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.
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.
13152 reports the primary complex repair for its longer base length in this anatomic group. Use 13153 for each qualifying additional segment.
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 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
Modesto · This locality
$194.34
$195.38
$1.04 higher than Modesto
$194.34
The same base rate than Modesto
$194.40
$0.06 higher than Modesto
$194.34
The same base rate than Modesto
$194.34
The same base rate than Modesto
$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 / territory | 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 |
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.
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.
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
| Component | RVU | Locality factor | Adjusted |
|---|---|---|---|
| Physician work | 2.32 | × 1.017 | 2.3594 |
| Practice expense | 2.98 | × 1.096 | 3.2661 |
| Malpractice | 0.36 | × 0.536 | 0.1930 |
| Total RVUs | 5.8185 | ||
| Conversion factor | × 33.4009 | ||
Office / nonfacility rate, Modesto$194.34
Open 13153 in the RVU calculator →
Explore RVUs, geographic factors and the full formula
Office / nonfacility
| Component | RVU | Local GPCI |
|---|---|---|
| Work | 2.32 | 1.017 |
| Practice expense | 2.98 | 1.096 |
| Malpractice | 0.36 | 0.536 |
(2.32 × 1.017 + 2.98 × 1.096 + 0.36 × 0.536) × $33.4009 = $194.34
Facility
| Component | RVU | Local GPCI |
|---|---|---|
| Work | 2.32 | 1.017 |
| Practice expense | 0.72 | 1.096 |
| Malpractice | 0.36 | 0.536 |
(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.
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
$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.
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
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.
