CPT 13152 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 |
National average reimbursement for CPT 13152 by major payers:

$580.53

$654.70

$687.40

$841.75
| 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 13152 | ||||||
United | 13152 | $688.00 | 1790885895 - UNITED MEDICAL ENDOSCOPY CENTER | 454651695 - (CA) ADVANCED ENDOSCOPY AND PAIN CENTER LLC | CA | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 13152 | $117.00 | 1285912923 - ATLANTA HAND SPECIALIST SURGERY CENTER LLC | 452458463 - (GA) ATLANTA HAND SPECIALIST SURGERY CENTER LLC | GA | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 13152 | $615.00 | 1821453796 - MASON RIDGE AMBULATORY SURGERY CENTER LP, GATEWAY ENDOSCOPY CENTER | 205953364 | MO | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 13152 | $290.00 | 1992707855 - VESC LLC, ADVENTHEALTH SURGERY CENTER ORMOND BEACH | 593415079 - (FL) VESC LLC | FL | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 13152 | $163.00 | 1831545904 - MGH SURGERY LLC | 472736896 - (WV) MGH SURGERY LLC | WV | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 13152 | $116.00 | 1528643285 - SUMMIT HEALTH PARTNERS LLC, WESTERN CAROLINA SURGERY CENTER | 812722973 - (NC) SUMMIT HEALTH PARTNERS LLC | NC | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 13152 | $569.00 | 1770731853 - SHAWNEE MISSION PRAIRIE STAR SURGERY CENTER LLC, ADVENTHEALTH SURGERY CENTER LENEXA | 364634843 - (KS) SHAWNEE MISSION PRAIRIE STAR SURGERY CENTER LLC | KS | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 13152 | $333.00 | 1649376757 - ADS HEALTHCARE LLC, ADS AMBULATORY SURGERY CENTER | 481207671 - (KS) ADS HEALTHCARE LLC | KS | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 13152 | $77.00 | 1205963568 - BRYN MAWR MEDICAL SPECIALISTS ASSOCIATION | 231714249 - (PA) BRYN MAWR MEDICAL SPECIALISTS ASSOCIATION | PA | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 13152 | $86.00 | 1841368867 - DUBLIN EYE SURGERY CENTER LLC | 202788445 - (GA) DUBLIN EYE SURGERY CENTER LLC | GA | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 13152 | $688.00 | 1366406233 - MIDDLE TENNESSEE AMBULATORY SURGERY CENTER, L.P. | 621699667 - (TN) MIDDLE TENNESSEE AMBULATORY SURGERY CENTER LP | TN | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 13152 | $100.00 | 1104214261 - WEST CENTRAL SURGICAL CENTER-BAYSIDE | 472619181 - (OH) WEST CENTRAL SURGICAL CENTERBAYSIDE | OH | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 13152 | $1250.00 | 1346403854 - THE EMORY CLINIC INC, EMORY ORTHOPAEDIC SURGERY CENTER | 464115055 - (GA) EMORY AMBULATORY SURGERY CENTER AT DUNWOODY LLC | GA | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 13152 | $688.00 | 1053714758 - TEXAS PRECISION SURGERY CENTER | 471332895 - (TX) TEXAS PRECISION SURGERY CENTER L | TX | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 13152 | $164.00 | 1649501073 - SHORE HEALTH SYSTEM, INC., SHORE HEALTH SYSTEM SURGERY CENTER | 520610538 - (MD) SHORE HEALTH SYSTEM INC | 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 13152 vs. Other Surgical Procedures on the Integumentary System Codes
The CPT 13152 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 13152 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 |
| 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) |
| 14060-CPT | Moderate | Rep Plastic Facial Adnnexa <10 Sq Cm |
What is a fee schedule?
A fee schedule is a list of fixed prices that healthcare providers charge for specific services, including CPT 13152. These prices vary depending on payer type (Medicare, Medicaid, private insurance), geographic location, and provider contracts.
Understanding the 13152 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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