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See a sample rate comparisonCPT 15116 Fee Schedule
Last Verified: October 2026
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.
Epiderman 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; Each Additional 100 Sq Cm Or Each Additional One Percent Of Body Area Of Infants Andchildren Or Part Thereof (List Separately In Addition To Code For Primary Procedure)
| 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 59 - Distinct Procedural Service |
| Complexity Level | Low |
| Medicare Fee Schedule | View Medicare rates for 15116 |
| Medicaid Fee Schedule | View Medicaid rates for 15116 |
National average reimbursement for CPT 15116 by major payers:
$194.59
$213.50
$206.50
$237.14
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CPT 15116
5 of 25 sample ratesHigher to lower in this preview
Scott And White Hospital, Baylor Scott & White Medical Center - Taylor
Scott & White Hospital-Taylor
$1,444.00Published rateSouthwest Endoscopy LLC
$574.00Published rateTri-City Regional Surgery Center LLC
Tri-City Regional Surgery Center
$395.00Published rateInsight Surgery Center, LLC
Insight Surgery Center LLC
$250.00Published rateDoctors Surgery Center, PA
Doctors Surgery Center PA
$51.00Published rate
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See a sample payer proposalCPT 15116 vs. Other Surgical Procedures on the Integumentary System Codes
The CPT 15116 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 15116 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 |
|---|---|---|
| 15004-CPT | Moderate | Wound Prep F N Hf G, 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 Face Scalp Eyelids Mouth Neck Ears Orbits Genitalia Hands Feet And Or Multiple Digits First 100 Sq Cm Or 1 Of Body Area Of Infants And Children |
| 15115-CPT | Moderate | Epidrm A Grft Face Nck Hf G, Epidermal Autograft Face Scalp Eyelids Mouth Neck Ears Orbits Genitalia Hands Feet And Or Multiple Digits First 100 Sq Cm Or Less Or 1 Of Body Area Of Infants And Children |
| 15116-CPT | Low | Epiderman 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; Each Additional 100 Sq Cm Or Each Additional One Percent Of Body Area Of Infants Andchildren Or Part Thereof (List Separately In Addition To Code For Primary Procedure) |
| 15155-CPT | Moderate | Single-Layer Skin Graft, Surgery To Attach (Graft) Tissue To The Head Face Genitals Hands Feet Fingers Or Toes. The Grafted Tissue Is Grown (Cultured) Using A Sample From The Top Layer Of Skin (Epidermis). |
What is a fee schedule?
A fee schedule is a list of fixed prices that healthcare providers charge for specific services, including CPT 15116. These prices vary depending on payer type (Medicare, Medicaid, private insurance), geographic location, and provider contracts.
Understanding the 15116 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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