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 |
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 | $100.00 | 1558580910 - ORANGE CITY SURGICAL LLC, ADVENTHEALTH SURGERY CENTER BLUE SPRINGS | 208105013 - (FL) ORANGE CITY SURGICAL, LLC | FL | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 13133 | $130.00 | 1740978386 - DUKE HEALTH INTEGRATED PRACTICE, INC, DUKE GI AT BRIER CREEK | 862109896 - DUKE HEALTH INTEGRATED PRACTICE INC | NC | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 13133 | $546.00 | 1093960700 - PROLIANCE SURGEONS, INC., P.S., PROLIANCE HIGHLANDS SURGERY CENTER | 911606533 - (WA) PROLIANCE SURGEONS, INC., P.S. | WA | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 13133 | $1299.00 | 1629510326 - COLLEGE PARK ENDOSCOPY CENTER, LLC, COLLEGE PARK SURGERY CENTER | 474427740 - (KS) COLLEGE PARK ENDOSCOPY CENTER LLC | KS | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 13133 | $150.00 | 1922531268 - AMERICAN ACCESS CARE OF BALTIMORE ASC LLC | 814584087 - (MD) AMERICAN ACCESS CARE OF BALTIMORE ASC LLC | MD | 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 | $150.00 | 1336649714 - HEALTHQARE SERVICES ASC LLC, HEALTHQARE SERVICES ASC LLC | 815460194 - (VA) HEALTHQARE SERVICES ASC LLC | VA | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 13133 | $82.00 | 1740413400 - ATLANTIC SURGERY & LASER CENTER LLC | 262041000 - (FL) ATLANTIC SURGERY LASER CENTER LLC | FL | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 13133 | $143.00 | 1588620306 - SPECIALTY ORTHOPAEDICS SURGERY CENTER | 201170147 - (GA) SPECIALTY ORTHOPAEDICS SURGERY CENTER | GA | 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 | $150.00 | 1679804355 - LONESTAR AMBULATORY SURGICAL CENTER | 263806076 - (TX) LONESTAR AMBULATORY SURGICAL CENTER | TX | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 13133 | $1344.00 | 1891701611 - ESSEX ENDOSCOPY CENTER LLC | 223777761 - (NJ) ESSEX ENDOSCOPY CENTER LLC | NJ | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 13133 | $180.00 | 1558372029 - HOLIDAY SURGERY CENTER LIMITED PARTNERSHIP L L P | 593591411 - (FL) HOLIDAY SURGERY CENTER LIMITED PARTNERSHIP L L P | FL | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 13133 | $688.00 | 1013068642 - RENAISSANCE SURGERY CENTER, LLC | 205977652 - (CA) RENAISSANCE SURGERY CENTER, LLC | CA | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 13133 | $1206.00 | 1891857850 - CARES AMBULATORY SURGERY SERVICES | 223557777 | NJ | 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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