CPT 13151 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 • 24 - Ambulatory Surgical Center |
| Common Modifiers | • None • 59 - Distinct Procedural Service • 51 - Multiple procedures |
| Complexity Level | Moderate |
| Medicare Fee Schedule | View Medicare rates for 13151 |
National average reimbursement for CPT 13151 by major payers:
$484.15
$529.75
$551.66
$695.64
| 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 13151 | ||||||
United | 13151 | $646.00 | 1568979805 - ST DAVIDS AUSTIN AREA ASC LLC, ST . DAVID'S AUSTIN SURGERY CENTER | 611760247 - (TX) ST DAVIDS AUSTIN AREA ASC LLC | TX | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 13151 | $350.00 | 1447329990 - SEMMES-MURPHEY CLINIC PC, SEMMES MURPHEY SURGERY CENTER | 620642575 - (TN) SEMMES-MURPHEY CLINIC PC | TN | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 13151 | $120.00 | 1316924632 - CAROLINA BONE & JOINT SURGERY CENTER | 134241163 - (SC) CAROLINA BONE & JOINT SURGERY | SC | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 13151 | $574.00 | 1740260926 - STARK AMBULATORY SURGERY CENTER, LLC | 611448511 - (OH) STARK AMBULATORY SURGERY CENTER LLC | OH | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 13151 | $63.00 | 1093748527 - WOODHAMS LASER & LENS IMPLANT CENTER LLC | 582631668 - (GA) WOODHAMS LASER LENS IMPLANT CENTER LLC | GA | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 13151 | $285.00 | 1609872597 - COLISEUM SAME DAY SURGERY CENTER LP | 621805346 - (GA) COLISEUM SAME DAY SURGERY CENTER LP | GA | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 13151 | $1344.00 | 1114965803 - ADVANCED ENDOSCOPY & SURGICAL CENTER LLC, ADVANCED ENDOSCOPY & SURGICAL CENTER | 113660090 - (NJ) ADVANCED ENDOSCOPY SURGICAL CENTER LLC | NJ | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 13151 | $82.00 | 1972194199 - AMELIA ISLAND SURGERY CENTER LLC | 861376716 - (FL) AMELIA ISLAND SURGERY CENTER LLC | FL | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 13151 | $126.00 | 1114491073 - ASC DEVELOPMENT COMPANY LLC | 203405773 - (MD) ASC DEVELOPMENT COMPANY LLC | MD | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 13151 | $574.00 | 1093985525 - SURGERY CENTER OF CORAL GABLES LLC, CORAL GABLES SURGERY CENTER | 204843518 - (FL) SURGERY CENTER OF CORAL GABLES LLC | FL | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 13151 | $107.00 | 1326176215 - ENDOSCOPY CENTER OF ST THOMAS LLC, NGS ENDOSCOPY CENTER | 621512411 - (TN) ENDOSCOPY CENTER OF ST THOMAS LLC | TN | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 13151 | $1543.00 | 1922576818 - GREATER NEW HAVEN ASC, LLC | 814648930 - (CT) GREATER NEW HAVEN ASC LLC | CT | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 13151 | $110.00 | 1801094669 - CLEVELAND EYE AND LASER SURGERY CENTER LLC | 205487161 - (OH) CLEVELAND EYE & LASER SURGERY CENTER | OH | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 13151 | $557.00 | 1518920040 - COUNTRYSIDE SURGERY CENTER, LTD | 752400186 - (FL) COUNTRYSIDE SURGERY CENTER LTD | FL | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 13151 | $935.00 | 1750838801 - MEMORIAL HOUSTON SURGERY CENTER, LLC, MEMORIAL HOUSTON SURGERY CENTER | 371782795 - (TX) MEMORIAL HOUSTON SURGERY CENTER, | TX | 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 13151 vs. Other Surgical Procedures on the Integumentary System Codes
The CPT 13151 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 13151 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 |
|---|---|---|
| 13151-CPT | Moderate | Rep Complex Facial Adn 1.0-2.5cm |
| 13152-CPT | Moderate | Compls Rpr Eye Nose Ear Lip 2.6-7.5 |
| 14060-CPT | Moderate | Rep Plastic Facial Adnnexa <10 Sq Cm |
| 15004-CPT | Moderate | Surgical Preparation Or Creation Of Recipient Siteby Excision Of Opern Wounds Burn Eschar Or Scar (Including Subcutaneous Tissues) Or Incisional Release Of Scar Contracture Face Scalp Eyelids Mouth Neck Ears Orbits Genitalia Hands Feet And/Or Multiple Digits; First 100 Sq Cm Or 1% Of Body Area Of Infants And Children |
What is a fee schedule?
A fee schedule is a list of fixed prices that healthcare providers charge for specific services, including CPT 13151. These prices vary depending on payer type (Medicare, Medicaid, private insurance), geographic location, and provider contracts.
Understanding the 13151 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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