CPT code 13153: Complex repair, additional 5 cm or less2026 Medicare rate & RVUs in Puerto Rico
Reports each additional 5 cm or less of complex closure for eyelid, nose, ear, or lip wounds after the qualifying base repair.
In Puerto Rico, Medicare pays $189.96 for 13153 in the office and $113.65 when it’s performed in a hospital or facility.
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.
On this page 11 sections
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 Puerto Rico 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. Puerto Rico pays $189.96. The RVUs are the same everywhere; the geographic indexes change the dollars.
- Puerto Rico · this page$189.96
- Los Angeles, CA · California$206.40+$16.44
- Washington, DC area · District of Columbia$212.31+$22.35
- Miami, FL · Florida$211.52+$21.56
- Chicago, IL · Illinois$205.66+$15.70
- Manhattan, NY · New York$217.18+$27.22
- Alaska · Alaska$228.86+$38.90
Other areas in Puerto Rico first, then benchmark localities. Bars start at $0.
Every other payment area
| Payment locality | Office | Facility |
|---|---|---|
| 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 |
| Madera, CACalifornia | $194.34 | $111.61 |
| Merced, CACalifornia | $194.34 | $111.61 |
| Modesto, CACalifornia | $194.34 | $111.61 |
| Napa, CACalifornia | $219.67 | $120.18 |
| Oxnard, CACalifornia | $204.80 | $115.58 |
| Redding, CACalifornia | $194.34 | $111.61 |
| Rest of CaliforniaCalifornia | $194.34 | $111.61 |
| Riverside, CACalifornia | $198.23 | $115.50 |
| Sacramento, CACalifornia | $202.48 | $114.69 |
| Salinas, CACalifornia | $201.70 | $114.21 |
| San Diego, CACalifornia | $205.38 | $115.09 |
| Marin County, CACalifornia | $230.71 | $124.28 |
| San Francisco, CACalifornia | $230.31 | $123.87 |
| San Benito County, CACalifornia | $235.99 | $127.14 |
| Santa Clara County, CACalifornia | $234.32 | $125.47 |
| San Luis Obispo, CACalifornia | $198.62 | $112.64 |
| Santa Cruz, CACalifornia | $206.50 | $114.78 |
| Santa Maria, CACalifornia | $202.16 | $114.15 |
| Santa Rosa, CACalifornia | $208.49 | $115.79 |
| Stockton, CACalifornia | $194.34 | $111.61 |
| Vallejo, CACalifornia | $219.08 | $119.59 |
| Visalia, CACalifornia | $194.34 | $111.61 |
| Yuba City, CACalifornia | $194.34 | $111.61 |
| ColoradoColorado | $193.72 | $113.40 |
| ConnecticutConnecticut | $200.79 | $119.49 |
| DelawareDelaware | $187.03 | $112.45 |
| Fort Lauderdale, FLFlorida | $200.06 | $123.59 |
| Rest of FloridaFlorida | $190.72 | $118.55 |
| Atlanta, GAGeorgia | $193.29 | $116.60 |
| Rest of GeorgiaGeorgia | $180.61 | $113.27 |
| Hawaii, Guam, HIHawaii | $197.62 | $111.80 |
| IowaIowa | $173.34 | $104.27 |
| IdahoIdaho | $174.75 | $105.30 |
| East St. Louis, ILIllinois | $193.28 | $123.83 |
| Rest of IllinoisIllinois | $187.16 | $118.24 |
| Suburban Chicago, ILIllinois | $201.56 | $124.04 |
| IndianaIndiana | $175.60 | $105.63 |
| KansasKansas | $173.53 | $105.29 |
| KentuckyKentucky | $176.98 | $109.87 |
| New Orleans, LALouisiana | $184.81 | $113.78 |
| Rest of LouisianaLouisiana | $177.10 | $110.29 |
| Metropolitan Boston, MAMassachusetts | $210.21 | $120.08 |
| Rest of MassachusettsMassachusetts | $193.12 | $113.64 |
| Baltimore area, MDMaryland | $200.40 | $119.41 |
| Rest of MarylandMaryland | $190.03 | $113.64 |
| Rest of MaineMaine | $176.54 | $107.09 |
| Southern Maine, MEMaine | $183.72 | $108.91 |
| Detroit, MIMichigan | $193.81 | $120.97 |
| Rest of MichiganMichigan | $181.94 | $113.02 |
| MinnesotaMinnesota | $183.47 | $105.80 |
| Metropolitan Kansas City, MOMissouri | $182.70 | $111.82 |
| Metropolitan St. Louis, MOMissouri | $184.30 | $112.43 |
| Rest of MissouriMissouri | $175.00 | $109.93 |
| MississippiMississippi | $172.08 | $107.08 |
| MontanaMontana | $189.03 | $113.54 |
| North CarolinaNorth Carolina | $178.04 | $107.61 |
| North DakotaNorth Dakota | $181.91 | $106.42 |
| NebraskaNebraska | $173.91 | $104.23 |
| New HampshireNew Hampshire | $191.63 | $113.05 |
| Northern New JerseyNew Jersey | $210.67 | $123.11 |
| Rest of New JerseyNew Jersey | $202.47 | $120.04 |
| New MexicoNew Mexico | $183.20 | $113.98 |
| NevadaNevada | $187.14 | $111.58 |
| NYC suburbs and Long Island, NYNew York | $223.13 | $133.37 |
| Poughkeepsie and northern NYC suburbs, NYNew York | $204.52 | $121.86 |
| Queens, NYNew York | $217.44 | $128.21 |
| Rest of New YorkNew York | $180.50 | $108.79 |
| OhioOhio | $180.49 | $111.57 |
| OklahomaOklahoma | $175.72 | $108.31 |
| Portland, OROregon | $198.26 | $114.39 |
| Rest of OregonOregon | $185.08 | $109.90 |
| Metropolitan Philadelphia, PAPennsylvania | $196.85 | $118.26 |
| Rest of PennsylvaniaPennsylvania | $180.23 | $110.93 |
| Rhode IslandRhode Island | $192.51 | $114.53 |
| South CarolinaSouth Carolina | $179.68 | $109.93 |
| South DakotaSouth Dakota | $181.06 | $105.58 |
| TennesseeTennessee | $174.42 | $105.81 |
| Austin, TXTexas | $193.61 | $113.74 |
| Beaumont, TXTexas | $179.24 | $110.54 |
| Brazoria, TXTexas | $186.13 | $111.32 |
| Dallas, TXTexas | $187.64 | $112.46 |
| Fort Worth, TXTexas | $186.80 | $112.37 |
| Galveston, TXTexas | $186.90 | $111.95 |
| Houston, TXTexas | $193.49 | $118.54 |
| Rest of TexasTexas | $182.81 | $111.17 |
| UtahUtah | $181.85 | $110.89 |
| VirginiaVirginia | $183.82 | $109.62 |
| Virgin Islands, VIUnited States Virgin Islands | $189.96 | $113.65 |
| VermontVermont | $182.11 | $107.38 |
| Rest of WashingtonWashington | $192.46 | $112.97 |
| King County, WAWashington | $213.32 | $120.70 |
| WisconsinWisconsin | $176.55 | $104.23 |
| West VirginiaWest Virginia | $181.19 | $115.60 |
| WyomingWyoming | $185.92 | $110.44 |
13153 rates by state
Office rate range in each state. Select a state to see its payment localities.
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
| State / territory | Office rate range | Localities |
|---|---|---|
| AK | $228.86 | 1 |
| AL | $171.39 | 1 |
| AR | $169.18 | 1 |
| AZ | $184.23 | 1 |
| CA | $194.34–$235.99 | 29 |
| CO | $193.72 | 1 |
| CT | $200.79 | 1 |
| DC | $212.31 | 1 |
| DE | $187.03 | 1 |
| FL | $190.72–$211.52 | 3 |
| GA | $180.61–$193.29 | 2 |
| GU | $197.62 | 1 |
| HI | $197.62 | 1 |
| IA | $173.34 | 1 |
| ID | $174.75 | 1 |
| IL | $187.16–$205.66 | 4 |
| IN | $175.60 | 1 |
| KS | $173.53 | 1 |
| KY | $176.98 | 1 |
| LA | $177.10–$184.81 | 2 |
| MA | $193.12–$210.21 | 2 |
| MD | $190.03–$212.31 | 3 |
| ME | $176.54–$183.72 | 2 |
| MI | $181.94–$193.81 | 2 |
| MN | $183.47 | 1 |
| MO | $175.00–$184.30 | 3 |
| MS | $172.08 | 1 |
| MT | $189.03 | 1 |
| NC | $178.04 | 1 |
| ND | $181.91 | 1 |
| NE | $173.91 | 1 |
| NH | $191.63 | 1 |
| NJ | $202.47–$210.67 | 2 |
| NM | $183.20 | 1 |
| NV | $187.14 | 1 |
| NY | $180.50–$223.13 | 5 |
| OH | $180.49 | 1 |
| OK | $175.72 | 1 |
| OR | $185.08–$198.26 | 2 |
| PA | $180.23–$196.85 | 2 |
| PR | $189.96 | 1 |
| RI | $192.51 | 1 |
| SC | $179.68 | 1 |
| SD | $181.06 | 1 |
| TN | $174.42 | 1 |
| TX | $179.24–$193.61 | 8 |
| UT | $181.85 | 1 |
| VA | $183.82–$212.31 | 2 |
| VI | $189.96 | 1 |
| VT | $182.11 | 1 |
| WA | $192.46–$213.32 | 2 |
| WI | $176.55 | 1 |
| WV | $181.19 | 1 |
| WY | $185.92 | 1 |
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.
The exact Puerto Rico 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
91
- Locality
- Puerto Rico
- Physician work
- 1.000
- Practice expense
- 1.011
- Malpractice
- 0.985
| Component | RVU | Locality factor | Adjusted |
|---|---|---|---|
| Physician work | 2.32 | × 1.000 | 2.3200 |
| Practice expense | 2.98 | × 1.011 | 3.0128 |
| Malpractice | 0.36 | × 0.985 | 0.3546 |
| Total RVUs | 5.6874 | ||
| Conversion factor | × 33.4009 | ||
Office rate, Puerto Rico$189.96
Office: (2.32 × 1 + 2.98 × 1.011 + 0.36 × 0.985) × $33.4009 = $189.96
Facility: (2.32 × 1 + 0.72 × 1.011 + 0.36 × 0.985) × $33.4009 = $113.65
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. |
How 13153 has changed in Puerto Rico
13153 · Office / nonfacility
$189.96
Effective 2026-10-01
The base rate is $9.70 higher than on 2025-10-01, moving from $180.26 to $189.96 (5.4%).
It is unchanged from the immediately preceding available release, effective 2026-07-01.
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
January 1, 2026
RVU26A
$180.26changed to$189.96
- 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 1.007 changed to 1.011
- Malpractice GPCI 0.982 changed to 0.985
Held through RVU26B, RVU26C, RVU26D.
January 1, 2025
RVU25A
$184.84changed to$180.26
- 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.
March 9, 2024
RVU24AR
$181.82changed to$184.84
- Conversion factor 32.7442 changed to 33.2875
Held through RVU24B, RVU24C, RVU24D.
January 1, 2024
RVU24A
$188.98changed to$181.82
- 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 1.008 changed to 1.007
- Malpractice GPCI 0.984 changed to 0.982
October 1, 2023
RVU23D
$188.41changed to$188.98
- Practice expense GPCI 1.000 changed to 1.008
- Malpractice GPCI 1.000 changed to 0.984
January 1, 2023
RVU23A
$190.59changed to$188.41
- 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 1.008 changed to 1.000
- Malpractice GPCI 0.986 changed to 1.000
Held through RVU23B, RVU23C.
January 1, 2022
RVU22A
$193.23changed to$190.59
- Conversion factor 34.8931 changed to 34.6062
- Practice expense RVU 2.80 changed to 2.77
Held through RVU22B, RVU22C, RVU22D.
January 1, 2021
RVU21A
$197.33changed to$193.23
- Conversion factor 36.0896 changed to 34.8931
- Practice expense RVU 2.73 changed to 2.80
- Malpractice GPCI 0.988 changed to 0.986
Held through RVU21B, RVU21C, RVU21D.
January 1, 2020
RVU20A
$198.77changed to$197.33
- 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 1.007 changed to 1.008
- Malpractice GPCI 0.990 changed to 0.988
Held through RVU20B, RVU20C, RVU20D.
January 1, 2019
RVU19A
$198.92changed to$198.77
- 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.
January 1, 2018
RVU18AR1
$179.27changed to$198.92
- 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
- Practice expense GPCI 0.856 changed to 1.007
- Malpractice GPCI 0.642 changed to 0.990
Held through RVU18B, RVU18C, RVU18D.
January 1, 2017
RVU17A
$158.62changed to$179.27
- Conversion factor 35.8043 changed to 35.8887
- Practice expense RVU 2.75 changed to 2.77
- Practice expense GPCI 0.705 changed to 0.856
- Malpractice GPCI 0.293 changed to 0.642
Held through RVU17B, RVU17C, RVU17D.
January 1, 2016
RVU16A
$159.23changed to$158.62
- 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.
July 1, 2015
RVU15C
$158.44changed to$159.23
- Conversion factor 35.7547 changed to 35.9335
Held through RVU15D.
January 1, 2015
RVU15A
$156.18changed to$158.44
- Conversion factor 35.8228 changed to 35.7547
- Practice expense RVU 2.72 changed to 2.76
- Practice expense GPCI 0.692 changed to 0.705
- Malpractice GPCI 0.271 changed to 0.293
Held through RVU15B.
January 1, 2014
RVU14A
$153.63changed to$156.18
- 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 0.678 changed to 0.692
- Malpractice GPCI 0.249 changed to 0.271
Held through RVU14B, RVU14C, RVU14D.
January 1, 2013
RVU13AR
Earliest loaded release: $153.63
Held through RVU13B, RVU13C, RVU13D.
| Effective from | Office | Facility | CMS release |
|---|---|---|---|
| 2026-10-01 | $189.96 | $113.65 | RVU26D |
| 2026-07-01 | $189.96 | $113.65 | RVU26C |
| 2026-04-01 | $189.96 | $113.65 | RVU26B |
| 2026-01-01 | $189.96 | $113.65 | RVU26A |
| 2025-10-01 | $180.26 | $132.70 | RVU25D |
| 2025-07-01 | $180.26 | $132.70 | RVU25C |
| 2025-04-01 | $180.26 | $132.70 | RVU25B |
| 2025-01-01 | $180.26 | $132.70 | RVU25A |
| 2024-10-01 | $184.84 | $134.90 | RVU24D |
| 2024-07-01 | $184.84 | $134.90 | RVU24C |
| 2024-04-01 | $184.84 | $134.90 | RVU24B |
| 2024-03-09 | $184.84 | $134.90 | RVU24AR |
| 2024-01-01 | $181.82 | $132.69 | RVU24A |
| 2023-10-01 | $188.98 | $137.40 | RVU23D |
| 2023-07-01 | $188.41 | $137.24 | RVU23C |
| 2023-04-01 | $188.41 | $137.24 | RVU23B |
| 2023-01-01 | $188.41 | $137.24 | RVU23A |
| 2022-10-01 | $190.59 | $138.61 | RVU22D |
| 2022-07-01 | $190.59 | $138.61 | RVU22C |
| 2022-04-01 | $190.59 | $138.61 | RVU22B |
| 2022-01-01 | $190.59 | $138.61 | RVU22A |
| 2021-10-01 | $193.23 | $139.76 | RVU21D |
| 2021-07-01 | $193.23 | $139.76 | RVU21C |
| 2021-04-01 | $193.23 | $139.76 | RVU21B |
| 2021-01-01 | $193.23 | $139.76 | RVU21A |
| 2020-10-01 | $197.33 | $145.31 | RVU20D |
| 2020-07-01 | $197.33 | $145.31 | RVU20C |
| 2020-04-01 | $197.33 | $145.31 | RVU20B |
| 2020-01-01 | $197.33 | $145.31 | RVU20A |
| 2019-10-01 | $198.77 | $146.87 | RVU19D |
| 2019-07-01 | $198.77 | $146.87 | RVU19C |
| 2019-04-01 | $198.77 | $146.87 | RVU19B |
| 2019-01-01 | $198.77 | $146.87 | RVU19A |
| 2018-10-01 | $198.92 | $147.08 | RVU18D |
| 2018-07-01 | $198.92 | $147.08 | RVU18C |
| 2018-04-01 | $198.92 | $147.08 | RVU18B |
| 2018-01-01 | $198.92 | $147.08 | RVU18AR1 |
| 2017-10-01 | $179.27 | $135.34 | RVU17D |
| 2017-07-01 | $179.27 | $135.34 | RVU17C |
| 2017-04-01 | $179.27 | $135.34 | RVU17B |
| 2017-01-01 | $179.27 | $135.34 | RVU17A |
| 2016-10-01 | $158.62 | $122.77 | RVU16D |
| 2016-07-01 | $158.62 | $122.77 | RVU16C |
| 2016-04-01 | $158.62 | $122.77 | RVU16B |
| 2016-01-01 | $158.62 | $122.77 | RVU16A |
| 2015-10-01 | $159.23 | $123.01 | RVU15D |
| 2015-07-01 | $159.23 | $123.01 | RVU15C |
| 2015-04-01 | $158.44 | $122.39 | RVU15B |
| 2015-01-01 | $158.44 | $122.39 | RVU15A |
| 2014-10-01 | $156.18 | $121.72 | RVU14D |
| 2014-07-01 | $156.18 | $121.72 | RVU14C |
| 2014-04-01 | $156.18 | $121.72 | RVU14B |
| 2014-01-01 | $156.18 | $121.72 | RVU14A |
| 2013-10-01 | $153.63 | $116.95 | RVU13D |
| 2013-07-01 | $153.63 | $116.95 | RVU13C |
| 2013-04-01 | $153.63 | $116.95 | RVU13B |
| 2013-01-01 | $153.63 | $116.95 | RVU13AR |
Where the Puerto Rico rate applies
Puerto Rico is a Medicare payment area, not a city. Our Census mapping connects it to 292 cities and communities in Puerto Rico. Some span more than one payment area; confirm with the service ZIP.
- Aceitunas
- Adjuntas
- Aguada
- Aguadilla
- Aguas Buenas
- Aguas Claras
- Aguilita
- Aibonito
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
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