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 |
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 | $685.44 | 1942224001 - KRISTI COTTRELL | 350593390 - DEACONESS HOSPITAL INC | CA | Nurse Practitioner (363L00000X) |
United | 15100 | $1022.00 | 1902875438 - CENTRAL PARK ENDOSCOPY CENTER LLC, ENDOSCOPY CENTER AT CENTRAL PARK | 752894418 - (TX) CENTRAL PARK ENDOSCOPY CENTER LLC | TX | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 15100 | $576.00 | 1669437497 - CASCADE SURGICENTER, LLC | 731677879 - (OR) CASCADE SURGICENTER LLC | OR | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 15100 | $2111.00 | 1619071214 - RADS OF AMERICA, LLC, PREMIER RADIOLOGY PAIN MANAGEMENT CENTER | 200597581 - (TN) RADS OF AMERICA LLC | TN | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 15100 | $568.00 | 1548263619 - AZAR EYE SURGERY CENTER LLC | 522325381 - (MD) AZAR EYE SURGERY CENTER LLC | MD | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 15100 | $427.00 | 1073079596 - PREMIER GASTROENTEROLOGY ASSOCIATES PLLC, PREMIER SURGERY CENTER | 824134212 - (AR) PREMIER GASTROENTEROLOGY ASSOCIATES, PLLC | AR | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 15100 | $353.00 | 1871718270 - PRINCE GEORGES MULTI SPECIALTY SURGERY CENTER | 521842302 - (MD) PRINCE GEORGES MULTI SPECIALTY SURGERY CENTER | MD | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 15100 | $576.00 | 1962916577 - FREEWAY SURGICENTER OF HOUSTON, LLC, SURGERY CENTER OF SOUTHWEST HOUSTON | 823453993 - (TX) FREEWAY SURGICENTER OF HOUSTON LLC | TX | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 15100 | $3787.00 | 1578561890 - THE ENDOSCOPY CENTER AT ST. FRANCIS, LLC | 351958962 - (IN) THE ENDOSCOPY CENTER AT ST FRANCIS LLC | IN | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 15100 | $656.00 | 1144845116 - LEGACY CENTER FOR SPINAL SURGERY, LLC | 843166515 - (GA) LEGACY CENTER FOR SPINAL SURGERY LLC | GA | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 15100 | $576.00 | 1639682503 - SOUTH PLAINS SURGERY CENTER LLC | 822142398 - (TX) SOUTH PLAINS SURGERY CENTER LLC | TX | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 15100 | $2024.00 | 1316395270 - IRVINE SURGICAL PARTNERS LLC | 812776218 - (CA) IRVINE SURGICAL PARTNERS LLC | CA | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 15100 | $1348.00 | 1710321328 - VALLEY PHYSICIANS SURGERY CENTER AT NORTHRIDGE LLC | 800864336 - (CA) VALLEY PHYSICIANS SURGERY CENTER OF NORTHRIDGE LLC | CA | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 15100 | $685.44 | 1194989269 - GREGORY BURCHETT | 350593390 - DEACONESS HOSPITAL INC | AZ | Certified Registered Nurse Anesthetist (367500000X) |
United | 15100 | $380.00 | 1588735708 - FILUTOWSKI EYE INSTITUTE PA, LAKE MARY SURGICAL CENTER | 593111497 - (FL) FILUTOWSKI EYE INSTITUTE, P.A. | FL | 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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