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

Reports complex closure of a qualifying eyelid, nose, ear, or lip wound when the repaired length is 2.6 to 7.5 cm.

CMS RVU26DEffective Oct 1, 2026One payment locality52.1K Medicare services in 2024

In Queens, NY, Medicare pays $564.72 for 13152 in the office and $314.03 when it’s performed in a hospital or facility.

$564.72Office (non-facility)
$314.03Hospital or facility
+15.1%vs the national office rate ($490.66)

Check a contract rate as a % of Medicare · 13152 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 13152 for the payment locality that covers the ZIP.

On this page 11 sections
  1. Rate in Queens, NY
  2. What 13152 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 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.

How Queens, NY compares for 13152

Across 109 of 109 payment localities, the office rate for 13152 runs from $439.00 in Arkansas to $631.30 in San Benito County, CA. Queens, NY pays $564.72. The RVUs are the same everywhere; the geographic indexes change the dollars.

13152 in Queens, NY vs other payment areas
  1. Queens, NY · this page$564.72
  2. Manhattan, NY · New York$561.73−$2.99
  3. NYC suburbs and Long Island, NY · New York$575.25+$10.53
  4. Poughkeepsie and northern NYC suburbs, NY · New York$530.91−$33.81
  5. Rest of New York · New York$469.79−$94.93
  6. Los Angeles, CA · California$545.16−$19.56
  7. Washington, DC area · District of Columbia$555.09−$9.63

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

Every other payment area

13152 in every other Medicare payment locality
Payment localityOfficeFacility
Miami, FLFlorida$533.96$313.17
Chicago, ILIllinois$519.74$306.59
AlaskaAlaska$587.78$361.90
AlabamaAlabama$444.78$259.20
ArkansasArkansas$439.00$256.81
ArizonaArizona$478.54$273.02
Bakersfield, CACalifornia$514.44$281.98
Chico, CACalifornia$512.61$280.15

13152 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.

$439.00

$587.78

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

View every state and territory as a table
13152 office rate range by state
State / territoryOffice rate rangeLocalities
AK$587.781
AL$444.781
AR$439.001
AZ$478.541
CA$512.61–$631.3029
CO$507.251
CT$521.231
DC$555.091
DE$485.921
FL$487.87–$533.963
GA$462.57–$500.022
GU$522.671
HI$522.671
IA$453.191
ID$456.221
IL$476.35–$519.744
IN$458.561
KS$452.111
KY$456.041
LA$455.73–$475.952
MA$505.01–$553.032
MD$494.28–$555.093
ME$459.26–$480.472
MI$467.51–$494.272
MN$484.911
MO$449.24–$476.483
MS$444.161
MT$490.621
NC$463.451
ND$478.561
NE$455.171
NH$500.261
NJ$526.85–$550.412
NM$470.161
NV$487.551
NY$469.79–$575.255
OH$465.051
OK$454.421
OR$483.42–$521.112
PA$465.24–$509.872
PR$493.611
RI$501.541
SC$465.091
SD$477.131
TN$454.271
TX$462.55–$505.878
UT$470.811
VA$479.63–$555.092
VI$493.611
VT$477.631
WA$503.75–$562.882
WI$464.121
WV$460.631
WY$485.361

See 13152 in every payment locality

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

Office or facility?

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.

The exact Queens, NY inputs and CMS source lines

PPRRVU2026_Oct_nonQPP.csv

1,443

Code
13152
Physician work
5.21
Practice expense
8.87
Malpractice
0.61

GPCI2026.csv

81

Locality
Queens, NY
Physician work
1.064
Practice expense
1.182
Malpractice
1.442
Office calculation for 13152 in Queens, NY
ComponentRVULocality factorAdjusted
Physician work5.21× 1.0645.5434
Practice expense8.87× 1.18210.4843
Malpractice0.61× 1.4420.8796
Total RVUs16.9074
Conversion factor× 33.4009

Office rate, Queens, NY$564.72

Office: (5.21 × 1.064 + 8.87 × 1.182 + 0.61 × 1.442) × $33.4009 = $564.72

Facility: (5.21 × 1.064 + 2.52 × 1.182 + 0.61 × 1.442) × $33.4009 = $314.03

Open 13152 in the RVU calculator

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

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 · 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.

SurgeryVisit
Sep 28, 2026Oct 14, 2026

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%).

When to use modifier 51

Codes related to 13152

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

Codes related to 13152
CodeHow it relatesOffice range, Queens, NY
Same family
13151Complex repair, eyelid, nose, ear, or lipSame anatomic group; covers complex repairs measuring 1.1 to 2.5 cm.$483.14
Primary code
13153Complex repair, additional 5 cm or lessAdd-on for each additional 5 cm or less of qualifying repair length.$217.44
Used instead
13132Complex wound repair, 2.6–7.5 cm, specified sitesComplex repair level for specified sites such as the forehead, cheek, chin, mouth, or neck.$532.46
13121Complex repair, scalp, arm, or leg, 2.6–7.5 cmComplex repair level for the scalp, arms, or legs at 2.6 to 7.5 cm.$482.34
13101Complex repair, trunk, 2.6–7.5 cmComplex repair level for the trunk at 2.6 to 7.5 cm.$451.55

How 13152 has changed in Queens, NY

13152 · Office / nonfacility

$564.72

Effective 2026-10-01

The base rate is $9.95 higher than on 2025-10-01, moving from $554.77 to $564.72 (1.8%).

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

    $554.77changed to$564.72

    • Conversion factor 32.3465 changed to 33.4009
    • Work RVU 5.34 changed to 5.21
    • Practice expense RVU 8.81 changed to 8.87
    • Malpractice RVU 0.64 changed to 0.61
    • 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

    $575.46changed to$554.77

    • Conversion factor 33.2875 changed to 32.3465
    • Practice expense RVU 8.90 changed to 8.81
    • Malpractice RVU 0.66 changed to 0.64

    Held through RVU25B, RVU25C, RVU25D.

  3. March 9, 2024

    RVU24AR

    $566.07changed to$575.46

    • Conversion factor 32.7442 changed to 33.2875

    Held through RVU24B, RVU24C, RVU24D.

  4. January 1, 2024

    RVU24A

    $604.16changed to$566.07

    • Conversion factor 33.8872 changed to 32.7442
    • Practice expense RVU 8.93 changed to 8.90
    • Malpractice RVU 0.65 changed to 0.66
    • 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

    $628.26changed to$604.16

    • Conversion factor 34.6062 changed to 33.8872
    • Practice expense RVU 8.87 changed to 8.93
    • Malpractice RVU 0.61 changed to 0.65
    • 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

    $636.04changed to$628.26

    • Conversion factor 34.8931 changed to 34.6062
    • Practice expense RVU 8.93 changed to 8.87

    Held through RVU22B, RVU22C, RVU22D.

  7. January 1, 2021

    RVU21A

    $622.95changed to$636.04

    • Conversion factor 36.0896 changed to 34.8931
    • Practice expense RVU 8.44 changed to 8.93
    • Malpractice RVU 0.58 changed to 0.61
    • 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

    $624.29changed to$622.95

    • Conversion factor 36.0391 changed to 36.0896
    • Practice expense RVU 8.34 changed to 8.44
    • Malpractice RVU 0.80 changed to 0.58
    • 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

    $621.01changed to$624.29

    • Conversion factor 35.9996 changed to 36.0391
    • Practice expense RVU 8.28 changed to 8.34

    Held through RVU19B, RVU19C, RVU19D.

  10. January 1, 2018

    RVU18AR1

    $619.10changed to$621.01

    • Conversion factor 35.8887 changed to 35.9996
    • Practice expense RVU 8.26 changed to 8.28
    • Malpractice GPCI 2.151 changed to 2.121

    Held through RVU18B, RVU18C, RVU18D.

  11. January 1, 2017

    RVU17A

    $618.05changed to$619.10

    • Conversion factor 35.8043 changed to 35.8887
    • Practice expense RVU 8.22 changed to 8.26
    • Malpractice RVU 0.82 changed to 0.80
    • 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

    $614.44changed to$618.05

    • Conversion factor 35.9335 changed to 35.8043
    • Practice expense RVU 8.23 changed to 8.22
    • Malpractice RVU 0.74 changed to 0.82

    Held through RVU16B, RVU16C, RVU16D.

  13. July 1, 2015

    RVU15C

    $611.38changed to$614.44

    • Conversion factor 35.7547 changed to 35.9335

    Held through RVU15D.

  14. January 1, 2015

    RVU15A

    $597.17changed to$611.38

    • Conversion factor 35.8228 changed to 35.7547
    • Practice expense RVU 8.03 changed to 8.23
    • Malpractice RVU 0.77 changed to 0.74
    • 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

    $569.02changed to$597.17

    • Conversion factor 34.0230 changed to 35.8228
    • Work RVU 4.90 changed to 5.34
    • Practice expense RVU 8.73 changed to 8.03
    • Malpractice RVU 0.73 changed to 0.77
    • 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: $569.02

    Held through RVU13B, RVU13C, RVU13D.

Rates in every CMS release
Effective fromOfficeFacilityCMS release
2026-10-01$564.72$314.03RVU26D
2026-07-01$564.72$314.03RVU26C
2026-04-01$564.72$314.03RVU26B
2026-01-01$564.72$314.03RVU26A
2025-10-01$554.77$370.77RVU25D
2025-07-01$554.77$370.77RVU25C
2025-04-01$554.77$370.77RVU25B
2025-01-01$554.77$370.77RVU25A
2024-10-01$575.46$379.75RVU24D
2024-07-01$575.46$379.75RVU24C
2024-04-01$575.46$379.75RVU24B
2024-03-09$575.46$379.75RVU24AR
2024-01-01$566.07$373.55RVU24A
2023-10-01$604.16$399.62RVU23D
2023-07-01$604.16$399.62RVU23C
2023-04-01$604.16$399.62RVU23B
2023-01-01$604.16$399.62RVU23A
2022-10-01$628.26$414.51RVU22D
2022-07-01$628.26$414.51RVU22C
2022-04-01$628.26$414.51RVU22B
2022-01-01$628.26$414.51RVU22A
2021-10-01$636.04$417.51RVU21D
2021-07-01$636.04$417.51RVU21C
2021-04-01$636.04$417.51RVU21B
2021-01-01$636.04$417.51RVU21A
2020-10-01$622.95$420.54RVU20D
2020-07-01$622.95$420.54RVU20C
2020-04-01$622.95$420.54RVU20B
2020-01-01$622.95$420.54RVU20A
2019-10-01$624.29$430.11RVU19D
2019-07-01$624.29$430.11RVU19C
2019-04-01$624.29$430.11RVU19B
2019-01-01$624.29$430.11RVU19A
2018-10-01$621.01$431.80RVU18D
2018-07-01$621.01$431.80RVU18C
2018-04-01$621.01$431.80RVU18B
2018-01-01$621.01$431.80RVU18AR1
2017-10-01$619.10$433.05RVU17D
2017-07-01$619.10$433.05RVU17C
2017-04-01$619.10$433.05RVU17B
2017-01-01$619.10$433.05RVU17A
2016-10-01$618.05$432.17RVU16D
2016-07-01$618.05$432.17RVU16C
2016-04-01$618.05$432.17RVU16B
2016-01-01$618.05$432.17RVU16A
2015-10-01$614.44$427.02RVU15D
2015-07-01$614.44$427.02RVU15C
2015-04-01$611.38$424.90RVU15B
2015-01-01$611.38$424.90RVU15A
2014-10-01$597.17$416.64RVU14D
2014-07-01$597.17$416.64RVU14C
2014-04-01$597.17$416.64RVU14B
2014-01-01$597.17$416.64RVU14A
2013-10-01$569.02$373.86RVU13D
2013-07-01$569.02$373.86RVU13C
2013-04-01$569.02$373.86RVU13B
2013-01-01$569.02$373.86RVU13AR

Price 13152 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

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
RVUs for 13152PPRRVU2026_Oct_nonQPP.csv, line 1,443 (RVU26D)
Geographic factors for Queens, NYGPCI2026.csv, line 81 (RVU26D)

Open CMS sourceHow we calculate rates

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