How much does Medicare pay for CPT 13133?

Medicare allowed an average of $157.28 per service and paid $125.75 of that, the balance being the patient's coinsurance and deductible (2024 data). Providers submitted an average of $423.46, which is what they billed rather than what they received — Medicare pays its fee schedule regardless of the charge.

What is CPT code 13133?

Complicated repair of wound of forehead, cheeks, chin, mouth, neck, underarms, genitals, hands, or feet, each additional 5.0 cm or less. It was billed 4,986 times to 4,504 Medicare beneficiaries by 204 providers in 2024.

Does 13133 pay differently in an office than a hospital?

Yes. The allowed amount averaged $162.73 in an office setting and $122.35 in a facility. The office rate is generally higher because the practice supplies the room, staff and equipment out of that single payment; in a hospital those are billed separately by the facility.

Which specialty bills 13133 most?

Dermatology, with 3,007 services from 129 clinicians. Next are Micrographic Dermatologic Surgery, Plastic and Reconstructive Surgery, Otolaryngology.

CPT 13133

Complicated repair of wound of forehead, cheeks, chin, mouth, neck, underarms, genitals, hands, or feet, each additional 5.0 cm or less

$157.28Medicare-allowed amount per service, averaged across 4,986 services

Providers submitted

$423.46

Asking price, not received

Medicare allowed

$157.28

The fee schedule figure

Medicare paid

$125.75

Balance is patient coinsurance

Providers submitted an average of $423.46 for this code and Medicare allowed $157.28 — 2.7× less. That gap is normal and means nothing on its own: Medicare pays its fee schedule regardless of what is billed, so the submitted figure describes a hospital chargemaster, not a price anyone paid. Of the allowed amount Medicare paid $125.75 (80%); the rest is the patient’s coinsurance and deductible.

Office pays differently to hospital

Office / non-facility: $162.73
Hospital / facility: $122.35

The office rate is higher because the practice supplies the room, staff and equipment out of that payment. In a hospital the facility bills those separately, so the clinician's share is smaller — the total cost to Medicare is usually higher, not lower. 4,312 services were billed in an office setting and 674 in a facility.

Services: 4,986
Beneficiaries: 4,504
Providers billing it: 204
Total allowed: $784,198

What Medicare pays for CPT 13133

Across 4,986 services billed by 204 providers to 4,504 beneficiaries, Medicare allowed an average of $157.28 per service. The allowed amount is the figure that matters: it is what Medicare and the patient together owe, set by the fee schedule and adjusted for local practice costs. What a provider chose to submit has no bearing on it.

Who bills 13133

Specialty	Services	Beneficiaries	Avg allowed	Providers
Dermatology	3,007	2,763	$161.19	129
Micrographic Dermatologic Surgery	1,249	1,145	$156.30	44
Plastic and Reconstructive Surgery	333	296	$147.58	16
Otolaryngology	145	66	$136.33	5
Physician Assistant	117	111	$138.51	5
Undefined Physician type	56	54	$171.52	2
Pathology	48	46	$114.15	1
Podiatry	19	11	$129.26	1
Nurse Practitioner	12	12	$134.61	1

13133 reimbursement by state

Two different numbers. Allowed is what Medicare actually allowed in that state, which includes the local practice-cost adjustment. Standardized strips that geographic adjustment out of the payment, so it is the column to use when comparing states — a difference there reflects how the code was billed, not what it costs to run a practice locally.

State	Services	Allowed	Standardized pmt	Providers
Texas	769	$157.29	$124.51	28
California	493	$170.82	$129.76	24
Florida	419	$166.16	$127.79	16
Georgia	284	$153.92	$125.04	8
Arizona	252	$140.62	$111.74	8
Illinois	200	$166.53	$131.45	8
Alabama	175	$150.47	$128.87	6
New Jersey	171	$163.63	$127.29	3
South Carolina	167	$156.78	$131.35	4
North Carolina	161	$154.81	$131.37	6
Pennsylvania	156	$143.35	$108.14	6
Massachusetts	132	$167.24	$127.15	7
Indiana	120	$144.60	$121.64	7
Wisconsin	120	$130.33	$113.55	5
Virginia	114	$163.70	$131.43	6
Missouri	111	$148.35	$121.82	7
Washington	105	$145.47	$112.44	5
Kansas	99	$128.35	$109.63	4
New York	94	$192.37	$131.62	4
Nevada	83	$167.85	$131.09	5
Utah	80	$149.66	$123.57	4
Colorado	79	$171.33	$131.12	5
Maryland	76	$171.23	$125.72	4
Arkansas	69	$153.95	$131.15	2
Michigan	61	$164.65	$131.71	3
Oklahoma	55	$155.96	$131.17	2
South Dakota	52	$155.97	$131.83	2
Minnesota	35	$161.12	$131.46	1
Tennessee	34	$152.77	$131.15	2
Idaho	33	$137.98	$114.39	2
Oregon	33	$178.48	$131.13	1
Kentucky	30	$131.04	$112.72	2
Connecticut	28	$155.34	$131.22	1
Ohio	22	$157.11	$130.85	1
Mississippi	19	$154.47	$132.92	1
West Virginia	15	$150.35	$133.58	1
Rhode Island	15	$126.99	$96.76	1
North Dakota	14	$116.57	$96.18	1
Delaware	11	$121.46	$96.95	1

Related codes

13132Complicated repair of wound of forehead$269.67
13121Complicated repair of wound of scalp$297.90
13101Complicated repair of wound of trunk$328.17
13152Complicated repair of wound of eyelids$268.00
13131Complicated repair of wound of forehead$229.32
13151Complicated repair of wound of eyelids$235.39
13122Complicated repair of wound of scalp$115.92
13120Complicated repair of wound of scalp$264.15
13102Complicated repair of wound of trunk$96.99
13160Extensive or complicated repair of surface wound reopening$650.97
13100Complicated repair of wound of trunk$317.65

Billing this code is not the same as earning it

An allowed amount is revenue to a practice, not income to a clinician. It funds staff, premises, equipment and supplies before anyone is paid. What clinicians actually earn is published separately by the Department of Labor, and what industry pays them is published separately again by CMS — this site carries both.

What doctors are paid →·Look up a clinician →·All procedure codes →

Where this comes from. CMS Medicare Physician & Other Practitioners, by Provider and Service, 2024. It covers fee-for-service Original Medicare Part B only — not Medicare Advantage, not Medicaid, and not commercial insurance, which typically pays more for the same code.

How it is averaged. CMS publishes one average per provider per code. Every figure here is re-weighted by the number of services, so a clinician who billed the code 4,000 times counts 4,000 times more than one who billed it twice. CMS also suppresses any provider-code pair with fewer than 11 beneficiaries, so low-volume practice is missing from these totals by design.