CPT code 13153: Complex repair, additional 5 cm or less2026 Medicare rate & RVUs in Maryland
Reports each additional 5 cm or less of complex closure for eyelid, nose, ear, or lip wounds after the qualifying base repair.
Medicare pays $190.03–$212.31 for 13153 in the office in Maryland, from Rest of Maryland to Washington, DC area. 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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What 13153 covers
This add-on represents additional length of a complex wound repair involving the eyelid, nose, ear, or lip. Complex repair involves more than routine layered suturing, such as substantial wound-edge undermining, scar revision, or extensive debridement. Surgeons performing facial trauma repair, reconstruction after lesion removal, or other complex closure may report it in office or facility settings when the repair extends beyond the length covered by the primary code.
Choose the primary code from the repair’s total length and report this add-on for each additional segment of 5 cm or less beyond the primary code’s range. Document the anatomic site, total repaired length, and work supporting a complex rather than routine closure. This is not a stand-alone service: report it only with a qualifying primary complex-repair procedure. CMS pays it within that primary procedure’s global period.
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 13153 pays more and less in Maryland
The same RVUs, adjusted for each area’s costs. Open a locality for its calculation, history and nearby areas.
3 payment localities
$190.03 to $212.31
| Payment locality | Office | Facility |
|---|---|---|
| Baltimore area, MD | $200.40 | $119.41 |
| Rest of Maryland | $190.03 | $113.64 |
| Washington, DC area | $212.31 | $123.39 |
How the 13153 rate is calculated
Each of 13153’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 · 13153
RVUs × geographic indexes × conversion factor
Work2.32
2.32 RVUs× 1.000 GPCI
Practice expense2.98
2.98 RVUs× 1.000 GPCI
Malpractice0.36
0.36 RVUs× 1.000 GPCI
Adjusted RVUs
5.6600
Conversion factor
$33.4009
Medicare rate
$189.05
Every GPCI starts at 1.000, the national rate. Enter a ZIP or drag a slider.
Payment rules and modifiers for 13153
The CMS indicators that decide how 13153 is paid alongside other services.
CMS payment indicators · 13153
Complex repair, additional 5 cm or less
| Rule | CMS value | What it means |
|---|---|---|
| Global period | ZZZ | Add-on code: falls within the primary procedure’s global period. |
| Multiple procedures | 0 | No multiple-procedure reduction. |
| 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. |
13153 compared with similar codes
Compare codes · National
5 codes, side by side
How to choose
- 13151Complex repairEyelid, nose, ear, or lip
- 13151 reports the primary complex repair for its length range at the eyelid, nose, ear, or lip; 13153 captures additional length beyond the primary range.
- 13152Complex repairEyelid, nose, ear, or lip
- 13152 reports the primary complex repair for its longer base length in this anatomic group. Use 13153 for each qualifying additional segment.
- 13133Complex repairEach additional 5 cm or less
- 13133 is an additional-length code for a different complex-repair anatomic group, such as the forehead or cheek; 13153 is for eyelids, nose, ears, or lips.
- 13102Complex repairAdditional trunk length
- 13102 covers additional complex-repair length for the trunk, not the eyelid, nose, ear, or lip group.
13153 billing questions
Which primary repair codes can accompany 13153?
Use it with the applicable primary complex-repair code for eyelids, nose, ears, or lips, such as 13151 or 13152. It is not reported by itself.
When should 13152 be used instead?
13152 covers the primary complex repair in its specified length range. Report 13153 for each additional 5 cm or less beyond the primary code’s range.
How many units of 13153 should be reported?
Report one unit for each additional segment of 5 cm or less supported by the documented repair length. Record the total length and how it supports the units billed.
What documentation supports complex repair rather than a simpler closure?
Document the repaired site and length, along with the work that makes the closure complex, such as substantial undermining, scar revision, or extensive debridement.
Can 13153 be reported with a repair code for another body region?
No. This add-on is for additional complex-repair length in the eyelid, nose, ear, or lip code group; other anatomic groups have their own repair codes.
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
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