$396.65
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 Complex repair Medicare reimbursement rates in Wisconsin
Reports each additional 5 cm or less of complex closure for eyelid, nose, ear, or lip wounds after the qualifying base repair. Compare 13153 office and facility rates across CMS payment localities in Wisconsin.
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 13153 in Wisconsin?
Wisconsin 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
$176.55
1 of 1 localities have a supported rate.
Payment area: Wisconsin
One mapped payment locality.
Facility setting
$104.23
1 of 1 localities have a supported rate.
Payment area: Wisconsin
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.
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 Wisconsin, from the same CMS release.
$464.12
13152 reports the primary complex repair for its longer base length in this anatomic group. Use 13153 for each qualifying additional segment.
$158.09
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.
$112.55
13102 covers additional complex-repair length for the trunk, not the eyelid, nose, ear, or lip group.
Compare 13153 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
Wisconsin →
Office / nonfacility
$176.55
Facility
$104.23
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 13153 in Wisconsin.
PPRRVU2026_Oct_nonQPP.csv
1,444
- Code
- 13153
- Physician work
- 2.32
- Practice expense
- 2.98
- Malpractice
- 0.36
GPCI2026.csv
111
- Locality
- Wisconsin
- Physician work
- 1.000
- Practice expense
- 0.958
- Malpractice
- 0.308
| Component | RVU | Locality factor | Adjusted |
|---|---|---|---|
| Physician work | 2.32 | × 1.000 | 2.3200 |
| Practice expense | 2.98 | × 0.958 | 2.8548 |
| Malpractice | 0.36 | × 0.308 | 0.1109 |
| Total RVUs | 5.2857 | ||
| Conversion factor | × 33.4009 | ||
Office / nonfacility rate, Wisconsin$176.55
Explore RVUs, geographic factors and the full formula
Office / nonfacility
| Component | RVU | Local GPCI |
|---|---|---|
| Work | 2.32 | 1 |
| Practice expense | 2.98 | 0.958 |
| Malpractice | 0.36 | 0.308 |
(2.32 × 1 + 2.98 × 0.958 + 0.36 × 0.308) × $33.4009 = $176.55
Facility
| Component | RVU | Local GPCI |
|---|---|---|
| Work | 2.32 | 1 |
| Practice expense | 0.72 | 0.958 |
| Malpractice | 0.36 | 0.308 |
(2.32 × 1 + 0.72 × 0.958 + 0.36 × 0.308) × $33.4009 = $104.23
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.
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.
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
1,44714001,,Tis trnfr trunk 10.1-30sqcm,A,,8.56,15.49,,7.83,,1.63,25.68,18.02,0,090,0.10,0.71,0.19,2,0,1,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
10802402,WA,02,SEATTLE (KING CNTY),1.050,1.227,0.817
10902402,WA,99,REST OF WASHINGTON,1.013,1.053,0.761
11011402,WV,16,WEST VIRGINIA,1.000,0.869,1.431
11106302,WI,00,WISCONSIN,1.000,0.958,0.308
11203602,WY,21,WYOMING**,1.000,1.000,0.740
113"MAC Assignments as of November 22, 2023",,,,,,
114,,,,,,