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

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 Queens, NY, Medicare pays $217.44 for 13153 in the office and $128.21 when it’s performed in a hospital or facility.

$217.44Office (non-facility)
$128.21Hospital or facility
+15.0%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 Queens, NY
  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 Queens, NY 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. Queens, NY pays $217.44. The RVUs are the same everywhere; the geographic indexes change the dollars.

13153 in Queens, NY vs other payment areas
  1. Queens, NY · this page$217.44
  2. Manhattan, NY · New York$217.18−$0.26
  3. NYC suburbs and Long Island, NY · New York$223.13+$5.69
  4. Poughkeepsie and northern NYC suburbs, NY · New York$204.52−$12.92
  5. Rest of New York · New York$180.50−$36.94
  6. Los Angeles, CA · California$206.40−$11.04
  7. Washington, DC area · District of Columbia$212.31−$5.13

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

Every other payment area

13153 in every other Medicare payment locality
Payment localityOfficeFacility
Miami, FLFlorida$211.52$132.93
Chicago, ILIllinois$205.66$129.80
AlaskaAlaska$228.86$148.47
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

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 Queens, NY 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

81

Locality
Queens, NY
Physician work
1.064
Practice expense
1.182
Malpractice
1.442
Office calculation for 13153 in Queens, NY
ComponentRVULocality factorAdjusted
Physician work2.32× 1.0642.4685
Practice expense2.98× 1.1823.5224
Malpractice0.36× 1.4420.5191
Total RVUs6.5100
Conversion factor× 33.4009

Office rate, Queens, NY$217.44

Office: (2.32 × 1.064 + 2.98 × 1.182 + 0.36 × 1.442) × $33.4009 = $217.44

Facility: (2.32 × 1.064 + 0.72 × 1.182 + 0.36 × 1.442) × $33.4009 = $128.21

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, Queens, NY
Add-on codes
13151Complex repair, eyelid, nose, ear, or lipPrimary complex-repair code for the applicable shorter length range in this anatomic group.$483.14
13152Complex repair, eyelid, nose, ear, or lipPrimary complex-repair code for the applicable longer base length in this anatomic group.$564.72
Used instead
13102Complex repair, additional trunk lengthAdditional-length complex repair code for wounds in the trunk code group.$139.10
13122Complex repair, additional scalp or limb lengthAdditional-length complex repair code for the scalp, arms, or legs code group.$147.91
13133Complex repair, each additional 5 cm or lessAdditional-length complex repair code for a different anatomic group, including forehead and cheek sites.$192.49

How 13153 has changed in Queens, NY

13153 · Office / nonfacility

$217.44

Effective 2026-10-01

The base rate is $9.25 higher than on 2025-10-01, moving from $208.19 to $217.44 (4.4%).

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

    $208.19changed to$217.44

    • 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
    • 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

    $213.36changed to$208.19

    • 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

    $209.88changed to$213.36

    • Conversion factor 32.7442 changed to 33.2875

    Held through RVU24B, RVU24C, RVU24D.

  4. January 1, 2024

    RVU24A

    $226.54changed to$209.88

    • 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
    • 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

    $236.00changed to$226.54

    • 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
    • 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

    $239.24changed to$236.00

    • 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

    $239.48changed to$239.24

    • Conversion factor 36.0896 changed to 34.8931
    • Practice expense RVU 2.73 changed to 2.80
    • 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

    $237.78changed to$239.48

    • 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
    • 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

    $237.62changed to$237.78

    • 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

    $238.49changed to$237.62

    • 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 2.151 changed to 2.121

    Held through RVU18B, RVU18C, RVU18D.

  11. January 1, 2017

    RVU17A

    $237.37changed to$238.49

    • Conversion factor 35.8043 changed to 35.8887
    • Practice expense RVU 2.75 changed to 2.77
    • 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

    $237.09changed to$237.37

    • 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

    $235.92changed to$237.09

    • Conversion factor 35.7547 changed to 35.9335

    Held through RVU15D.

  14. January 1, 2015

    RVU15A

    $230.43changed to$235.92

    • Conversion factor 35.8228 changed to 35.7547
    • Practice expense RVU 2.72 changed to 2.76
    • 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

    $227.65changed to$230.43

    • 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
    • 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: $227.65

    Held through RVU13B, RVU13C, RVU13D.

Rates in every CMS release
Effective fromOfficeFacilityCMS release
2026-10-01$217.44$128.21RVU26D
2026-07-01$217.44$128.21RVU26C
2026-04-01$217.44$128.21RVU26B
2026-01-01$217.44$128.21RVU26A
2025-10-01$208.19$151.76RVU25D
2025-07-01$208.19$151.76RVU25C
2025-04-01$208.19$151.76RVU25B
2025-01-01$208.19$151.76RVU25A
2024-10-01$213.36$154.09RVU24D
2024-07-01$213.36$154.09RVU24C
2024-04-01$213.36$154.09RVU24B
2024-03-09$213.36$154.09RVU24AR
2024-01-01$209.88$151.58RVU24A
2023-10-01$226.54$164.52RVU23D
2023-07-01$226.54$164.52RVU23C
2023-04-01$226.54$164.52RVU23B
2023-01-01$226.54$164.52RVU23A
2022-10-01$236.00$172.68RVU22D
2022-07-01$236.00$172.68RVU22C
2022-04-01$236.00$172.68RVU22B
2022-01-01$236.00$172.68RVU22A
2021-10-01$239.24$174.11RVU21D
2021-07-01$239.24$174.11RVU21C
2021-04-01$239.24$174.11RVU21B
2021-01-01$239.24$174.11RVU21A
2020-10-01$239.48$176.83RVU20D
2020-07-01$239.48$176.83RVU20C
2020-04-01$239.48$176.83RVU20B
2020-01-01$239.48$176.83RVU20A
2019-10-01$237.78$175.93RVU19D
2019-07-01$237.78$175.93RVU19C
2019-04-01$237.78$175.93RVU19B
2019-01-01$237.78$175.93RVU19A
2018-10-01$237.62$175.84RVU18D
2018-07-01$237.62$175.84RVU18C
2018-04-01$237.62$175.84RVU18B
2018-01-01$237.62$175.84RVU18AR1
2017-10-01$238.49$176.90RVU17D
2017-07-01$238.49$176.90RVU17C
2017-04-01$238.49$176.90RVU17B
2017-01-01$238.49$176.90RVU17A
2016-10-01$237.37$176.42RVU16D
2016-07-01$237.37$176.42RVU16C
2016-04-01$237.37$176.42RVU16B
2016-01-01$237.37$176.42RVU16A
2015-10-01$237.09$175.48RVU15D
2015-07-01$237.09$175.48RVU15C
2015-04-01$235.92$174.61RVU15B
2015-01-01$235.92$174.61RVU15A
2014-10-01$230.43$170.83RVU14D
2014-07-01$230.43$170.83RVU14C
2014-04-01$230.43$170.83RVU14B
2014-01-01$230.43$170.83RVU14A
2013-10-01$227.65$163.01RVU13D
2013-07-01$227.65$163.01RVU13C
2013-04-01$227.65$163.01RVU13B
2013-01-01$227.65$163.01RVU13AR

Price 13153 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

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 Queens, NYGPCI2026.csv, line 81 (RVU26D)

Open CMS sourceHow we calculate rates

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