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See a sample rate comparisonHealthcare providers use this code to document and receive reimbursement for visits that address high-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 | 11 - Office 24 - Ambulatory Surgical Center |
| Common Modifiers | None 79 - Unrelated procedure - postop period RT - Right side of body |
| Complexity Level | High |
| Medicare Fee Schedule | View Medicare rates for 15260 |
| Medicaid Fee Schedule | View Medicaid rates for 15260 |
National average reimbursement for CPT 15260 by major payers:

$1,139.06

$1,256.71

$1,295.60

$1,563.91
Choose a payer to see a sample of rates for CPT 15260.
Deaconess Hospital Inc
The Outpatient Center Of Boynton Beach, Ltd.
Deaconess Hospital Inc
Novamed Surgery Center Of Cleveland LLC
Kuresmart Pain Management Surgery Centercolumbia LLC
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Rate Benchmarking
Select a published rate, define comparable providers, and see where that rate falls in your market.
See a sample rate comparisonPayer Contract Negotiation
Use your fee schedule and market benchmarks to set target rates and draft a letter for your payer.
See a sample payer proposalCPT 15260 vs. Other Surgical Procedures on the Integumentary System Codes
The CPT 15260 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 15260 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 |
|---|---|---|
| 14350-CPT | Moderate | Reattach Finger Or Toe, Surgery Including Cosmetic Reconstruction To Reattach A Finger Or Toe. The Procedure Involves Collecting Skin For Grafting And Preparing The Attachment Site. |
| 15135-CPT | High | Derm Autograft Face Nck Hf G, Dermal 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 |
| 15260-CPT | High | Three-Layer Skin Graft, Surgery To Collect Tissue Consisting Of All Three Layers Of Skin From One Area Of The Body And Attach (Graft) It To Another Site On The Nose Ears Eyelids Or Lips. |
| 15261-CPT | Moderate | Fth Grf Fr N E E L Each Addl, Full Thickness Graft Free Including Direct Closure Of Donor Site Nose Ears Eyelids And Or Lips 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 15260. These prices vary depending on payer type (Medicare, Medicaid, private insurance), geographic location, and provider contracts.
Understanding the 15260 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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