Billing code 13151: Complex repairMedicare rate & RVUs
Report this service for a complex repair of a wound on an eyelid, nose, ear, or lip when the repaired length is 1.1 to 2.5 cm.
Medicare pays $419.18 for 13151 nationally in the office and $233.14 in a hospital or facility. Local office rates run $374.25–$542.42.
Medicare rate · 13151
Complex repair
Swap in your local Medicare rate.
- Work RVUs
- 4.23
- Total RVUs
- 12.55
- Global days
- 010
National rate · 2026
$419.18
Office setting, before claim adjustments.
See every locality for 13151 → · Billed by an NP, PA or therapist? →
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 10 sections
What 13151 covers
This service covers a complex repair of a wound on an eyelid, nose, ear, or lip, with a repaired length of 1.1 to 2.5 cm. It may be performed for a traumatic laceration or another wound requiring work beyond routine layered closure, such as extensive undermining, substantial wound preparation, or scar revision. Surgeons, plastic surgeons, dermatologic surgeons, and emergency clinicians may perform these repairs in office or facility settings.
Choose the code by the wound’s anatomic site, complexity, and repaired length. Document the location, length, wound characteristics, and additional work that supports complex repair. Related postoperative visits during the 10-day global period are included. When multiple procedures are performed in the same session, the highest-valued procedure is paid in full and other procedures are subject to the standard 50% multiple-procedure reduction. Modifier 50 is inappropriate for this code. Medicare does not pay an assistant at surgery, and co-surgery 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.
Where 13151 pays more and less
The same RVUs, adjusted for each area’s costs. Open a locality for its calculation, history and nearby areas.
109 payment localities
$374.25 to $542.42
109 of 109 payment localities
| Payment locality | Office | Facility |
|---|---|---|
| Alabama | $379.28 | $216.50 |
| Alaska* | $499.30 | $301.17 |
| Arizona | $408.68 | $228.40 |
| Arkansas | $374.25 | $214.44 |
| Atlanta | $427.14 | $238.12 |
| Austin | $432.71 | $235.88 |
| Bakersfield | $440.41 | $236.51 |
| Baltimore/Surr. Cntys | $444.47 | $244.84 |
| Beaumont | $394.49 | $225.19 |
| Brazoria | $414.29 | $229.92 |
| Chicago | $443.10 | $256.13 |
| Chico | $438.91 | $235.01 |
| Colorado | $433.94 | $235.99 |
| Connecticut | $445.63 | $245.26 |
| Dallas | $417.04 | $231.74 |
| Dc + Md/Va Suburbs | $475.19 | $256.03 |
| Delaware | $415.07 | $231.26 |
| Detroit | $421.50 | $241.96 |
| East St. Louis | $415.22 | $244.06 |
| El Centro | $438.99 | $235.09 |
| Fort Lauderdale | $436.07 | $247.61 |
| Fort Worth | $414.64 | $231.20 |
| Fresno | $438.91 | $235.01 |
| Galveston | $415.61 | $230.87 |
| Hanford-Corcoran | $438.91 | $235.01 |
| Hawaii, Guam | $447.93 | $236.40 |
| Houston | $424.76 | $240.02 |
| Idaho | $389.48 | $218.32 |
| Indiana | $391.53 | $219.07 |
| Iowa | $386.91 | $216.68 |
| Kansas | $385.82 | $217.64 |
| Kentucky | $388.77 | $223.38 |
| Los Angeles-Long Beach-Anaheim (Los Angeles/Orange Cnty) | $467.16 | $247.07 |
| Madera | $438.91 | $235.01 |
| Manhattan | $480.32 | $264.14 |
| Merced | $438.91 | $235.01 |
| Metropolitan Boston | $473.81 | $251.67 |
| Metropolitan Kansas City | $402.86 | $228.17 |
| Metropolitan Philadelphia | $435.66 | $241.99 |
| Metropolitan St. Louis | $406.68 | $229.56 |
| Miami | $455.43 | $261.75 |
| Minnesota | $415.00 | $223.56 |
| Mississippi | $378.52 | $218.33 |
| Modesto | $438.91 | $235.01 |
| Montana** | $419.15 | $233.10 |
| Napa | $502.93 | $257.72 |
| Nebraska | $388.68 | $216.96 |
| Nevada** | $416.65 | $230.42 |
| New Hampshire | $427.80 | $234.13 |
| New Mexico | $400.86 | $230.26 |
| New Orleans | $406.04 | $230.98 |
| North Carolina | $395.65 | $222.07 |
| North Dakota** | $409.26 | $223.22 |
| Northern Nj | $471.01 | $255.20 |
| Nyc Suburbs/Long Island | $491.90 | $270.70 |
| Ohio | $396.59 | $226.73 |
| Oklahoma | $387.51 | $221.37 |
| Oxnard-Thousand Oaks-Ventura | $464.38 | $244.48 |
| Portland | $446.16 | $239.47 |
| Poughkpsie/N Nyc Suburbs | $453.86 | $250.14 |
| Puerto Rico | $421.80 | $233.71 |
| Queens | $483.14 | $263.24 |
| Redding | $438.91 | $235.01 |
| Rest Of California | $438.91 | $235.01 |
| Rest Of Florida | $416.09 | $238.23 |
| Rest Of Georgia | $394.18 | $228.23 |
| Rest Of Illinois | $405.86 | $236.00 |
| Rest Of Louisiana | $388.44 | $223.79 |
| Rest Of Maine | $391.97 | $220.81 |
| Rest Of Maryland | $422.36 | $234.08 |
| Rest Of Massachusetts | $431.90 | $235.99 |
| Rest Of Michigan | $398.61 | $228.75 |
| Rest Of Missouri | $382.70 | $222.33 |
| Rest Of New Jersey | $450.48 | $247.32 |
| Rest Of New York | $401.16 | $224.42 |
| Rest Of Oregon | $413.18 | $227.88 |
| Rest Of Pennsylvania | $396.84 | $226.06 |
| Rest Of Texas | $404.24 | $227.69 |
| Rest Of Washington | $430.87 | $234.97 |
| Rhode Island | $428.68 | $236.50 |
| Riverside-San Bernardino-Ontario | $444.34 | $240.44 |
| Sacramento-Roseville-Folsom | $459.09 | $242.73 |
| Salinas | $457.34 | $241.72 |
| San Diego-Chula Vista-Carlsbad | $466.97 | $244.46 |
| San Francisco-Oakland-Berkeley (Marin Cnty) | $530.66 | $268.34 |
| San Francisco-Oakland-Berkeley (San Francisco/San Mateo/Alameda/Contra Costa Cnty) | $530.09 | $267.77 |
| San Jose-Sunnyvale-Santa Clara (San Benito Cnty) | $542.42 | $274.15 |
| San Jose-Sunnyvale-Santa Clara (Santa Clara Cnty) | $540.10 | $271.83 |
| San Luis Obispo-Paso Robles | $450.14 | $238.24 |
| Santa Cruz-Watsonville | $470.56 | $244.51 |
| Santa Maria-Santa Barbara | $458.75 | $241.82 |
| Santa Rosa-Petaluma | $475.22 | $246.76 |
| Seattle (King Cnty) | $482.48 | $254.21 |
| South Carolina | $396.83 | $224.92 |
| South Dakota** | $408.09 | $222.05 |
| Southern Maine | $410.67 | $226.30 |
| Stockton | $438.91 | $235.01 |
| Suburban Chicago | $440.12 | $249.05 |
| Tennessee | $387.68 | $218.57 |
| Utah | $401.81 | $226.93 |
| Vallejo | $502.11 | $256.90 |
| Vermont | $408.32 | $224.14 |
| Virgin Islands | $421.80 | $233.71 |
| Virginia | $409.83 | $226.95 |
| Visalia | $438.91 | $235.01 |
| West Virginia | $392.16 | $230.49 |
| Wisconsin | $396.65 | $218.43 |
| Wyoming** | $414.84 | $228.80 |
| Yuba City | $438.91 | $235.01 |
13151 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.
$374.25
$499.30
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 | $499.30 | 1 |
| AL | $379.28 | 1 |
| AR | $374.25 | 1 |
| AZ | $408.68 | 1 |
| CA | $438.91–$542.42 | 29 |
| CO | $433.94 | 1 |
| CT | $445.63 | 1 |
| DC | $475.19 | 1 |
| DE | $415.07 | 1 |
| FL | $416.09–$455.43 | 3 |
| GA | $394.18–$427.14 | 2 |
| GU | $447.93 | 1 |
| HI | $447.93 | 1 |
| IA | $386.91 | 1 |
| ID | $389.48 | 1 |
| IL | $405.86–$443.10 | 4 |
| IN | $391.53 | 1 |
| KS | $385.82 | 1 |
| KY | $388.77 | 1 |
| LA | $388.44–$406.04 | 2 |
| MA | $431.90–$473.81 | 2 |
| MD | $422.36–$475.19 | 3 |
| ME | $391.97–$410.67 | 2 |
| MI | $398.61–$421.50 | 2 |
| MN | $415.00 | 1 |
| MO | $382.70–$406.68 | 3 |
| MS | $378.52 | 1 |
| MT | $419.15 | 1 |
| NC | $395.65 | 1 |
| ND | $409.26 | 1 |
| NE | $388.68 | 1 |
| NH | $427.80 | 1 |
| NJ | $450.48–$471.01 | 2 |
| NM | $400.86 | 1 |
| NV | $416.65 | 1 |
| NY | $401.16–$491.90 | 5 |
| OH | $396.59 | 1 |
| OK | $387.51 | 1 |
| OR | $413.18–$446.16 | 2 |
| PA | $396.84–$435.66 | 2 |
| PR | $421.80 | 1 |
| RI | $428.68 | 1 |
| SC | $396.83 | 1 |
| SD | $408.09 | 1 |
| TN | $387.68 | 1 |
| TX | $394.49–$432.71 | 8 |
| UT | $401.81 | 1 |
| VA | $409.83–$475.19 | 2 |
| VI | $421.80 | 1 |
| VT | $408.32 | 1 |
| WA | $430.87–$482.48 | 2 |
| WI | $396.65 | 1 |
| WV | $392.16 | 1 |
| WY | $414.84 | 1 |
How the 13151 rate is calculated
Each of 13151’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 · 13151
RVUs × geographic indexes × conversion factor
Swap in your local Medicare rate.
Work 4.23Practice expense 7.82Malpractice 0.50
All indexes start at 1.000 (the national rate). Enter a ZIP or drag a slider.
Payment rules and modifiers for 13151
13151 has a 10-day global period: related visits in that window are included in the surgery payment.
CMS payment indicators · 13151
Complex repair
| Rule | CMS value | What it means |
|---|---|---|
| Global period | 010 | Minor procedure: the day of the procedure plus 10 days after are included. |
| Multiple procedures | 2 | Standard reduction: highest-valued procedure at 100%, others at 50%. |
| 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. |
| Split (54/55/56) | 0.10/0.80/0.10 | Share of the payment for pre-op, the procedure itself, and post-op care. |
Global surgery period · 13151
Complex repair
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.
What modifiers do to the payment
Modifier 51 · payment effect
With and without the modifier
13151 without 51 · national office
$419.18
Complex repair
13151-51 · Second procedure: 50%
$209.59
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%).
13151 compared with similar codes
Compare codes
13151 vs 13152 vs 12051 vs 12011: national Medicare rates
Swap in your local Medicare rate.
How to choose
- 13152Complex repair
- This code applies to repaired lengths of 1.1 to 2.5 cm. Use 13152 for the same anatomic group when the repaired length is 2.6 to 7.5 cm.
- 12051Facial repair
- Both cover repairs in the same general anatomic group, but 12051 is for intermediate repair. Choose 13151 only when the wound and repair work meet complex-repair criteria.
- 12011Wound repair
- This code is for simple repair of a short wound in the same general anatomic group. It does not represent the additional work required for complex repair.
13151 billing questions
How is this code distinguished from 13152?
Both describe complex repair in the same anatomic group. Use 13151 for a repaired length of 1.1 to 2.5 cm; 13152 covers the next length range, 2.6 to 7.5 cm.
When is 13151 appropriate instead of 12051?
Use 13151 when the repair meets the criteria for complex repair. Code 12051 is for an intermediate repair in the same general anatomic group, not a complex repair.
What wound details should the record include?
Document the specific site, repaired length, and wound features or repair work supporting complexity, such as extensive undermining or substantial wound preparation.
Can 13153 be reported with 13151?
13153 is the add-on code for each additional length increment beyond the initial repair range. Report it with the appropriate primary complex-repair code when the documented total repaired length supports it.
Can modifier 50 or an assistant-at-surgery claim be used?
Modifier 50 is inappropriate for this code. Medicare does not pay an assistant at surgery for this service.
Are related postoperative visits separately reported?
Related postoperative visits during the 10-day global period are included in the procedure payment.
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
Fee sheets
Put 13151 and the rest of your codes on one sheet
Build a fee sheet from your own code list at your locality, put your payer contracts beside Medicare, and see what changed each quarter.
Build my fee sheetOr price your code list free →