CPT 15157 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 |
| Common Modifiers | • None • 59 - Distinct Procedural Service • 58 - Staged or related procedure during postoperative period |
| Complexity Level | Moderate |
| Medicare Fee Schedule | View Medicare rates for 15157 |
National average reimbursement for CPT 15157 by major payers:
$222.63
$235.52
$227.85
$296.15
| 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 15157 | ||||||
United | 15157 | $150.00 | 1174634778 - THE CENTER FOR SPECIALIZED SURGERY, LP | 203364256 | PA | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 15157 | $1875.00 | 1184937468 - GRASS VALLEY OUTPATIENT SURGERY CENTER LP, GRASS VALLEY SURGERY CENTER | 272185264 | CA | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 15157 | $688.00 | 1245605633 - HARBOR HEIGHTS SURGERY CENTER, LLC | 473886948 - (MD) HARBOR HEIGHTS SURGERY CENTER LLC | MD | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 15157 | $163.00 | 1720024284 - PMA SURGERY CENTER, LLC | 721550480 - (TN) PMA SURGERY CENTER LLC | TN | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 15157 | $164.00 | 1689188823 - FLORIDA ORTHOPAEDIC INSTITUTE SURGERY CENTER LLC | 593646134 - (FL) FLORIDA ORTHOPAEDIC INSTITUTE SURGERY CENTER LLC | FL | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 15157 | $326.00 | 1972532539 - WILTON SURGERY CENTER LLC | 30496951 - (CT) WILTON SURGERY CENTER LLC | CT | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 15157 | $370.00 | 1043254162 - FVOSA SURGICAL PARTNERS, LLC, ORTHOPEDIC & SPORTS SURGERY CENTER | 202394424 - (WI) FVOSA SURGICAL PARTNERS, LLC | WI | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 15157 | $531.00 | 1104485440 - SURGCENTER OF GREATER JACKSONVILLE, LLC | 832504492 - (FL) SURGCENTER OF GREATER JACKSONVILLE LLC | FL | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 15157 | $538.00 | 1538316278 - PHYSICIANS' SURGERY CENTER OF DOWNEY, LLC | 205170962 - (CA) PHYSICIANS SURGERY CENTER OF | CA | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 15157 | $566.00 | 1427152073 - PATIENT PARTNERS LLC | 201400198 - (TN) PATIENT PARTNERS LLC | TN | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 15157 | $500.00 | 1275629081 - VISION CARE OF MAINE LLC | 10525143 - (ME) VISION CARE OF MAINE LLC | ME | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 15157 | $4613.00 | 1679892913 - BELTWAY SURGERY CENTERS, L.L.C. | 352072586 | IN | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 15157 | $108.00 | 1083694319 - KINGS EYE CENTER MEDICAL GROUP, INC., KINGS EYE SURGICAL CENTER | 770566388 - (CA) KINGS EYE CENTER MEDICAL GROUP, INC. | CA | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 15157 | $150.00 | 1679939318 - CRATER LAKE SURGERY CENTER LLC | 475641623 - (OR) CRATER LAKE SURGERY CENTER LLC | OR | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 15157 | $100.00 | 1881699106 - CENTER FOR DAY SURGERY | 621845006 - (TN) CENTER FOR DAY SURGERY | TN | 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 15157 vs. Other Surgical Procedures on the Integumentary System Codes
The CPT 15157 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 15157 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 |
|---|---|---|
| 13132-CPT | Moderate | Rep Complex Face Hands 2.5-7.5cm |
| 15004-CPT | Moderate | Surgical Preparation Or Creation Of Recipient Siteby Excision Of Opern 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 | 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 |
| 15157-CPT | Moderate | Tissue Cultured Epiderman Autograft Face Scalp Eyelids Mouth Neck Ears Orbits Genitalia Hands Feet And/Or Multiple Digits; First 25 Sq Cm Or Less; 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); Use 15157in Conjunction With 15156 |
What is a fee schedule?
A fee schedule is a list of fixed prices that healthcare providers charge for specific services, including CPT 15157. These prices vary depending on payer type (Medicare, Medicaid, private insurance), geographic location, and provider contracts.
Understanding the 15157 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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