CPT 13133 Fee Schedule
Healthcare providers use this code to document and receive reimbursement for visits that address moderate-level medical decision-making, often including multiple diagnoses or prescription management.
| Key Fact | Detail |
|---|---|
| Service Type | • Surgery • Surgical Procedures on the Integumentary System |
| Common Place of Service | • 11 - Office • 21 - Inpatient Hospital |
| Common Modifiers | • None • 59 - Distinct Procedural Service • 79 - Unrelated procedure - postop period |
| Complexity Level | Low |
| Medicare Fee Schedule | View Medicare rates for 13133 |
National average reimbursement for CPT 13133 by major payers:
$198.12
$219.32
$224.80
$279.06
| Payer | Code | Rate | NPI | Tax ID | State | Specialty |
|---|---|---|---|---|---|---|
Select a payer to view fee schedule data Choose a payer from the options above to see rates for CPT 13133 | ||||||
United | 13133 | $574.00 | 1043303894 - DOCTORS OUTPATIENT SURGERY CENTER OF JUPITER, LLC, LASER & SURGERY CENTER OF THE PALM BEACHES | 650953183 - (FL) DRS. OUTPATIENT SURGERY CENTER OF JUPITER, LLC | FL | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 13133 | $175.00 | 1114552338 - GEORGIA INTERVENTIONAL PAIN | 842028147 - (GA) GEORGIA INTERVENTIONAL PAIN | GA | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 13133 | $91.00 | 1508209743 - CRESCENT VIEW SURGERY CENTER, LLC | 462070269 | LA | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 13133 | $116.00 | 1063905818 - INNOVATIVE EYE SURGERY CENTER, PLLC | 822843902 - (KY) INNOVATIVE EYE SURGERY CENTER PLLC | KY | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 13133 | $84.00 | 1629409578 - PAIN CENTER OF WYOMING VALLEY, LLC | 462023592 - (PA) PAIN CENTER OF WYOMING VALLEY LLC | PA | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 13133 | $100.00 | 1386381408 - CYPRESS AMBULATORY SURGERY CENTER, LLC, WELLNESS AVENUE SURGERY CENTER | 823481913 | FL | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 13133 | $219.00 | 1679728901 - ESSEX SPECIALIZED SURGICAL INSTITUTE LLC | 263777820 - (NJ) ESSEX SPECIALIZED SURGICAL INSTITUTE LLC | NJ | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 13133 | $250.00 | 1922028265 - ATLANTIC GASTRO SURGICENTER, LLC, T/A ACCESS | 223645443 - (NJ) ATLANTIC GASTRO SURGICENTER LLC | NJ | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 13133 | $179.00 | 1053353359 - VISION SURGERY & LASER CENTER, LLC | 931308251 - (OR) VISION SURGERY LASER CENTER LLC | OR | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 13133 | $322.00 | 1790822864 - NORTHWEST EYE SPECIALISTS,LLC | 860720868 - (AZ) NORTHWEST EYE SPECIALISTS, P.L.L.C. | AZ | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 13133 | $109.00 | 1013513308 - JOHN KENYON AMERICAN EYE INSTITUTE LLC, EYE SURGERY CENTER OF ELIZABETHTOWN | 351907389 - JOHN-KENYON AMERICAN EYE INSTITUTE | KY | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 13133 | $283.00 | 1275513806 - PINNACLE CATARACT AND LASER INSTITUTE LLC | 743117000 - (WI) PINNACLE CATARACT AND LASER INSTITUTE LLC | WI | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 13133 | $1708.00 | 1164404638 - CAMPUS EYE GROUP ASC INC, SURGICENTER ANESTHESIA ASSOCIATES | 223047283 | NJ | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 13133 | $279.00 | 1972778579 - G A ENDOSCOPY CENTER, LLC | 262346936 - (MO) G A ENDOSCOPY CENTER LLC | MO | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 13133 | $120.00 | 1457784852 - SMART PAIN SURGERY CENTER AT OWINGS MILLS, LLC, CLEARWAY SURGERY CENTER OF OWINGS MILLS | 454995677 - (MD) SMART PAIN SURGERY CENTER AT OWINGS MILLS LLC | MD | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 99202 | $100.00 | 1234567890 | 1234567890 | CA | Cardiologist |
United | 99202 | $100.00 | 1234567890 | 1234567890 | CA | Cardiologist |
United | 99202 | $100.00 | 1234567890 | 1234567890 | CA | Cardiologist |
United | 99202 | $100.00 | 1234567890 | 1234567890 | CA | Cardiologist |
United | 99202 | $100.00 | 1234567890 | 1234567890 | CA | Cardiologist |
United | 99202 | $100.00 | 1234567890 | 1234567890 | CA | Cardiologist |
United | 99202 | $100.00 | 1234567890 | 1234567890 | CA | Cardiologist |
United | 99202 | $100.00 | 1234567890 | 1234567890 | CA | Cardiologist |
United | 99202 | $100.00 | 1234567890 | 1234567890 | CA | Cardiologist |
United | 99202 | $100.00 | 1234567890 | 1234567890 | CA | Cardiologist |
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CPT 13133 vs. Other Surgical Procedures on the Integumentary System Codes
The CPT 13133 code is part of the Surgery services used for Surgical Procedures on the Integumentary System. It represents a moderate-complexity encounter and is one of several codes that vary based on time spent, level of medical decision-making, and documentation requirements.
The CPT 13133 code involves more provider time and moderate medical decision-making, unlike lower-level codes that require less time and simpler assessments. It typically includes multiple diagnoses, medication management, or test interpretation, leading to higher reimbursement and more detailed documentation requirements.
| Code | Complexity | Description |
|---|---|---|
| 13131-CPT | Moderate | Complx Rpr Face Hnd Ft 1.1-2.5 Cm |
| 13132-CPT | Moderate | Rep Complex Face Hands 2.5-7.5cm |
| 13133-CPT | Low | Repair, Complex, Forehead, Cheeks, Chin, Mouth, Neck, Axillae, Genitalia, Hands And/Or Feet; Each Additional 5 Cm Or Less (List Separately In Addition To Code For Primary Procedure) |
| 13153-CPT | Moderate | Repair, Complex, Eyelids, Nose, Ears And/Or Lips; Each Additional 5 Cm Or Less (List Separately In Addition To Code For Primary Procedure) |
What is a fee schedule?
A fee schedule is a list of fixed prices that healthcare providers charge for specific services, including CPT 13133. These prices vary depending on payer type (Medicare, Medicaid, private insurance), geographic location, and provider contracts.
Understanding the 13133 fee schedule helps patients estimate costs and providers optimize billing for accurate reimbursements.
Factors that affect fee schedules
Medicare & Medicaid Rates
Government-set reimbursement amounts
Private Insurance Rates
Negotiated rates between providers and insurance companies
Geographic Location
Costs may be higher in urban areas.
Provider Type
Hospital providers may have different rates than private practice.
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