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See a sample rate comparisonCPT 13153 Fee Schedule
Medicare rates as of October 2026
CPT 13153 is classified under Surgery, in the Surgical Procedures on the Integumentary System subgroup.
Cmplx Rpr E N E L Addl 5cm, Repair Complex Eyelids Nose Ears And Or Lips Each Additional 5 Cm Or Less List Separately In Addition To Code For Primary Procedure
| Key Fact | Detail |
|---|---|
| Service Type | Surgery Surgical Procedures on the Integumentary System |
| Common Place of Service | 21 - Inpatient Hospital 11 - Office |
| Common Modifiers | 59 - Distinct Procedural Service 51 - Multiple procedures |
| Complexity Level | Moderate |
| Medicare Fee Schedule | $189.05 national non-facility rate (2026) · View Medicare rates for 13153 |
| Medicaid Fee Schedule | $150.805 median of the 8 states in the free preview · View Medicaid rates for 13153 |
National average reimbursement for CPT 13153 by major payers:
$226.35
BCBS / Anthem
$240.38
UnitedHealthcare
$239.20
Aetna
$295.82
Cigna
Compare published rates across providers.
Choose a payer to see a sample of rates for CPT 13153.
CPT 13153
5 of 25 sample ratesHigher to lower in this preview
Parkview Ortho Center, LLC
Parkview Ortho Center LLC
$1,267.00Published rateAdvanced Surgical Care Of Lutz, LLC, Advanced Surgical Care Of New Tampa
Advanced Surgical Care Of Lutz LLC
$574.00Published rateSurgical Center At Columbia Orthopaedic Group LLC
$431.00Published rateNs Surgical Center LLC
$138.00Published rateRegional Eye Surgery Center,LLC
Regional Eye Surgery Center, LLC
$64.00Published rate
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See a sample payer proposalCPT 13153 vs. Other Surgical Procedures on the Integumentary System Codes
The table lists codes related to 13153. Select one to see its fee schedule.
| Code | Complexity | Description |
|---|---|---|
| 13133-CPT | Low | Cmplx Rpr F C C M N Ax G H F, 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 |
| 13152-CPT | Moderate | Clean And Stitch Wound, Cleaning And Removal Of Damaged Or Infected Tissue For A Wound On The Eyes Nose Or Ears. The Wound Is Stitched Closed. |
| 13153-CPT | Moderate | Cmplx Rpr E N E L Addl 5cm, 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 | Adjacent Tissue Transfer Or Re, Adjacent Tissue Transfer Or Rearrangement Eyelids Noseears Andor Lips Defect 10 Sq Cm Or Less Adjacent Tissue Transfer Or Rearrangement Eyelids Nose |
What is a fee schedule?
A fee schedule is a list of fixed prices that healthcare providers charge for specific services, including CPT 13153. These prices vary depending on payer type (Medicare, Medicaid, private insurance), geographic location, and provider contracts.
Understanding the 13153 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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