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

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 South Dakota, Medicare pays $408.09 for 13151 in the office and $222.05 when it’s performed in a hospital or facility.

$408.09Office (non-facility)
$222.05Hospital or facility
−2.6%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 South Dakota
  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 South Dakota 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. South Dakota pays $408.09. The RVUs are the same everywhere; the geographic indexes change the dollars.

13151 in South Dakota vs other payment areas
  1. South Dakota · this page$408.09
  2. Los Angeles, CA · California$467.16+$59.07
  3. Washington, DC area · District of Columbia$475.19+$67.10
  4. Miami, FL · Florida$455.43+$47.34
  5. Chicago, IL · Illinois$443.10+$35.01
  6. Manhattan, NY · New York$480.32+$72.23
  7. Alaska · Alaska$499.30+$91.21

Other areas in South Dakota 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.

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 South Dakota 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

94

Locality
South Dakota
Physician work
1.000
Practice expense
1.000
Malpractice
0.336
Office calculation for 13151 in South Dakota
ComponentRVULocality factorAdjusted
Physician work4.23× 1.0004.2300
Practice expense7.82× 1.0007.8200
Malpractice0.50× 0.3360.1680
Total RVUs12.2180
Conversion factor× 33.4009

Office rate, South Dakota$408.09

Office: (4.23 × 1 + 7.82 × 1 + 0.5 × 0.336) × $33.4009 = $408.09

Facility: (4.23 × 1 + 2.25 × 1 + 0.5 × 0.336) × $33.4009 = $222.05

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

How 13151 has changed in South Dakota

13151 · Office / nonfacility

$408.09

Effective 2026-10-01

The base rate is $10.87 higher than on 2025-10-01, moving from $397.22 to $408.09 (2.7%).

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

    $397.22changed to$408.09

    • 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 0.382 changed to 0.336

    Held through RVU26B, RVU26C, RVU26D.

  2. January 1, 2025

    RVU25A

    $411.31changed to$397.22

    • 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

    $404.60changed to$411.31

    • Conversion factor 32.7442 changed to 33.2875

    Held through RVU24B, RVU24C, RVU24D.

  4. January 1, 2024

    RVU24A

    $419.75changed to$404.60

    • Conversion factor 33.8872 changed to 32.7442
    • Practice expense RVU 7.85 changed to 7.81
    • Malpractice GPCI 0.364 changed to 0.382
  5. January 1, 2023

    RVU23A

    $425.33changed to$419.75

    • 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 0.347 changed to 0.364

    Held through RVU23B, RVU23C, RVU23D.

  6. January 1, 2022

    RVU22A

    $429.43changed to$425.33

    • 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

    $426.13changed to$429.43

    • Conversion factor 36.0896 changed to 34.8931
    • Practice expense RVU 7.28 changed to 7.79
    • Malpractice GPCI 0.368 changed to 0.347

    Held through RVU21B, RVU21C, RVU21D.

  8. January 1, 2020

    RVU20A

    $422.84changed to$426.13

    • 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 0.389 changed to 0.368

    Held through RVU20B, RVU20C, RVU20D.

  9. January 1, 2019

    RVU19A

    $418.06changed to$422.84

    • 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

    $416.33changed to$418.06

    • 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 0.395 changed to 0.389

    Held through RVU18B, RVU18C, RVU18D.

  11. January 1, 2017

    RVU17A

    $414.04changed to$416.33

    • Conversion factor 35.8043 changed to 35.8887
    • Practice expense RVU 6.96 changed to 7.00
    • Malpractice GPCI 0.400 changed to 0.395

    Held through RVU17B, RVU17C, RVU17D.

  12. January 1, 2016

    RVU16A

    $415.32changed to$414.04

    • 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

    $413.25changed to$415.32

    • Conversion factor 35.7547 changed to 35.9335

    Held through RVU15D.

  14. January 1, 2015

    RVU15A

    $409.38changed to$413.25

    • Conversion factor 35.8228 changed to 35.7547
    • Practice expense RVU 6.83 changed to 6.97
    • Malpractice GPCI 0.416 changed to 0.400

    Held through RVU15B.

  15. January 1, 2014

    RVU14A

    $417.83changed to$409.38

    • 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 0.432 changed to 0.416

    Held through RVU14B, RVU14C, RVU14D.

  16. January 1, 2013

    RVU13AR

    Earliest loaded release: $417.83

    Held through RVU13B, RVU13C, RVU13D.

Rates in every CMS release
Effective fromOfficeFacilityCMS release
2026-10-01$408.09$222.05RVU26D
2026-07-01$408.09$222.05RVU26C
2026-04-01$408.09$222.05RVU26B
2026-01-01$408.09$222.05RVU26A
2025-10-01$397.22$259.10RVU25D
2025-07-01$397.22$259.10RVU25C
2025-04-01$397.22$259.10RVU25B
2025-01-01$397.22$259.10RVU25A
2024-10-01$411.31$264.51RVU24D
2024-07-01$411.31$264.51RVU24C
2024-04-01$411.31$264.51RVU24B
2024-03-09$411.31$264.51RVU24AR
2024-01-01$404.60$260.19RVU24A
2023-10-01$419.75$267.93RVU23D
2023-07-01$419.75$267.93RVU23C
2023-04-01$419.75$267.93RVU23B
2023-01-01$419.75$267.93RVU23A
2022-10-01$425.33$269.60RVU22D
2022-07-01$425.33$269.60RVU22C
2022-04-01$425.33$269.60RVU22B
2022-01-01$425.33$269.60RVU22A
2021-10-01$429.43$271.36RVU21D
2021-07-01$429.43$271.36RVU21C
2021-04-01$429.43$271.36RVU21B
2021-01-01$429.43$271.36RVU21A
2020-10-01$426.13$280.33RVU20D
2020-07-01$426.13$280.33RVU20C
2020-04-01$426.13$280.33RVU20B
2020-01-01$426.13$280.33RVU20A
2019-10-01$422.84$283.01RVU19D
2019-07-01$422.84$283.01RVU19C
2019-04-01$422.84$283.01RVU19B
2019-01-01$422.84$283.01RVU19A
2018-10-01$418.06$283.78RVU18D
2018-07-01$418.06$283.78RVU18C
2018-04-01$418.06$283.78RVU18B
2018-01-01$418.06$283.78RVU18AR1
2017-10-01$416.33$283.90RVU17D
2017-07-01$416.33$283.90RVU17C
2017-04-01$416.33$283.90RVU17B
2017-01-01$416.33$283.90RVU17A
2016-10-01$414.04$282.28RVU16D
2016-07-01$414.04$282.28RVU16C
2016-04-01$414.04$282.28RVU16B
2016-01-01$414.04$282.28RVU16A
2015-10-01$415.32$282.37RVU15D
2015-07-01$415.32$282.37RVU15C
2015-04-01$413.25$280.96RVU15B
2015-01-01$413.25$280.96RVU15A
2014-10-01$409.38$280.42RVU14D
2014-07-01$409.38$280.42RVU14C
2014-04-01$409.38$280.42RVU14B
2014-01-01$409.38$280.42RVU14A
2013-10-01$417.83$279.02RVU13D
2013-07-01$417.83$279.02RVU13C
2013-04-01$417.83$279.02RVU13B
2013-01-01$417.83$279.02RVU13AR

Price 13151 for an earlier date of service

Where the South Dakota rate applies

South Dakota is a Medicare payment area, not a city. Our Census mapping connects it to 485 cities and communities in South Dakota. Some span more than one payment area; confirm with the service ZIP.

  • Aberdeen
  • Agar
  • Agency Village
  • Akaska
  • Albee
  • Alcester
  • Alexandria
  • Allen

Browse all communities in South Dakota

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 South DakotaGPCI2026.csv, line 94 (RVU26D)

Open CMS sourceHow we calculate rates

Did this answer your question about what 13151 pays in South Dakota?

Tell us what you were actually trying to work out. We’ll answer you directly, or build the page that does.

Fee sheets · Coming soon

Put 13151 and the rest of your codes on one sheet

Your codes at your locality, with payer contracts beside Medicare.

Join the waitlist