CPT 15040 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 | • 21 - Inpatient Hospital • 22 - On Campus Outpatient Hospital • 24 - Ambulatory Surgical Center |
| Common Modifiers | • None • 59 - Distinct Procedural Service • 58 - Staged or related procedure during postoperative period |
| Complexity Level | Moderate |
National average reimbursement for CPT 15040 by major payers:
$275.07
$330.38
$330.27
$421.65
| 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 15040 | ||||||
United | 15040 | $1286.00 | 1689216152 - BAPTIST HEALTH SURGERY CENTER LLC | 843280181 - (KY) BAPTIST HEALTH SURGERY CENTER, L | KY | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 15040 | $1067.00 | 1538389812 - IRONBOUND ENDO SURGICAL CENTER, INC. | 223651393 | NJ | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 15040 | $1425.00 | 1932162195 - COVENANT HIGH PLAINS SURGERY CENTER, LLC, COVENANT HIGH PLAINS SURGERY CENTER - QUAKER AVENUE | 752177401 - (TX) COVENANT HIGH PLAINS SURGERY CENTER LLC | TX | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 15040 | $2345.00 | 1720161615 - MANKATO SURGICAL CENTER, L.L.C., MANKATO SURGERY CENTER | 411924647 - (MN) MANKATO SURGICAL CENTER, LLC | MN | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 15040 | $961.00 | 1982211728 - FT SCOTT SURGERY CENTER LLC | 853127325 | KS | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 15040 | $1258.00 | 1407275282 - SURGCENTER CAMELBACK LLC | 464169482 - (AZ) SURGCENTER CAMELBACK LLC | AZ | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 15040 | $670.00 | 1184106049 - SURGCENTER OF NORTHERN BALTIMORE, LLC | 823078615 - (MD) SURGCENTER OF NORTHERN BALTIMORE LLC | MD | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 15040 | $1300.00 | 1609803204 - AFFILIATED ENDOSCOPY SERVICES OF CLIFTON LLC, AFFILIATED ENDOSCOPY SERVICES OF CLIFTON | 270064844 - (NJ) AFFILIATED ENDOSCOPY SERVICES OF CLIFTON LLC | NJ | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 15040 | $1757.00 | 1609253392 - GLBESC, LLC, MEMORIALCARE OUTPATIENT SURGICAL CENTER LONG BEACH | 473495605 - (CA) GLBESC LLC | CA | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 15040 | $620.00 | 1639135346 - SURGERY CENTERS OF DES MOINES LTD | 363562598 | IA | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 15040 | $675.00 | 1881125870 - RENAL ASSOCIATES, P.A. | 742083988 - (TX) RENAL ASSOCIATES, PA | TX | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 15040 | $3009.00 | 1841858024 - VANGUARD ASC, LLC, VANGUARD SURGICAL CENTER | 352661529 | NJ | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 15040 | $2489.00 | 1467057372 - SOUTHWEST CONNECTICUT SURGERY CENTER, LLC | 852607391 - (CT) SOUTHWEST CONNECTICUT SURGERY CENTER, LLC | CT | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 15040 | $640.00 | 1619051760 - GREENVILLE ENDOSCOPY CENTER INC | 570965754 - (SC) GREENVILLE ENDOSCOPY CENTER INC | SC | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 15040 | $490.00 | 1518957851 - SURGICENTER OF RACINE LTD | 391645163 - (WI) SURGICENTER OF RACINE LTD | WI | 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 15040 vs. Other Surgical Procedures on the Integumentary System Codes
The CPT 15040 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 15040 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 |
|---|---|---|
| 15040-CPT | Moderate | Harvest Of Skin For Tissue Cultured Skin Autograft;100 Sq Cm Or Less |
| 15050-CPT | Moderate | Pinch Graft, Single Or Multiple, To Cover Small Ulcer, Tip Of Digit, Or Other Minimal Open Area (Except On Face), Up To Defect Size 2 Cm Diameter |
| 15110-CPT | Moderate | Epidermal Autograft Trunk Arms Legs First 100 Sq Cm Or Less Or One Percent Of Body Area Of Infants & Children |
| 15120-CPT | Moderate | Split-Thichkness Autograft Face Scalp Eyelids Mouth Neck Ears Orbits Genitalia Hands Feet And/Or Multiple Digits; First 100 Sq Cm Or Less Or One Percent Of Body Area Of Infants And Children (Except 15050) |
What is a fee schedule?
A fee schedule is a list of fixed prices that healthcare providers charge for specific services, including CPT 15040. These prices vary depending on payer type (Medicare, Medicaid, private insurance), geographic location, and provider contracts.
Understanding the 15040 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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