CPT code 13152: Complex repair, eyelid, nose, ear, or lip2026 Medicare rate & RVUs in Missouri
Reports complex closure of a qualifying eyelid, nose, ear, or lip wound when the repaired length is 2.6 to 7.5 cm.
Medicare pays $449.24–$476.48 for 13152 in the office in Missouri, from Rest of Missouri to Metropolitan St. Louis, MO. Which amount applies depends on the service address.
Medicare allowed amount for participating (non-QP) physicians, before deductible, coinsurance and claim adjustments. Not a patient’s bill or a hospital charge.
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On this page 9 sections
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 in Missouri
The same RVUs, adjusted for each area’s costs. Open a locality for its calculation, history and nearby areas.
3 payment localities
$449.24 to $476.48
| Payment locality | Office | Facility |
|---|---|---|
| Metropolitan Kansas City, MO | $472.12 | $272.96 |
| Metropolitan St. Louis, MO | $476.48 | $274.56 |
| Rest of Missouri | $449.24 | $266.42 |
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.
How the rate is built · 13152
RVUs × geographic indexes × conversion factor
Work5.21
5.21 RVUs× 1.000 GPCI
Practice expense8.87
8.87 RVUs× 1.000 GPCI
Malpractice0.61
0.61 RVUs× 1.000 GPCI
Adjusted RVUs
14.6900
Conversion factor
$33.4009
Medicare rate
$490.66
Every GPCI starts at 1.000, the national rate. Enter a ZIP or drag a slider.
Payment rules and modifiers for 13152
13152 has a 10-day global period: related visits in that window are included in the surgery payment.
CMS payment indicators · 13152
Complex repair, eyelid, nose, ear, or lip
| Rule | CMS value | What it means |
|---|---|---|
| Global period | 010 | Minor procedure: the day of the procedure plus 10 days after are included. |
| Multiple procedures | 2 | Standard reduction: highest-valued procedure at 100%, others at 50%. |
| Bilateral (modifier 50) | 0 | The 150% bilateral adjustment doesn’t apply. |
| Assistant at surgery (80/81/82/AS) | 1 | Not paid (statutory restriction). |
| Co-surgeons (62) | 0 | Not permitted. |
| Team surgery (66) | 0 | Not permitted. |
| Professional/technical | 0 | Physician service: no professional/technical split. |
| Split (54/55/56) | 0.10/0.80/0.10 | Share of the payment for pre-op, the procedure itself, and post-op care. |
Global surgery period · 13152
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.
What modifiers do to the payment
Modifier 51 · payment effect
With and without the modifier
13152 without 51 · national office
$490.66
Complex repair, eyelid, nose, ear, or lip
13152-51 · Second procedure: 50%
$245.33
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%).
13152 compared with similar codes
Compare codes · National
5 codes, side by side
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.
13152 billing questions
How is 13152 distinguished from 13151?
Both cover complex repairs in the eyelid, nose, ear, or lip area. Choose 13152 for a repaired length of 2.6 to 7.5 cm; 13151 covers 1.1 to 2.5 cm.
Can 13153 be reported with 13152?
Yes. 13153 is the add-on code for each additional 5 cm or less of qualifying complex repair length beyond the primary-code range.
What documentation supports reporting a complex repair?
Record the exact anatomic site, final repaired length, closure details, and the specific features that made the work more complex than routine layered closure.
Can modifier 50 be used for repairs on both sides?
No. The CMS bilateral adjustment does not apply to this code, and modifier 50 is inappropriate.
Are related postoperative visits separately included in payment?
Related postoperative visits during the 10-day global period are included.
Can an assistant or co-surgeon be reported?
Medicare does not pay an assistant at surgery for this code. Co-surgeons and team surgery are not permitted.
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
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