| CPT Code | Description |
Physician Reimbursement - Office
|
Physician Reimbursement - Facility
|
Facility Reimbursement
|
| 15271 | Application of skin substitute graft to trunk, arms, legs, total wound surface area up to 100 sq cm; first 25 sq cm or less wound surface area. * Facility reimbursement: for high cost skin substitutes, refer to column "facility reimbursement" of this CPT code. For low cost, refer to CPT codes C5271 to C5278 |
$145.08
|
$87.48
|
$1,568.43
|
| 15272 | Application of skin substitute graft to trunk, arms, legs, total wound surface area up to 100 sq cm; each additional 25 sq cm wound surface area, or part thereof (List separately in addition to code for primary procedure) * Facility reimbursement: for high cost skin substitutes, refer to column "facility reimbursement" of this CPT code. For low cost, refer to CPT codes C5271 to C5278 |
$28.08
|
$18.36
|
$0.00
|
| 15273 | Application of skin substitute graft to trunk, arms, legs, total wound surface area greater than or equal to 100 sq cm; first 100 sq cm wound surface area, or 1% of body area of infants and children. * Facility reimbursement: for high cost skin substitutes, refer to column "facility reimbursement" of this CPT code. For low cost, refer to CPT codes C5271 to C5278 |
$309.24
|
$211.68
|
$2,710.48
|
| 15274 | Application of skin substitute graft to trunk, arms, legs, total wound surface area greater than or equal to 100 sq cm; each additional 100 sq cm wound surface area, or part thereof, or each additional 1% of body area of infants and children, or part thereof (List separately in addition to code for primary procedure) |
$73.08
|
$47.88
|
$0.00
|
| 15275 | Application of skin substitute graft to face, scalp, eyelids, mouth, neck, ears, orbits, genitalia, hands, feet, and/or multiple digits, total wound surface area up to 100 sq cm; first 25 sq cm or less wound surface area. * Facility reimbursement: for high cost skin substitutes, refer to column "facility reimbursement" of this CPT code. For low cost, refer to CPT codes C5271 to C5278 |
$153.36
|
$99.00
|
$1,568.43
|
| 15276 | Application of skin substitute graft to face, scalp, eyelids, mouth, neck, ears, orbits, genitalia, hands, feet, and/or multiple digits, total wound surface area up to 100 sq cm; each additional 25 sq cm wound surface area, or part thereof (List separately in addition to code for primary procedure) |
$35.64
|
$26.28
|
$0.00
|
| 15277 | Application of skin substitute graft to face, scalp, eyelids, mouth, neck, ears, orbits, genitalia, hands, feet, and/or multiple digits, total wound surface area greater than or equal to 100 sq cm; first 100 sq cm wound surface area, or 1% of body area of infants and children.* Facility reimbursement: For low cost skin substitute, refer to CPT codes C5271 to C5278 |
$338.40
|
$238.68
|
$1,568.43
|
| 15278 | Application of skin substitute graft to face, scalp, eyelids, mouth, neck, ears, orbits, genitalia, hands, feet, and/or multiple digits, total wound surface area greater than or equal to 100 sq cm; each additional 100 sq cm wound surface area, or part thereof, or each additional 1% of body area of infants and children, or part thereof (List separately in addition to code for primary procedure) |
$87.48
|
$60.12
|
$0.00
|