CPT code 13152: Complex repair, eyelid, nose, ear, or lip2026 Medicare rate & RVUs

Medicare pays $490.66 for 13152 nationally in the office and $278.56 in a hospital or facility. Local office rates run $439.00–$631.30.

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

What 13152 covers

This code covers complex closure of a qualifying wound on an eyelid, nose, ear, or lip, such as a traumatic laceration or a defect after lesion removal. The repair involves more than a routine layered closure, for example because extensive undermining or another complexity is required. Plastic surgeons, facial plastic surgeons, otolaryngologists, and dermatologic surgeons may perform these repairs in office or facility settings.

Select the code by the repair’s anatomic site, complexity, and final repaired length; this level covers 2.6 to 7.5 cm. Document the specific site, length, closure performed, and the features that make the repair complex. The 10-day global period includes related postoperative visits during that period. When multiple procedures are performed in the same session, the highest-valued procedure is paid in full and others are subject to the standard 50% reduction. Modifier 50 is inappropriate. Medicare does not pay an assistant at surgery, and co-surgeons 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.

Where 13152 pays more and less

The same RVUs, adjusted for each area’s costs. Open a locality for its calculation, history and nearby areas.

109 of 109 payment localities

13152 rates by state

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

How the 13152 rate is calculated

Each of 13152’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.

Payment rules and modifiers for 13152

13152 has a 10-day global period: related visits in that window are included in the surgery payment.

What modifiers do to the payment

When to use modifier 51

13152 compared with similar codes

How to choose

13151Complex repairEyelid, nose, ear, or lip

Use 13151 for a qualifying complex eyelid, nose, ear, or lip repair measuring 1.1 to 2.5 cm; 13152 covers 2.6 to 7.5 cm.

13132Complex wound repair2.6–7.5 cm, specified sites

13132 covers the 2.6-to-7.5-cm level for a different group of sites, including the forehead, cheeks, chin, mouth, and neck. Select by the repair site, not length alone.

13153Complex repairAdditional 5 cm or less

13153 reports additional qualifying repair length in 5-cm-or-less increments; it is an add-on, not the primary code for the 2.6-to-7.5-cm segment.

13160Wound closureExtensive or complicated

13160 concerns secondary closure of a surgical wound or dehiscence. 13152 is for a qualifying complex repair of an eyelid, nose, ear, or lip wound.

Codes related to 13152

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

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

Open CMS sourceHow we calculate rates