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CPT code 13153: Complex repair, additional 5 cm or less2026 Medicare rate & RVUs in North Carolina

Reports each additional 5 cm or less of complex closure for eyelid, nose, ear, or lip wounds after the qualifying base repair.

CMS RVU26DEffective Oct 1, 2026One payment locality695 Medicare services in 2024

In North Carolina, Medicare pays $178.04 for 13153 in the office and $107.61 when it’s performed in a hospital or facility.

$178.04Office (non-facility)
$107.61Hospital or facility
−5.8%vs the national office rate ($189.05)

Check a contract rate as a % of Medicare · 13153 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 13153 for the payment locality that covers the ZIP.

On this page 11 sections
  1. Rate in North Carolina
  2. What 13153 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 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.

How North Carolina compares for 13153

Across 109 of 109 payment localities, the office rate for 13153 runs from $169.18 in Arkansas to $235.99 in San Benito County, CA. North Carolina pays $178.04. The RVUs are the same everywhere; the geographic indexes change the dollars.

13153 in North Carolina vs other payment areas
  1. North Carolina · this page$178.04
  2. Los Angeles, CA · California$206.40+$28.36
  3. Washington, DC area · District of Columbia$212.31+$34.27
  4. Miami, FL · Florida$211.52+$33.48
  5. Chicago, IL · Illinois$205.66+$27.62
  6. Manhattan, NY · New York$217.18+$39.14
  7. Alaska · Alaska$228.86+$50.82

Other areas in North Carolina first, then benchmark localities. Bars start at $0.

Every other payment area

13153 in every other Medicare payment locality
Payment localityOfficeFacility
AlabamaAlabama$171.39$105.34
ArkansasArkansas$169.18$104.34
ArizonaArizona$184.23$111.09
Bakersfield, CACalifornia$195.38$112.64
Chico, CACalifornia$194.34$111.61
El Centro, CACalifornia$194.40$111.67
Fresno, CACalifornia$194.34$111.61
Hanford, CACalifornia$194.34$111.61

13153 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.

$169.18

$228.86

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

View every state and territory as a table
13153 office rate range by state
State / territoryOffice rate rangeLocalities
AK$228.861
AL$171.391
AR$169.181
AZ$184.231
CA$194.34–$235.9929
CO$193.721
CT$200.791
DC$212.311
DE$187.031
FL$190.72–$211.523
GA$180.61–$193.292
GU$197.621
HI$197.621
IA$173.341
ID$174.751
IL$187.16–$205.664
IN$175.601
KS$173.531
KY$176.981
LA$177.10–$184.812
MA$193.12–$210.212
MD$190.03–$212.313
ME$176.54–$183.722
MI$181.94–$193.812
MN$183.471
MO$175.00–$184.303
MS$172.081
MT$189.031
NC$178.041
ND$181.911
NE$173.911
NH$191.631
NJ$202.47–$210.672
NM$183.201
NV$187.141
NY$180.50–$223.135
OH$180.491
OK$175.721
OR$185.08–$198.262
PA$180.23–$196.852
PR$189.961
RI$192.511
SC$179.681
SD$181.061
TN$174.421
TX$179.24–$193.618
UT$181.851
VA$183.82–$212.312
VI$189.961
VT$182.111
WA$192.46–$213.322
WI$176.551
WV$181.191
WY$185.921

See 13153 in every payment locality

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

Office or facility?

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.

The exact North Carolina inputs and CMS source lines

PPRRVU2026_Oct_nonQPP.csv

1,444

Code
13153
Physician work
2.32
Practice expense
2.98
Malpractice
0.36

GPCI2026.csv

83

Locality
North Carolina
Physician work
1.000
Practice expense
0.933
Malpractice
0.639
Office calculation for 13153 in North Carolina
ComponentRVULocality factorAdjusted
Physician work2.32× 1.0002.3200
Practice expense2.98× 0.9332.7803
Malpractice0.36× 0.6390.2300
Total RVUs5.3304
Conversion factor× 33.4009

Office rate, North Carolina$178.04

Office: (2.32 × 1 + 2.98 × 0.933 + 0.36 × 0.639) × $33.4009 = $178.04

Facility: (2.32 × 1 + 0.72 × 0.933 + 0.36 × 0.639) × $33.4009 = $107.61

Open 13153 in the RVU calculator

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

RuleCMS valueWhat it means
Global periodZZZAdd-on code: falls within the primary procedure’s global period.
Multiple procedures0No multiple-procedure reduction.
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.

Codes related to 13153

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

Codes related to 13153
CodeHow it relatesOffice range, North Carolina
Add-on codes
13151Complex repair, eyelid, nose, ear, or lipPrimary complex-repair code for the applicable shorter length range in this anatomic group.$395.65
13152Complex repair, eyelid, nose, ear, or lipPrimary complex-repair code for the applicable longer base length in this anatomic group.$463.45
Used instead
13102Complex repair, additional trunk lengthAdditional-length complex repair code for wounds in the trunk code group.$112.93
13122Complex repair, additional scalp or limb lengthAdditional-length complex repair code for the scalp, arms, or legs code group.$120.74
13133Complex repair, each additional 5 cm or lessAdditional-length complex repair code for a different anatomic group, including forehead and cheek sites.$158.89

How 13153 has changed in North Carolina

13153 · Office / nonfacility

$178.04

Effective 2026-10-01

The base rate is $9.01 higher than on 2025-10-01, moving from $169.03 to $178.04 (5.3%).

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

    $169.03changed to$178.04

    • Conversion factor 32.3465 changed to 33.4009
    • Work RVU 2.38 changed to 2.32
    • Practice expense RVU 2.80 changed to 2.98
    • Malpractice RVU 0.38 changed to 0.36
    • Practice expense GPCI 0.926 changed to 0.933
    • Malpractice GPCI 0.665 changed to 0.639

    Held through RVU26B, RVU26C, RVU26D.

  2. January 1, 2025

    RVU25A

    $173.41changed to$169.03

    • Conversion factor 33.2875 changed to 32.3465
    • Practice expense RVU 2.79 changed to 2.80
    • Malpractice RVU 0.37 changed to 0.38

    Held through RVU25B, RVU25C, RVU25D.

  3. March 9, 2024

    RVU24AR

    $170.58changed to$173.41

    • Conversion factor 32.7442 changed to 33.2875

    Held through RVU24B, RVU24C, RVU24D.

  4. January 1, 2024

    RVU24A

    $178.29changed to$170.58

    • Conversion factor 33.8872 changed to 32.7442
    • Practice expense RVU 2.82 changed to 2.79
    • Malpractice RVU 0.36 changed to 0.37
    • Practice expense GPCI 0.927 changed to 0.926
    • Malpractice GPCI 0.742 changed to 0.665

  5. January 1, 2023

    RVU23A

    $180.96changed to$178.29

    • Conversion factor 34.6062 changed to 33.8872
    • Practice expense RVU 2.77 changed to 2.82
    • Malpractice RVU 0.34 changed to 0.36
    • Practice expense GPCI 0.928 changed to 0.927
    • Malpractice GPCI 0.819 changed to 0.742

    Held through RVU23B, RVU23C, RVU23D.

  6. January 1, 2022

    RVU22A

    $183.43changed to$180.96

    • Conversion factor 34.8931 changed to 34.6062
    • Practice expense RVU 2.80 changed to 2.77

    Held through RVU22B, RVU22C, RVU22D.

  7. January 1, 2021

    RVU21A

    $186.81changed to$183.43

    • Conversion factor 36.0896 changed to 34.8931
    • Practice expense RVU 2.73 changed to 2.80
    • Practice expense GPCI 0.930 changed to 0.928
    • Malpractice GPCI 0.757 changed to 0.819

    Held through RVU21B, RVU21C, RVU21D.

  8. January 1, 2020

    RVU20A

    $187.22changed to$186.81

    • Conversion factor 36.0391 changed to 36.0896
    • Practice expense RVU 2.74 changed to 2.73
    • Malpractice RVU 0.38 changed to 0.34
    • Practice expense GPCI 0.931 changed to 0.930
    • Malpractice GPCI 0.695 changed to 0.757

    Held through RVU20B, RVU20C, RVU20D.

  9. January 1, 2019

    RVU19A

    $187.44changed to$187.22

    • Conversion factor 35.9996 changed to 36.0391
    • Practice expense RVU 2.76 changed to 2.74
    • Malpractice RVU 0.37 changed to 0.38

    Held through RVU19B, RVU19C, RVU19D.

  10. January 1, 2018

    RVU18AR1

    $187.95changed to$187.44

    • Conversion factor 35.8887 changed to 35.9996
    • Practice expense RVU 2.77 changed to 2.76
    • Malpractice RVU 0.38 changed to 0.37
    • Malpractice GPCI 0.732 changed to 0.695

    Held through RVU18B, RVU18C, RVU18D.

  11. January 1, 2017

    RVU17A

    $187.23changed to$187.95

    • Conversion factor 35.8043 changed to 35.8887
    • Practice expense RVU 2.75 changed to 2.77
    • Practice expense GPCI 0.930 changed to 0.931
    • Malpractice GPCI 0.768 changed to 0.732

    Held through RVU17B, RVU17C, RVU17D.

  12. January 1, 2016

    RVU16A

    $187.69changed to$187.23

    • Conversion factor 35.9335 changed to 35.8043
    • Practice expense RVU 2.76 changed to 2.75
    • Malpractice RVU 0.36 changed to 0.38

    Held through RVU16B, RVU16C, RVU16D.

  13. July 1, 2015

    RVU15C

    $186.76changed to$187.69

    • Conversion factor 35.7547 changed to 35.9335

    Held through RVU15D.

  14. January 1, 2015

    RVU15A

    $185.22changed to$186.76

    • Conversion factor 35.8228 changed to 35.7547
    • Practice expense RVU 2.72 changed to 2.76
    • Practice expense GPCI 0.929 changed to 0.930
    • Malpractice GPCI 0.732 changed to 0.768

    Held through RVU15B.

  15. January 1, 2014

    RVU14A

    $184.89changed to$185.22

    • Conversion factor 34.0230 changed to 35.8228
    • Practice expense RVU 3.01 changed to 2.72
    • Malpractice RVU 0.38 changed to 0.36
    • Practice expense GPCI 0.927 changed to 0.929
    • Malpractice GPCI 0.695 changed to 0.732

    Held through RVU14B, RVU14C, RVU14D.

  16. January 1, 2013

    RVU13AR

    Earliest loaded release: $184.89

    Held through RVU13B, RVU13C, RVU13D.

Rates in every CMS release
Effective fromOfficeFacilityCMS release
2026-10-01$178.04$107.61RVU26D
2026-07-01$178.04$107.61RVU26C
2026-04-01$178.04$107.61RVU26B
2026-01-01$178.04$107.61RVU26A
2025-10-01$169.03$125.30RVU25D
2025-07-01$169.03$125.30RVU25C
2025-04-01$169.03$125.30RVU25B
2025-01-01$169.03$125.30RVU25A
2024-10-01$173.41$127.49RVU24D
2024-07-01$173.41$127.49RVU24C
2024-04-01$173.41$127.49RVU24B
2024-03-09$173.41$127.49RVU24AR
2024-01-01$170.58$125.41RVU24A
2023-10-01$178.29$130.86RVU23D
2023-07-01$178.29$130.86RVU23C
2023-04-01$178.29$130.86RVU23B
2023-01-01$178.29$130.86RVU23A
2022-10-01$180.96$133.11RVU22D
2022-07-01$180.96$133.11RVU22C
2022-04-01$180.96$133.11RVU22B
2022-01-01$180.96$133.11RVU22A
2021-10-01$183.43$134.21RVU21D
2021-07-01$183.43$134.21RVU21C
2021-04-01$183.43$134.21RVU21B
2021-01-01$183.43$134.21RVU21A
2020-10-01$186.81$138.81RVU20D
2020-07-01$186.81$138.81RVU20C
2020-04-01$186.81$138.81RVU20B
2020-01-01$186.81$138.81RVU20A
2019-10-01$187.22$139.24RVU19D
2019-07-01$187.22$139.24RVU19C
2019-04-01$187.22$139.24RVU19B
2019-01-01$187.22$139.24RVU19A
2018-10-01$187.44$139.51RVU18D
2018-07-01$187.44$139.51RVU18C
2018-04-01$187.44$139.51RVU18B
2018-01-01$187.44$139.51RVU18AR1
2017-10-01$187.95$140.17RVU17D
2017-07-01$187.95$140.17RVU17C
2017-04-01$187.95$140.17RVU17B
2017-01-01$187.95$140.17RVU17A
2016-10-01$187.23$139.95RVU16D
2016-07-01$187.23$139.95RVU16C
2016-04-01$187.23$139.95RVU16B
2016-01-01$187.23$139.95RVU16A
2015-10-01$187.69$139.90RVU15D
2015-07-01$187.69$139.90RVU15C
2015-04-01$186.76$139.21RVU15B
2015-01-01$186.76$139.21RVU15A
2014-10-01$185.22$138.96RVU14D
2014-07-01$185.22$138.96RVU14C
2014-04-01$185.22$138.96RVU14B
2014-01-01$185.22$138.96RVU14A
2013-10-01$184.89$134.75RVU13D
2013-07-01$184.89$134.75RVU13C
2013-04-01$184.89$134.75RVU13B
2013-01-01$184.89$134.75RVU13AR

Price 13153 for an earlier date of service

Where the North Carolina rate applies

North Carolina is a Medicare payment area, not a city. Our Census mapping connects it to 785 cities and communities in North Carolina. Some span more than one payment area; confirm with the service ZIP.

  • Aberdeen
  • Advance
  • Ahoskie
  • Alamance
  • Albemarle
  • Alexis
  • Alliance
  • Altamahaw

Browse all communities in North Carolina

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

Show the CMS file lines behind this rate
RVUs for 13153PPRRVU2026_Oct_nonQPP.csv, line 1,444 (RVU26D)
Geographic factors for North CarolinaGPCI2026.csv, line 83 (RVU26D)

Open CMS sourceHow we calculate rates

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