On this page

CMS RVU26D · Effective 2026-10-01

13153 in Modesto

Office / nonfacility

$194.34

Base rate per service

Facility setting

$111.61

Base rate per service

Amounts below use the non-QP conversion factor for participating physicians. These are base physician payments before claim-level adjustments, not patient costs or total hospital charges.

Complex wound repair

About 13153: Complex eyelid, nose, ear, or lip repair, additional length

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

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.

CMS billing rules for 13153

Global period
Add-on code: billed only together with a primary procedure and paid within that procedure's global period.

Where the value comes from

  • Work RVU2.32 · 41%
  • Practice expense (office) RVU2.98 · 53%
  • Malpractice RVU0.36 · 6%

695

Medicare services in 2024 · #3267 by national volume

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.

13153 compared with similar codes

Office rates for Modesto, from the same CMS release.

13151

Complex repair

Eyelid, nose, ear, or lip

$438.91

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.

13152

Complex repair

Eyelid, nose, ear, or lip

$512.61

13152 reports the primary complex repair for its longer base length in this anatomic group. Use 13153 for each qualifying additional segment.

13133

Complex repair

Each additional 5 cm or less

$173.44

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.

13102

Complex repair

Additional trunk length

$124.85

13102 covers additional complex-repair length for the trunk, not the eyelid, nose, ear, or lip group.

The same code, a different location

How does Modesto compare?

In Bakersfield, the office rate for 13153 is $195.38—$1.04 higher than the $194.34 rate in Modesto. Both use the same code, release and participation basis.

13153 across payment areas

Same release and payment basis · bars start at $0

  1. Modesto · This locality

    $194.34

  2. $1.04 higher than Modesto

  3. Chico

    $194.34

    The same base rate than Modesto

  4. El Centro

    $194.40

    $0.06 higher than Modesto

  5. Fresno

    $194.34

    The same base rate than Modesto

  6. The same base rate than Modesto

  7. $12.06 higher than Modesto

Other payment areas listed in California appear first, followed by selected cross-country examples. The chart compares amounts, not distance.

Across 109 of 109 CMS payment localities with a supported office rate, 13153 ranges from $169.18 in Arkansas to $235.99 in San Jose-Sunnyvale-Santa Clara (San Benito Cnty). This is a geographic range, not an average.

The code’s RVUs stay the same in these comparisons. Geographic adjustments to work, practice expense and malpractice change the dollar amount. A city name alone may not identify the payment area for a service address.

Compare all 108 other payment areas
  • Madera

    California · 13153

    Office

    $194.34

    Facility

    $111.61

    The same base rate than Modesto for the office setting.

  • Merced

    California · 13153

    Office

    $194.34

    Facility

    $111.61

    The same base rate than Modesto for the office setting.

  • Napa

    California · 13153

    Office

    $219.67

    Facility

    $120.18

    $25.33 higher than Modesto for the office setting.

  • Oxnard-Thousand Oaks-Ventura

    California · 13153

    Office

    $204.80

    Facility

    $115.58

    $10.46 higher than Modesto for the office setting.

  • Redding

    California · 13153

    Office

    $194.34

    Facility

    $111.61

    The same base rate than Modesto for the office setting.

  • Rest Of California

    California · 13153

    Office

    $194.34

    Facility

    $111.61

    The same base rate than Modesto for the office setting.

  • Riverside-San Bernardino-Ontario

    California · 13153

    Office

    $198.23

    Facility

    $115.50

    $3.89 higher than Modesto for the office setting.

  • Sacramento-Roseville-Folsom

    California · 13153

    Office

    $202.48

    Facility

    $114.69

    $8.14 higher than Modesto for the office setting.

  • Salinas

    California · 13153

    Office

    $201.70

    Facility

    $114.21

    $7.36 higher than Modesto for the office setting.

  • San Diego-Chula Vista-Carlsbad

    California · 13153

    Office

    $205.38

    Facility

    $115.09

    $11.04 higher than Modesto for the office setting.

  • San Francisco-Oakland-Berkeley (Marin Cnty)

    California · 13153

    Office

    $230.71

    Facility

    $124.28

    $36.37 higher than Modesto for the office setting.

  • San Francisco-Oakland-Berkeley (San Francisco/San Mateo/Alameda/Contra Costa Cnty)

    California · 13153

    Office

    $230.31

    Facility

    $123.87

    $35.97 higher than Modesto for the office setting.

  • San Jose-Sunnyvale-Santa Clara (San Benito Cnty)

    California · 13153

    Office

    $235.99

    Facility

    $127.14

    $41.65 higher than Modesto for the office setting.

  • San Jose-Sunnyvale-Santa Clara (Santa Clara Cnty)

    California · 13153

    Office

    $234.32

    Facility

    $125.47

    $39.98 higher than Modesto for the office setting.

  • San Luis Obispo-Paso Robles

    California · 13153

    Office

    $198.62

    Facility

    $112.64

    $4.28 higher than Modesto for the office setting.

  • Santa Cruz-Watsonville

    California · 13153

    Office

    $206.50

    Facility

    $114.78

    $12.16 higher than Modesto for the office setting.

  • Santa Maria-Santa Barbara

    California · 13153

    Office

    $202.16

    Facility

    $114.15

    $7.82 higher than Modesto for the office setting.

  • Santa Rosa-Petaluma

    California · 13153

    Office

    $208.49

    Facility

    $115.79

    $14.15 higher than Modesto for the office setting.

  • Stockton

    California · 13153

    Office

    $194.34

    Facility

    $111.61

    The same base rate than Modesto for the office setting.

  • Vallejo

    California · 13153

    Office

    $219.08

    Facility

    $119.59

    $24.74 higher than Modesto for the office setting.

  • Visalia

    California · 13153

    Office

    $194.34

    Facility

    $111.61

    The same base rate than Modesto for the office setting.

  • Yuba City

    California · 13153

    Office

    $194.34

    Facility

    $111.61

    The same base rate than Modesto for the office setting.

  • Dc + Md/Va Suburbs

    District of Columbia · 13153

    Office

    $212.31

    Facility

    $123.39

    $17.97 higher than Modesto for the office setting.

  • Miami

    Florida · 13153

    Office

    $211.52

    Facility

    $132.93

    $17.18 higher than Modesto for the office setting.

  • Chicago

    Illinois · 13153

    Office

    $205.66

    Facility

    $129.80

    $11.32 higher than Modesto for the office setting.

  • Manhattan

    New York · 13153

    Office

    $217.18

    Facility

    $129.46

    $22.84 higher than Modesto for the office setting.

  • Alaska*

    Alaska · 13153

    Office

    $228.86

    Facility

    $148.47

    $34.52 higher than Modesto for the office setting.

  • Alabama

    Alabama · 13153

    Office

    $171.39

    Facility

    $105.34

    $22.95 lower than Modesto for the office setting.

  • Arkansas

    Arkansas · 13153

    Office

    $169.18

    Facility

    $104.34

    $25.16 lower than Modesto for the office setting.

  • Arizona

    Arizona · 13153

    Office

    $184.23

    Facility

    $111.09

    $10.11 lower than Modesto for the office setting.

  • Colorado

    Colorado · 13153

    Office

    $193.72

    Facility

    $113.40

    $0.62 lower than Modesto for the office setting.

  • Connecticut

    Connecticut · 13153

    Office

    $200.79

    Facility

    $119.49

    $6.45 higher than Modesto for the office setting.

  • Delaware

    Delaware · 13153

    Office

    $187.03

    Facility

    $112.45

    $7.31 lower than Modesto for the office setting.

  • Fort Lauderdale

    Florida · 13153

    Office

    $200.06

    Facility

    $123.59

    $5.72 higher than Modesto for the office setting.

  • Rest Of Florida

    Florida · 13153

    Office

    $190.72

    Facility

    $118.55

    $3.62 lower than Modesto for the office setting.

  • Atlanta

    Georgia · 13153

    Office

    $193.29

    Facility

    $116.60

    $1.05 lower than Modesto for the office setting.

  • Rest Of Georgia

    Georgia · 13153

    Office

    $180.61

    Facility

    $113.27

    $13.73 lower than Modesto for the office setting.

  • Hawaii, Guam

    Hawaii · 13153

    Office

    $197.62

    Facility

    $111.80

    $3.28 higher than Modesto for the office setting.

  • Iowa

    Iowa · 13153

    Office

    $173.34

    Facility

    $104.27

    $21.00 lower than Modesto for the office setting.

  • Idaho

    Idaho · 13153

    Office

    $174.75

    Facility

    $105.30

    $19.59 lower than Modesto for the office setting.

  • East St. Louis

    Illinois · 13153

    Office

    $193.28

    Facility

    $123.83

    $1.06 lower than Modesto for the office setting.

  • Rest Of Illinois

    Illinois · 13153

    Office

    $187.16

    Facility

    $118.24

    $7.18 lower than Modesto for the office setting.

  • Suburban Chicago

    Illinois · 13153

    Office

    $201.56

    Facility

    $124.04

    $7.22 higher than Modesto for the office setting.

  • Indiana

    Indiana · 13153

    Office

    $175.60

    Facility

    $105.63

    $18.74 lower than Modesto for the office setting.

  • Kansas

    Kansas · 13153

    Office

    $173.53

    Facility

    $105.29

    $20.81 lower than Modesto for the office setting.

  • Kentucky

    Kentucky · 13153

    Office

    $176.98

    Facility

    $109.87

    $17.36 lower than Modesto for the office setting.

  • New Orleans

    Louisiana · 13153

    Office

    $184.81

    Facility

    $113.78

    $9.53 lower than Modesto for the office setting.

  • Rest Of Louisiana

    Louisiana · 13153

    Office

    $177.10

    Facility

    $110.29

    $17.24 lower than Modesto for the office setting.

  • Metropolitan Boston

    Massachusetts · 13153

    Office

    $210.21

    Facility

    $120.08

    $15.87 higher than Modesto for the office setting.

  • Rest Of Massachusetts

    Massachusetts · 13153

    Office

    $193.12

    Facility

    $113.64

    $1.22 lower than Modesto for the office setting.

  • Baltimore/Surr. Cntys

    Maryland · 13153

    Office

    $200.40

    Facility

    $119.41

    $6.06 higher than Modesto for the office setting.

  • Rest Of Maryland

    Maryland · 13153

    Office

    $190.03

    Facility

    $113.64

    $4.31 lower than Modesto for the office setting.

  • Rest Of Maine

    Maine · 13153

    Office

    $176.54

    Facility

    $107.09

    $17.80 lower than Modesto for the office setting.

  • Southern Maine

    Maine · 13153

    Office

    $183.72

    Facility

    $108.91

    $10.62 lower than Modesto for the office setting.

  • Detroit

    Michigan · 13153

    Office

    $193.81

    Facility

    $120.97

    $0.53 lower than Modesto for the office setting.

  • Rest Of Michigan

    Michigan · 13153

    Office

    $181.94

    Facility

    $113.02

    $12.40 lower than Modesto for the office setting.

  • Minnesota

    Minnesota · 13153

    Office

    $183.47

    Facility

    $105.80

    $10.87 lower than Modesto for the office setting.

  • Metropolitan Kansas City

    Missouri · 13153

    Office

    $182.70

    Facility

    $111.82

    $11.64 lower than Modesto for the office setting.

  • Metropolitan St. Louis

    Missouri · 13153

    Office

    $184.30

    Facility

    $112.43

    $10.04 lower than Modesto for the office setting.

  • Rest Of Missouri

    Missouri · 13153

    Office

    $175.00

    Facility

    $109.93

    $19.34 lower than Modesto for the office setting.

  • Mississippi

    Mississippi · 13153

    Office

    $172.08

    Facility

    $107.08

    $22.26 lower than Modesto for the office setting.

  • Montana**

    Montana · 13153

    Office

    $189.03

    Facility

    $113.54

    $5.31 lower than Modesto for the office setting.

  • North Carolina

    North Carolina · 13153

    Office

    $178.04

    Facility

    $107.61

    $16.30 lower than Modesto for the office setting.

  • North Dakota**

    North Dakota · 13153

    Office

    $181.91

    Facility

    $106.42

    $12.43 lower than Modesto for the office setting.

  • Nebraska

    Nebraska · 13153

    Office

    $173.91

    Facility

    $104.23

    $20.43 lower than Modesto for the office setting.

  • New Hampshire

    New Hampshire · 13153

    Office

    $191.63

    Facility

    $113.05

    $2.71 lower than Modesto for the office setting.

  • Northern Nj

    New Jersey · 13153

    Office

    $210.67

    Facility

    $123.11

    $16.33 higher than Modesto for the office setting.

  • Rest Of New Jersey

    New Jersey · 13153

    Office

    $202.47

    Facility

    $120.04

    $8.13 higher than Modesto for the office setting.

  • New Mexico

    New Mexico · 13153

    Office

    $183.20

    Facility

    $113.98

    $11.14 lower than Modesto for the office setting.

  • Nevada**

    Nevada · 13153

    Office

    $187.14

    Facility

    $111.58

    $7.20 lower than Modesto for the office setting.

  • Nyc Suburbs/Long Island

    New York · 13153

    Office

    $223.13

    Facility

    $133.37

    $28.79 higher than Modesto for the office setting.

  • Poughkpsie/N Nyc Suburbs

    New York · 13153

    Office

    $204.52

    Facility

    $121.86

    $10.18 higher than Modesto for the office setting.

  • Queens

    New York · 13153

    Office

    $217.44

    Facility

    $128.21

    $23.10 higher than Modesto for the office setting.

  • Rest Of New York

    New York · 13153

    Office

    $180.50

    Facility

    $108.79

    $13.84 lower than Modesto for the office setting.

  • Ohio

    Ohio · 13153

    Office

    $180.49

    Facility

    $111.57

    $13.85 lower than Modesto for the office setting.

  • Oklahoma

    Oklahoma · 13153

    Office

    $175.72

    Facility

    $108.31

    $18.62 lower than Modesto for the office setting.

  • Portland

    Oregon · 13153

    Office

    $198.26

    Facility

    $114.39

    $3.92 higher than Modesto for the office setting.

  • Rest Of Oregon

    Oregon · 13153

    Office

    $185.08

    Facility

    $109.90

    $9.26 lower than Modesto for the office setting.

  • Metropolitan Philadelphia

    Pennsylvania · 13153

    Office

    $196.85

    Facility

    $118.26

    $2.51 higher than Modesto for the office setting.

  • Rest Of Pennsylvania

    Pennsylvania · 13153

    Office

    $180.23

    Facility

    $110.93

    $14.11 lower than Modesto for the office setting.

  • Puerto Rico

    Puerto Rico · 13153

    Office

    $189.96

    Facility

    $113.65

    $4.38 lower than Modesto for the office setting.

  • Rhode Island

    Rhode Island · 13153

    Office

    $192.51

    Facility

    $114.53

    $1.83 lower than Modesto for the office setting.

  • South Carolina

    South Carolina · 13153

    Office

    $179.68

    Facility

    $109.93

    $14.66 lower than Modesto for the office setting.

  • South Dakota**

    South Dakota · 13153

    Office

    $181.06

    Facility

    $105.58

    $13.28 lower than Modesto for the office setting.

  • Tennessee

    Tennessee · 13153

    Office

    $174.42

    Facility

    $105.81

    $19.92 lower than Modesto for the office setting.

  • Austin

    Texas · 13153

    Office

    $193.61

    Facility

    $113.74

    $0.73 lower than Modesto for the office setting.

  • Beaumont

    Texas · 13153

    Office

    $179.24

    Facility

    $110.54

    $15.10 lower than Modesto for the office setting.

  • Brazoria

    Texas · 13153

    Office

    $186.13

    Facility

    $111.32

    $8.21 lower than Modesto for the office setting.

  • Dallas

    Texas · 13153

    Office

    $187.64

    Facility

    $112.46

    $6.70 lower than Modesto for the office setting.

  • Fort Worth

    Texas · 13153

    Office

    $186.80

    Facility

    $112.37

    $7.54 lower than Modesto for the office setting.

  • Galveston

    Texas · 13153

    Office

    $186.90

    Facility

    $111.95

    $7.44 lower than Modesto for the office setting.

  • Houston

    Texas · 13153

    Office

    $193.49

    Facility

    $118.54

    $0.85 lower than Modesto for the office setting.

  • Rest Of Texas

    Texas · 13153

    Office

    $182.81

    Facility

    $111.17

    $11.53 lower than Modesto for the office setting.

  • Utah

    Utah · 13153

    Office

    $181.85

    Facility

    $110.89

    $12.49 lower than Modesto for the office setting.

  • Virginia

    Virginia · 13153

    Office

    $183.82

    Facility

    $109.62

    $10.52 lower than Modesto for the office setting.

  • Virgin Islands

    United States Virgin Islands · 13153

    Office

    $189.96

    Facility

    $113.65

    $4.38 lower than Modesto for the office setting.

  • Vermont

    Vermont · 13153

    Office

    $182.11

    Facility

    $107.38

    $12.23 lower than Modesto for the office setting.

  • Rest Of Washington

    Washington · 13153

    Office

    $192.46

    Facility

    $112.97

    $1.88 lower than Modesto for the office setting.

  • Seattle (King Cnty)

    Washington · 13153

    Office

    $213.32

    Facility

    $120.70

    $18.98 higher than Modesto for the office setting.

  • Wisconsin

    Wisconsin · 13153

    Office

    $176.55

    Facility

    $104.23

    $17.79 lower than Modesto for the office setting.

  • West Virginia

    West Virginia · 13153

    Office

    $181.19

    Facility

    $115.60

    $13.15 lower than Modesto for the office setting.

  • Wyoming**

    Wyoming · 13153

    Office

    $185.92

    Facility

    $110.44

    $8.42 lower than Modesto for the office setting.

See how rates vary across the country

13153 · Office / nonfacility · Non-QP. Choose a state to explore its payment localities. A range means the amount varies within that state.

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 all state and territory rates as a table
State / territoryRate 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

Explore 13153 on the national rate map →

Where does this rate apply?

Modesto is a Medicare payment area. Our Census mapping connects it to 33 cities and communities in California, including the examples shown here.

Some communities span more than one payment area. Follow a city link to compare all of its mapped areas, or check the service-location ZIP above for an address-level starting point.

Why are the office and facility amounts different?

For 13153 in Modesto, the physician’s office rate is $194.34 and the facility-setting rate is $111.61: a difference of $82.73.

The calculation uses a different practice-expense RVU for each setting. Both amounts here are physician fee-schedule amounts. The facility figure does not include a hospital’s separate charges, so this comparison does not tell you the total cost of receiving care in each setting.

See the inputs behind this difference →

Use this rate

What is a percentage of Medicare worth?

Turn a percentage into dollars for 13153 in Modesto. This uses the base rate on this page, so the locality and release stay consistent.

Reference amount per service

$213.77

$194.34 × 110% = $213.77

A contract may specify another Medicare year or additional adjustments. This is percentage arithmetic on the displayed base rate, not a claim adjudication.

Working with a whole code list?

Compare an offer across your annual code mix, including an older Medicare schedule or flat per-code rates.

Compare your contract offer →

How this local rate is calculated

Each RVU component is multiplied by its own geographic practice cost index (GPCI). The three adjusted components are added, then multiplied by the conversion factor. These are the inputs used for 13153 in Modesto.

PPRRVU2026_Oct_nonQPP.csv

1,444

Code
13153
Physician work
2.32
Practice expense
2.98
Malpractice
0.36

GPCI2026.csv

16

Locality
Modesto
Physician work
1.017
Practice expense
1.096
Malpractice
0.536
Office / nonfacility calculation for 13153 in Modesto
ComponentRVULocality factorAdjusted
Physician work2.32× 1.0172.3594
Practice expense2.98× 1.0963.2661
Malpractice0.36× 0.5360.1930
Total RVUs5.8185
Conversion factor× 33.4009

Office / nonfacility rate, Modesto$194.34

Values as parsed from CMS release RVU26D, effective 2026-10-01. The amount is rounded to the nearest cent only at the end.

Open 13153 in the RVU calculator →

Explore RVUs, geographic factors and the full formula

Office / nonfacility

Office / nonfacility calculation inputs
ComponentRVULocal GPCI
Work2.321.017
Practice expense2.981.096
Malpractice0.360.536

(2.32 × 1.017 + 2.98 × 1.096 + 0.36 × 0.536) × $33.4009 = $194.34

Facility

Facility calculation inputs
ComponentRVULocal GPCI
Work2.321.017
Practice expense0.721.096
Malpractice0.360.536

(2.32 × 1.017 + 0.72 × 1.096 + 0.36 × 0.536) × $33.4009 = $111.61

The office and facility calculations use their respective practice-expense RVUs. The facility amount here is the physician fee, not a separate hospital or facility bill.

How this rate has changed

13153 · Office / nonfacility

$194.34

Effective 2026-10-01

The base rate is $10.40 higher than on 2025-10-01, moving from $183.94 to $194.34 (5.7%).

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

    $183.94changed to$194.34

    • 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 1.014 changed to 1.017
    • Practice expense GPCI 1.093 changed to 1.096
    • Malpractice GPCI 0.560 changed to 0.536

    Held through RVU26B, RVU26C, RVU26D.

  2. January 1, 2025

    RVU25A

    Earliest loaded release: $183.94

    Held through RVU25B, RVU25C, RVU25D.

Explore release dates and calculate this code in an earlier period →

Each row uses the accepted CMS release effective on that date and the same contractor and locality identifiers. Missing rates stay visible. Historical boundaries may differ; verify the service address for an older claim.

Inspect every release and its CMS source
Effective fromOffice / nonfacilityFacilityCMS release
2026-10-01$194.34$111.61RVU26D
2026-07-01$194.34$111.61RVU26C
2026-04-01$194.34$111.61RVU26B
2026-01-01$194.34$111.61RVU26A
2025-10-01$183.94$132.32RVU25D
2025-07-01$183.94$132.32RVU25C
2025-04-01$183.94$132.32RVU25B
2025-01-01$183.94$132.32RVU25A

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 indices and the applicable conversion factor. Unavailable or separately priced services are labeled rather than assigned a made-up amount.

Source: RVU26D. Effective 2026-10-01 through the day before 2027-01-01.

RVUs for 13153PPRRVU2026_Oct_nonQPP.csv, line 1,444 (RVU26D)
Geographic factors for ModestoGPCI2026.csv, line 16 (RVU26D)