CPT 15221 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 • GC - Service performed by resident under supervision • 59 - Distinct Procedural Service |
| Complexity Level | Low |
| Medicare Fee Schedule | View Medicare rates for 15221 |
National average reimbursement for CPT 15221 by major payers:
$160.61
$172.48
$177.00
$209.24
| 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 15221 | ||||||
United | 15221 | $150.00 | 1871026120 - ACCESS CARE PHYSICIANS OF NJ LLC | 203639484 | NJ | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 15221 | $300.00 | 1346918646 - TIMPVIEW ASC, LLC | 872314348 - (UT) TIMPVIEW ASC LLC | UT | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 15221 | $415.00 | 1093088999 - CHIPPENHAM AMBULATORY SURGERY CENTER, LLC | 371587067 - (VA) CHIPPENHAM AMBULATORY SURGERY CENTER LLC | VA | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 15221 | $225.00 | 1316678311 - OPTUM PEAK ENDOSCOPY CENTER LLC | 880934943 - (CO) OPTUM PEAK ENDOSCOPY CENTER LLC | CO | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 15221 | $965.00 | 1255500781 - IOWA CITY AMBULATORY SURGICAL CENTER, LLC | 208503424 - (IA) IOWA CITY AMBULATORY SURGICAL CENTER | IA | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 15221 | $105.00 | 1679602544 - TGH SURGERY CENTER AT MORSANI, LLC, TGH SURGERY CENTER | 812203868 | FL | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 15221 | $1708.00 | 1528016656 - VANTAGE SURGICAL ASSOCIATES, LLC, VANTAGE SURGERY CENTER | 450516750 - (NJ) VANTAGE SURGERY CENTER | NJ | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 15221 | $87.00 | 1922071315 - SENECA PA ASC LLC, THE SURGERY AND LASER CENTER | 621806254 - (PA) SENECA PA ASC, LLC | PA | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 15221 | $225.00 | 1609039056 - FARSHID PAYDAR MD PC, THE EYE CLINIC | 454779006 - (AZ) FARSHID PAYDAR MD PC | AZ | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 15221 | $555.00 | 1396211264 - PALM BEACH SURGICAL SUITES LLC | 830558319 - (FL) PALM BEACH SURGICAL SUITES LLC | FL | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 15221 | $150.00 | 1740210459 - SOUTH CAROLINA ENDOSCOPY CENTER | 562069531 - (SC) S.C. ENDOSCOPY CENTER LLC | SC | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 15221 | $306.00 | 1295015212 - MOSC, LLC | 452913174 - (AZ) MOSC LLC | AZ | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 15221 | $342.00 | 1609871847 - THE SURGERY CENTER, LLC | 582520623 - (GA) THE SURGERY CENTER LLC | GA | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 15221 | $214.00 | 1184686164 - SHORE AMBULATORY SURGICAL CENTER, LLC | 223778333 - (NJ) SHORE AMBULATORY SURGICAL CENTER LLC | NJ | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 15221 | $1413.00 | 1902877715 - AMBULATORY SURGICAL CENTER OF MORRIS COUNTY LLC, RIDGEDALE SURGERY CENTER | 223104481 - (NJ) AMBULATORY SURGICAL CENTER OF MORRIS COUNTY, INC. | NJ | 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 15221 vs. Other Surgical Procedures on the Integumentary System Codes
The CPT 15221 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 15221 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 |
|---|---|---|
| 14021-CPT | Moderate | Adj Tiss Trans Sclp Arm Leg 10.1-30 |
| 14350-CPT | Moderate | Fillet Finger/Toe Inc Recip Site |
| 15050-CPT | Moderate | Pinch Graft, Single Or Multiple, To Cover Small Ulcer, Tip Of Digit, Or Other Minimal Open Area (Except On Face), Up To Defect Size 2 Cm Diameter |
| 15221-CPT | Low | Full Thickness Graft, Free, Including Direct Closure Of Donor Site, Scalp, Arms, And/Or Legs; Each Additional 20 Sq Cm, 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 15221. These prices vary depending on payer type (Medicare, Medicaid, private insurance), geographic location, and provider contracts.
Understanding the 15221 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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