CPT 15100 Fee Schedule
Healthcare providers use this code to document and receive reimbursement for visits that address high-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 |
| Common Modifiers | • None • 58 - Staged or related procedure during postoperative period • GC - Service performed by resident under supervision |
| Complexity Level | High |
| Medicare Fee Schedule | View Medicare rates for 15100 |
National average reimbursement for CPT 15100 by major payers:
$1,005.87
$1,108.87
$1,155.60
$1,396.06
| 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 15100 | ||||||
United | 15100 | $997.00 | 1568583896 - EASTERN ORANGE AMBULATORY SURGERY CENTER, LLC | 205350007 - (NY) EASTERN ORANGE ASC LLC | NY | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 15100 | $576.00 | 1942245725 - SIERRA PACIFIC SURGERY CENTER LLC, SUMMIT SURGICAL | 954810282 - (CA) SUMMIT SURGICAL | CA | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 15100 | $685.44 | 1881929818 - TRACY WELSH | 350593390 - DEACONESS HOSPITAL INC | TN | Certified Registered Nurse Anesthetist (367500000X) |
United | 15100 | $663.00 | 1639176183 - BERKS CENTER FOR DIGESTIVE HEALTH, LP | 233068912 | PA | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 15100 | $645.00 | 1497797005 - DALLAS NEPHROLOGY ASSOCIATES, DALLAS NEPHROLOGY ASSOCIATES VASCULAR CENTER OF PLANO | 751366650 - (TX) DALLAS NEPHROLOGY ASSOCIATES, P.A. | TX | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 15100 | $1258.00 | 1265466288 - TAMARAC SURGERY CENTER LLC, THE SURGERY CENTER OF FT LAUDERDALE | 650963549 - (FL) TAMARAC SURGERY CENTER LLC | FL | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 15100 | $452.00 | 1770151722 - SPECIALTY SURGERY PARTNERS CENTER OF FLORIDA, LLC, ALLIANCE SPECIALTY SURGICAL CENTER | 863661396 - (FL) SPECIALTY SURGERY PARTNERS CENTER OF FLORIDA LLC | FL | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 15100 | $685.44 | 1376825786 - BRITTNEY FULCHER | 350593390 - DEACONESS HOSPITAL INC | IN | Family Nurse Practitioner (363LF0000X) |
United | 15100 | $700.00 | 1932132065 - AMBULATORY SURGICAL CTR OF AIKEN LLC, THE SURGERY CENTER OF AIKEN | 830879278 | SC | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 15100 | $1506.00 | 1720001928 - CAMPBELL CLINIC SURGERY CENTER, LLC | 621826300 | TN | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 15100 | $803.00 | 1407227358 - BAPTIST SURGERY AND ENDOSCOPY CENTERS LLC, BAPTIST HEALTH SURGERY CENTER AT NORTHPOINT | 201796841 | FL | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 15100 | $685.44 | 1942224001 - KRISTI COTTRELL | 350593390 - DEACONESS HOSPITAL INC | CA | Nurse Practitioner (363L00000X) |
United | 15100 | $390.00 | 1326494147 - CENTER FOR SPINE & PAIN MEDICINE PC, CSPM GAINESVILLE ASC | 341976829 - CENTER FOR SPINE AND PAIN MEDICI | GA | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 15100 | $495.00 | 1508846122 - HEALTH & WELLNESS SURGERY CENTER, TOWER SURGERY CENTER | 562437008 - (CA) HEALTH WELLNESS SURGERY CENTER | CA | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 15100 | $1276.00 | 1891148219 - SUMMIT AMBULATORY SURGICAL CENTER, LLC | 522148280 | 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 15100 vs. Other Surgical Procedures on the Integumentary System Codes
The CPT 15100 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 15100 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 |
|---|---|---|
| 14000-CPT | Moderate | Rep Plastic Trunk Und 10 Sq Cm |
| 15002-CPT | Moderate | Surgical Preparation Or Creation Of Recipient Site By Excision Of Open Wounds, Burn Eschar, Or Scar (Including Subcutaneous Tissues), Or Incisional Release Of Scar Contracture, Trunk, Arms, Legs; First 100 Sq Cm Or 1% Of Body Area Of Infants And Children |
| 15100-CPT | High | Split-Thickness Autograft Trunk Arms Legs; First 100 Sq Cm Or Less Or One Percent Of Body Area Of Infants And Children (Except 15050) |
| 15101-CPT | Moderate | Split-Thickness Autograft, Trunk, Arms, Legs; Each Additional 100 Sq Cm, Or Each Additional 1% Of Body Area Of Infants And Children, Or Part Thereof (List Separately In Addition To Code For Primary Procedure) |
What is a fee schedule?
A fee schedule is a list of fixed prices that healthcare providers charge for specific services, including CPT 15100. These prices vary depending on payer type (Medicare, Medicaid, private insurance), geographic location, and provider contracts.
Understanding the 15100 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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