CPT 15130 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 | • 22 - On Campus Outpatient Hospital • 21 - Inpatient Hospital |
| Common Modifiers | • None • RT - Right side of body • 58 - Staged or related procedure during postoperative period • 51 - Multiple procedures |
| Complexity Level | Moderate |
| Medicare Fee Schedule | View Medicare rates for 15130 |
National average reimbursement for CPT 15130 by major payers:
$815.60
$896.98
$881.01
$1,157.27
| 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 15130 | ||||||
United | 15130 | $1125.00 | 1396719563 - BAPTIST GERMANTOWN SURGERY CENTER, LLC, BAPTIST GERMANTOWN SURGERY CENTER | 621829424 - (TN) BAPTIST GERMANTOWN SURGERY CENTER LLC | TN | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 15130 | $2915.00 | 1619333010 - ORANGE ASC, LTD, ORTHOPEDIC ONE SURGERY CENTER AT EASTON | 464700223 - (OH) ORANGE ASC LTD DBA ORTHOPEDIC ONE SURGERY CENTER AT EASTON | OH | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 15130 | $2713.00 | 1508197039 - FREEMAN SURGICAL CENTER LLC | 431704371 - FREEMAN HEALTH SYSTEM | MO | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 15130 | $2859.00 | 1659772648 - SURGICAL SPECIALTY CENTER OF MID ATLANTIC, LLC | 465727021 - (MD) SURGICAL SPECIALTY CENTER OF MID-ATLANTIC, LLC | MD | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 15130 | $530.80 | 1467042804 - MARIA KLOPFENSTEIN | 350593390 - DEACONESS HOSPITAL INC | IN | Certified Registered Nurse Anesthetist (367500000X) |
United | 15130 | $2268.00 | 1427044452 - THE SURGERY CENTER AT SELF MEMORIAL HOSPITAL, LLC, SURGERY CENTER OF THE LAKELANDS | 571087792 - (SC) THE SURGERY CENTER AT SELF MEM | SC | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 15130 | $1155.29 | 1912369182 - JOHNNA WILSON | 350593390 - DEACONESS HOSPITAL INC | IN | Pediatric Critical Care Medicine Physician (2080P0203X) |
United | 15130 | $2621.00 | 1962405803 - MID RIVERS AMBULATORY SURGERY CENTER LP, MID RIVERS SURGERY CENTER | 203833902 - (MO) MID RIVERS AMBULATORY SURGERY CENTER LP | MO | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 15130 | $3995.00 | 1396009346 - PARAMUS ENDOSCOPY LLC, ENDOSCOPY CENTER OF BERGEN COUNTY | 453979491 - (NJ) PARAMUS ENDOSCOPY LLC | NJ | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 15130 | $1954.00 | 1912982349 - BAPTIST SURGERY AND ENDOSCOPY CENTERS LLC, MEDICAL ARTS SURGERY CENTER AT SOUTH MIAMI | 201796841 | FL | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 15130 | $2003.00 | 1720059421 - MINNESOTA EYE LASER & SURGERY CENTERS, LLC, MINNESOTA EYE LASER & SURGERY CENTERS | 460505033 - (MN) MINNESOTA EYE LASER SURGERY CENTERS LLC | MN | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 15130 | $1300.00 | 1538569207 - CUTTING EDGE SURGERY CENTER, LLC | 471696819 - (CA) CUTTING EDGE SURGERY CENTER LLC | CA | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 15130 | $4141.00 | 1588190904 - TEXAS HEALTH HUGULEY SURGERY CENTER, LLC | 821289045 - (TX) TEXAS HEALTH HUGULEY SURGERY CENTER LLC | TX | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 15130 | $2740.00 | 1306905815 - UAS MANAGEMENT, INC., UNIVERSITY SURGERY CENTER | 611845381 | CA | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 15130 | $5162.00 | 1659335438 - RESTON SURGERY CENTER, LP | 113654617 - (VA) RESTON SURGERY CENTER LP | VA | 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 15130 vs. Other Surgical Procedures on the Integumentary System Codes
The CPT 15130 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 15130 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 |
| 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) |
| 15130-CPT | Moderate | Dermal Autograft Trunk Arms Legs First 100 Sq Cm Or Less Or One Percent Of Body Area Of Infants & Children |
What is a fee schedule?
A fee schedule is a list of fixed prices that healthcare providers charge for specific services, including CPT 15130. These prices vary depending on payer type (Medicare, Medicaid, private insurance), geographic location, and provider contracts.
Understanding the 15130 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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