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CPT 15260 Fee Schedule

Last Verified: January 2026

Healthcare 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.

Graft Full Thick Face Adnex 20cm
Key FactDetail
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 LevelHigh

National average reimbursement for CPT 15260 by major payers:

bcbs

$1,139.06

uhc

$1,256.71

aetna

$1,295.60

cigna

$1,625.09

Preview provider-level rates for...
For billing codeCPT 15260
PayerCodeRateNPITax IDStateSpecialty

Select a payer to view fee schedule data

Choose a payer from the options above to see rates for CPT 15260

United
15260$540.001851845986 - WEST SHORE PAIN AND SPINE INSTITUTE, LLC812668532 - (PA) WEST SHORE PAIN AND SPINE INSTITUTE LLCPAAmbulatory Surgical Clinic/Center (261QA1903X)
United
15260$1258.001386657047 - THEDA OAKS GASTROENTEROLOGY & ENDOSCOPY CENTER, LLC20594510 - (TX) THEDA OAKS GASTROENTEROLOGY & ENDOSCOPY CTR, LTDTXAmbulatory Surgical Clinic/Center (261QA1903X)
United
15260$700.001952363368 - GOLDEN TRIANGLE SURGICENTER LP330529450 - (CA) GOLDEN TRIANGLE SURGICENTER LPCAAmbulatory Surgical Clinic/Center (261QA1903X)
United
15260$1073.001871513705 - SQUAW PEAK SURGICAL FACILITY INC860889294 - (AZ) SQUAW PEAK SURGICAL FACILITY INCAZAmbulatory Surgical Clinic/Center (261QA1903X)
United
15260$840.001013309459 - MELBOURNE SURGERY CENTER, LLC, MELBOURNE SURGERY CENTER582101921FLAmbulatory Surgical Clinic/Center (261QA1903X)
United
15260$457.001891772547 - NOVAMED SURGERY CENTER OF BATON ROUGE LLC, INTERVENTIONAL PAIN MANAGEMENT CENTER262609309 - (LA) NOVAMED SURGERY CENTER OF BATON ROUGE LLCLAAmbulatory Surgical Clinic/Center (261QA1903X)
United
15260$496.001770645905 - SILVER SPRING MD ENDOSCOPY ASC LLC, ENDOSCOPIC SURGICAL CENTRE OF MARYLAND205988845 - (MD) SILVER SPRING MD ENDOSCOPY ASC LLCMDAmbulatory Surgical Clinic/Center (261QA1903X)
United
15260$1771.541720435118 - ELIZABETH TURLEY350593390 - DEACONESS HOSPITAL INCKYFamily Medicine Physician (207Q00000X)
United
15260$450.001649407180 - PAIN MDS INC270279190 - (AZ) PAIN MDS INCAZAmbulatory Surgical Clinic/Center (261QA1903X)
United
15260$1503.001295790327 - ENDOSCOPY OF PLANO, LP, GASTROINTESTINAL ENDOSCOPY CENTER OF PLANO201477775 - (TX) ENDOSCOPY OF PLANO LPTXAmbulatory Surgical Clinic/Center (261QA1903X)
United
15260$1771.541295713857 - ARTHUR BENTSEN350593390 - DEACONESS HOSPITAL INCINPulmonary Disease Physician (207RP1001X)
United
15260$443.001538113238 - ADVANCED LASER & SURGICENTER OF ARIZONA, PC721546625AZAmbulatory Surgical Clinic/Center (261QA1903X)
United
15260$430.001154440972 - SEBASTOPOL ASC, L.P.621560936 - (CA) SEBASTOPOL ASC LPCAAmbulatory Surgical Clinic/Center (261QA1903X)
United
15260$1771.541346209798 - VERNON TAYLOR350593390 - DEACONESS HOSPITAL INCINEmergency Medicine Physician (207P00000X)
United
15260$1039.001053366930 - ADVANCED SURGERY CENTER, LLC342045695 - (NE) ADVANCED SURGERY CENTER, LLCNEAmbulatory Surgical Clinic/Center (261QA1903X)
United
99202$100.0012345678901234567890CACardiologist
United
99202$100.0012345678901234567890CACardiologist
United
99202$100.0012345678901234567890CACardiologist
United
99202$100.0012345678901234567890CACardiologist
United
99202$100.0012345678901234567890CACardiologist
United
99202$100.0012345678901234567890CACardiologist
United
99202$100.0012345678901234567890CACardiologist
United
99202$100.0012345678901234567890CACardiologist
United
99202$100.0012345678901234567890CACardiologist
United
99202$100.0012345678901234567890CACardiologist

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CPT 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.

CodeComplexityDescription
13151-CPTModerateRep Complex Facial Adn 1.0-2.5cm
14060-CPTModerateRep Plastic Facial Adnnexa <10 Sq Cm
14350-CPTModerateFillet Finger/Toe Inc Recip Site
15260-CPTHighGraft Full Thick Face Adnex 20cm

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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