07-01$426.02$297.05RVU14C
2014-04-01$426.02$297.05RVU14B
2014-01-01$426.02$297.05RVU14A
2013-10-01$432.67$293.85RVU13D
2013-07-01$432.67$293.85RVU13C
2013-04-01$432.67$293.85RVU13B
2013-01-01$432.67$293.85RVU13AR

Price 13151 for an earlier date of service

Where the Montana rate applies

Montana is a Medicare payment area, not a city. Our Census mapping connects it to 497 cities and communities in Montana. Some span more than one payment area; confirm with the service ZIP.

  • Absarokee
  • Acton
  • Alberton
  • Alder
  • Alzada
  • Amsterdam
  • Anaconda-Deer Lodge County
  • Antelope

Browse all communities in Montana

13151 billing questions

How is this code distinguished from 13152?

Both describe complex repair in the same anatomic group. Use 13151 for a repaired length of 1.1 to 2.5 cm; 13152 covers the next length range, 2.6 to 7.5 cm.

When is 13151 appropriate instead of 12051?

Use 13151 when the repair meets the criteria for complex repair. Code 12051 is for an intermediate repair in the same general anatomic group, not a complex repair.

What wound details should the record include?

Document the specific site, repaired length, and wound features or repair work supporting complexity, such as extensive undermining or substantial wound preparation.

Can 13153 be reported with 13151?

13153 is the add-on code for each additional length increment beyond the initial repair range. Report it with the appropriate primary complex-repair code when the documented total repaired length supports it.

Can modifier 50 or an assistant-at-surgery claim be used?

Modifier 50 is inappropriate for this code. Medicare does not pay an assistant at surgery for this service.

Are related postoperative visits separately reported?

Related postoperative visits during the 10-day global period are included in the procedure payment.

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 13151PPRRVU2026_Oct_nonQPP.csv, line 1,442 (RVU26D)
Geographic factors for MontanaGPCI2026.csv, line 71 (RVU26D)

Open CMS sourceHow we calculate rates

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