CPT 15101 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 |
| Common Modifiers | • None • 58 - Staged or related procedure during postoperative period • GC - Service performed by resident under supervision |
| Complexity Level | Moderate |
National average reimbursement for CPT 15101 by major payers:
$210.73
$243.70
$252.09
$297.82
| 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 15101 | ||||||
United | 15101 | $149.00 | 1699711382 - TOWSON SURGICAL CENTER LLC, TOWSON SURGICAL CENTER | 521945958 - (MD) TOWSON SURGICAL CENTER LLC | MD | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 15101 | $305.00 | 1972941714 - LEGENT OUTPATIENT SURGERY EULESS, LLC, LEGENT INTERVENTIONAL PAIN CENTER | 900866617 - (TX) LEGENT OUTPATIENT SURGERY EULESS LLC | TX | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 15101 | $566.00 | 1952333882 - THE MARYLAND CENTER FOR DIGESTIVE HEALTH LLC | 470856276 | MD | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 15101 | $1103.00 | 1174165237 - RIVER RIDGE SURGICAL SUITES, LLC | 833741084 - (IN) RIVER RIDGE SURGICAL SUITES LLC | IN | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 15101 | $160.00 | 1114922192 - GASTROENTEROLOGY ASSOCIATES ENDOSCOPY CENTER, LLC | 680380691 - (CA) GASTROENTEROLOGY ASSOC. ENDOSCOPY CENTER, LLC. DBA REDDING ENDOSCOPY | CA | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 15101 | $400.00 | 1346210259 - SURGICARE LLC | 351975122 - (IN) SURGICARE LLC | IN | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 15101 | $1070.00 | 1477552768 - COURT STREET SURGERY CENTER, LP | 300197423 | CA | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 15101 | $155.00 | 1265401202 - NORTHWEST ORTHOPAEDIC SPECIALISTS, P.S., THE ORTHOPAEDIC SURGERY CENTER | 911502837 - NORTHWEST ORTHOPAEDIC SPECIALISTS, P.S. | WA | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 15101 | $688.00 | 1891450805 - NORTH DENVER MUSCULOSKELETAL SURGICAL PARTNERS LLC | 364920288 - (CO) NORTH DENVER MUSCULOSKELETAL SURGICAL PARTNERS LLC | CO | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 15101 | $153.00 | 1124197165 - MCALLEN SURGICAL SPECIALTY CENTER LTD | 742952544 - (TX) MCALLEN SURGICAL SPECIALTY CENTER | TX | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 15101 | $122.00 | 1497740872 - SHASTA EYE SURGEONS INC, SURGERY CENTER OF NORTHERN CALIFORNIA | 205757123 - (CA) SHASTA EYE SURGEONS INC | CA | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 15101 | $149.00 | 1659657856 - ALFA SURGERY CENTER, LLC | 452748642 - (CA) ALFA SURGERY CENTER, LLC | CA | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 15101 | $200.00 | 1205878758 - ALBUQUERQUE AMBULATORY EYE SURGERY CENTER, LLC | 850481490 - (NM) ALBUQUERQUE AMBULATORY EYE SURGERY CENTER LLC | NM | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 15101 | $521.20 | 1841284742 - KLEINERT KUTZ SURGERY CENTER, LLC | 352095662 - (IN) KLEINERT KUTZ SURGERY CENTER LLC | IN | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 15101 | $127.00 | 1588329098 - GHS SERVICES, LLC, GASTRO SOUTH ENDOSCOPY CENTER | 854238832 - (GA) GHS SERVICES LLC | GA | 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 15101 vs. Other Surgical Procedures on the Integumentary System Codes
The CPT 15101 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 15101 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 15101. These prices vary depending on payer type (Medicare, Medicaid, private insurance), geographic location, and provider contracts.
Understanding the 15101 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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