$388.77
Use 13151 for a qualifying complex eyelid, nose, ear, or lip repair measuring 1.1 to 2.5 cm; 13152 covers 2.6 to 7.5 cm.
On this page
CMS RVU26D · Effective 2026-10-01
13152 Complex repair Medicare reimbursement rates in Kentucky
Reports complex closure of a qualifying eyelid, nose, ear, or lip wound when the repaired length is 2.6 to 7.5 cm. Compare 13152 office and facility rates across CMS payment localities in Kentucky.
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.
What does Medicare pay for 13152 in Kentucky?
Kentucky has 1 payment locality in this comparison. Use the service location to choose the applicable amount. These are the supported base rates for the payment area shown below, using the same CMS release.
Office / nonfacility
$456.04
1 of 1 localities have a supported rate.
Payment area: Kentucky
One mapped payment locality.
Facility setting
$267.49
1 of 1 localities have a supported rate.
Payment area: Kentucky
One mapped payment locality.
These are locality ranges, not averages or address-specific quotes. A facility-setting amount covers the physician service; it does not include a hospital’s separate bill. Choose a locality below to inspect its calculation, compare other payment areas, or price a percentage of Medicare.
Wound repair
About 13152: Complex eyelid, nose, ear, or lip repair
Reports complex closure of a qualifying eyelid, nose, ear, or lip wound when the repaired length is 2.6 to 7.5 cm.
This code covers complex closure of a qualifying wound on an eyelid, nose, ear, or lip, such as a traumatic laceration or a defect after lesion removal. The repair involves more than a routine layered closure, for example because extensive undermining or another complexity is required. Plastic surgeons, facial plastic surgeons, otolaryngologists, and dermatologic surgeons may perform these repairs in office or facility settings.
Select the code by the repair’s anatomic site, complexity, and final repaired length; this level covers 2.6 to 7.5 cm. Document the specific site, length, closure performed, and the features that make the repair complex. The 10-day global period includes related postoperative visits during that period. When multiple procedures are performed in the same session, the highest-valued procedure is paid in full and others are subject to the standard 50% reduction. Modifier 50 is inappropriate. Medicare does not pay an assistant at surgery, and co-surgeons and team surgery are not permitted.
CMS billing rules for 13152
- Global period
- Minor procedure with a 10-day global period: related postoperative visits for 10 days are included.
- Multiple procedures
- Standard multiple procedure reduction: the highest-valued procedure is paid in full and others at 50% when performed in the same session.
- Bilateral procedures
- Bilateral adjustment does not apply; the descriptor or anatomy makes modifier 50 inappropriate.
- Assistant at surgery
- Statutory restriction: assistant at surgery is not paid.
- Co-surgeons
- Co-surgeons not permitted.
- Team surgery
- Team surgery not permitted.
Where the value comes from
- Work RVU5.21 · 35%
- Practice expense (office) RVU8.87 · 60%
- Malpractice RVU0.61 · 4%
52.1K
Medicare services in 2024 · #764 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.
13152 compared with similar codes
Office rates for Kentucky, from the same CMS release.
$428.68
13132 covers the 2.6-to-7.5-cm level for a different group of sites, including the forehead, cheeks, chin, mouth, and neck. Select by the repair site, not length alone.
$176.98
13153 reports additional qualifying repair length in 5-cm-or-less increments; it is an add-on, not the primary code for the 2.6-to-7.5-cm segment.
No office rate
13160 concerns secondary closure of a surgical wound or dehiscence. 13152 is for a qualifying complex repair of an eyelid, nose, ear, or lip wound.
Compare 13152 by payment locality
Find the payment area for your service address, then open its rate page for calculation inputs, release history and the percentage-of-Medicare tool. A city may cross payment-area boundaries; the ZIP lookup above helps resolve the location.
1 of 1 payment localities
Kentucky →
Office / nonfacility
$456.04
Facility
$267.49
Need rates for a whole code list?
Fee-sheet and API access are in early access. Tell us which codes and locations your team needs.
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 13152 in Kentucky.
PPRRVU2026_Oct_nonQPP.csv
1,443
- Code
- 13152
- Physician work
- 5.21
- Practice expense
- 8.87
- Malpractice
- 0.61
GPCI2026.csv
55
- Locality
- Kentucky
- Physician work
- 1.000
- Practice expense
- 0.889
- Malpractice
- 0.915
| Component | RVU | Locality factor | Adjusted |
|---|---|---|---|
| Physician work | 5.21 | × 1.000 | 5.2100 |
| Practice expense | 8.87 | × 0.889 | 7.8854 |
| Malpractice | 0.61 | × 0.915 | 0.5582 |
| Total RVUs | 13.6536 | ||
| Conversion factor | × 33.4009 | ||
Office / nonfacility rate, Kentucky$456.04
Explore RVUs, geographic factors and the full formula
Office / nonfacility
| Component | RVU | Local GPCI |
|---|---|---|
| Work | 5.21 | 1 |
| Practice expense | 8.87 | 0.889 |
| Malpractice | 0.61 | 0.915 |
(5.21 × 1 + 8.87 × 0.889 + 0.61 × 0.915) × $33.4009 = $456.04
Facility
| Component | RVU | Local GPCI |
|---|---|---|
| Work | 5.21 | 1 |
| Practice expense | 2.52 | 0.889 |
| Malpractice | 0.61 | 0.915 |
(5.21 × 1 + 2.52 × 0.889 + 0.61 × 0.915) × $33.4009 = $267.49
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.
13152 billing questions
How is 13152 distinguished from 13151?
Both cover complex repairs in the eyelid, nose, ear, or lip area. Choose 13152 for a repaired length of 2.6 to 7.5 cm; 13151 covers 1.1 to 2.5 cm.
Can 13153 be reported with 13152?
Yes. 13153 is the add-on code for each additional 5 cm or less of qualifying complex repair length beyond the primary-code range.
What documentation supports reporting a complex repair?
Record the exact anatomic site, final repaired length, closure details, and the specific features that made the work more complex than routine layered closure.
Can modifier 50 be used for repairs on both sides?
No. The CMS bilateral adjustment does not apply to this code, and modifier 50 is inappropriate.
Are related postoperative visits separately included in payment?
Related postoperative visits during the 10-day global period are included.
Can an assistant or co-surgeon be reported?
Medicare does not pay an assistant at surgery for this code. Co-surgeons and team surgery are not permitted.
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.
1,44013132,,Cmplx rpr f/c/c/m/n/ax/g/h/f,A,,4.66,8.67,,2.35,,0.51,13.84,7.52,0,010,0.10,0.80,0.10,2,0,1,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
1,44113133,,Cmplx rpr f/c/c/m/n/ax/g/h/f,A,,2.14,2.62,,0.65,,0.27,5.03,3.06,0,ZZZ,0.00,0.00,0.00,0,0,1,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
1,44213151,,Cmplx rpr e/n/e/l 1.1-2.5 cm,A,,4.23,7.82,,2.25,,0.50,12.55,6.98,0,010,0.10,0.80,0.10,2,0,1,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
1,44313152,,Cmplx rpr e/n/e/l 2.6-7.5 cm,A,,5.21,8.87,,2.52,,0.61,14.69,8.34,0,010,0.10,0.80,0.10,2,0,1,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
1,44413153,,Cmplx rpr e/n/e/l addl 5cm/<,A,,2.32,2.98,,0.72,,0.36,5.66,3.40,0,ZZZ,0.00,0.00,0.00,0,0,1,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
1,44513160,,Sec clsr surg wnd/dehsn xtn,A,,11.74,8.34,NA,8.34,,2.10,22.18,22.18,0,090,0.10,0.71,0.19,2,0,1,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
1,44614000,,Tis trnfr trunk 10 sq cm/<,A,,6.21,12.68,,6.63,,1.09,19.98,13.93,0,090,0.10,0.71,0.19,2,0,1,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
5208102,IN,00,INDIANA,1.000,0.927,0.486
5305102,IA,00,IOWA,1.000,0.915,0.397
5405202,KS,00,KANSAS,1.000,0.904,0.504
5515102,KY,00,KENTUCKY,1.000,0.889,0.915
5607202,LA,01,NEW ORLEANS,1.000,0.941,1.136
5707202,LA,99,REST OF LOUISIANA,1.000,0.885,0.958
5814112,ME,03,SOUTHERN MAINE,1.000,0.991,0.631