CPT 15272 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 | • None • 11 - Office |
| Common Modifiers | • None • 59 - Distinct Procedural Service • GW - Condition not related to the patient's terminal condition |
| Complexity Level | Low |
| Medicare Fee Schedule | View Medicare rates for 15272 |
National average reimbursement for CPT 15272 by major payers:
$33.51
$35.58
$33.82
$51.81
| 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 15272 | ||||||
United | 15272 | $124.00 | 1316536352 - UROLOGICAL INSTITUTE OF MARYLAND | 352636464 - (MD) UROLOGICAL INSTITUTE OF MARYLAND | MD | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 15272 | $318.00 | 1558327213 - SURGICARE OF JACKSON LTD | 752162993 - (MS) SURGICARE OF JACKSON LTD | MS | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 15272 | $113.00 | 1487651956 - TRI-STATE GASTROENTEROLOGY ASSOCIATES, PSC, TRI-STATE DIGESTIVE DISORDER CENTER | 611192347 - (KY) TRI-STATE GASTROENTEROLOGY ASSOCIATES, PSC | KY | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 15272 | $135.00 | 1023169380 - JCMG SURGERY CENTER, INC. | 431809950 - (MO) JCMG SURGERY CENTER INC | MO | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 15272 | $673.00 | 1275281370 - MASS GENERAL BRIGHAM AMSURG INC. | 854372153 - (NH) MASS GENERAL BRIGHAM INCORPORATED | NH | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 15272 | $66.00 | 1124116264 - BOSTON EYE SURGERY & LASER CENTER TRUST, BOSTON EYE SURGERY & LASER CENTER | 43092292 - (MA) BOSTON EYE SURGERY & LASER CENTER TRUST | MA | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 15272 | $207.00 | 1689986879 - DEER POINTE SURGICAL CENTER, LLC, POA SURGERY CENTER | 272384315 - (MD) DEER POINTE SURGICAL CENTER, LLC | MD | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 15272 | $128.00 | 1063164960 - ADVANCED SURGICAL CARE OF VIERA, LLC | 872178964 - (FL) ADVANCED SURGICAL CARE OF VIERA LLC | FL | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 15272 | $79.00 | 1144216847 - RIVER PARK ASC LLC | 721510504 - (LA) RIVER PARK ASC LLC | LA | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 15272 | $109.00 | 1598952061 - ENDOSCOPY ASSOCIATES, LLC | 142006705 - (VA) ENDOSCOPY ASSOCIATES LLC | VA | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 15272 | $457.00 | 1619995180 - MED CITY DALLAS OUTPATIENT SURGERY CENTER, L.P., MEDICAL CITY SURGERY CENTER/DALLAS | 201043104 | TX | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 15272 | $244.00 | 1962958223 - NORTHGLENN ENDOSCOPY CENTER LLC | 812984347 - (CO) NORTHGLENN ENDOSCOPY CENTER LLC | CO | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 15272 | $94.00 | 1225776230 - ADVANCED AMBULATORY SURGICAL CENTER LLC | 871669738 - (KS) ADVANCED AMBULATORY SURGICAL CENTER LLC | KS | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 15272 | $555.00 | 1396919783 - SURGCENTER OF SOUTHERN MARYLAND, LLC | 261572885 - (MD) SURGCENTER OF SOUTHERN MARYLAND | MD | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 15272 | $84.00 | 1629409578 - PAIN CENTER OF WYOMING VALLEY, LLC | 462023592 - (PA) PAIN CENTER OF WYOMING VALLEY LLC | PA | 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 15272 vs. Other Surgical Procedures on the Integumentary System Codes
The CPT 15272 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 15272 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 |
|---|---|---|
| 15271-CPT | Low | Once Per Dos Application Of Skin Substitute Graft To Trunk, Arms, Legs, Total Wound Surface Area Up To 100 Sq.Cm; First 25 Sq Cm Or Less Wound Surface Area |
| 15272-CPT | Low | Application Of Skin Substitute Graft To Trunk, Arms, Legs, Total Wound Surface Area Up To 100 Sq Cm; Each Additional 25 Sq Cm Wound Surface Area, Or Part Thereof (List Separately In Addition To Code For Primary Procedure) |
| 15273-CPT | Moderate | Application Of Skin Substitute Graft To Trunk Arms Legs Total Wound Surface Area Greater Than Or Equal To 100 Sq Cm; First 100 Sq Cm Wound Surface Area Or 1% Of Body Area Of Infants And Children |
| 15274-CPT | Low | Application Of Skin Substitute Graft To Trunk Arms Legs Total Surface Area Greater Than Or Equal To 100 Sq Cm; Each Additional 100 Sq Cm Surface Area Or Thereof Or Each Additional 1% Of Body Area Of Infants And Children 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 15272. These prices vary depending on payer type (Medicare, Medicaid, private insurance), geographic location, and provider contracts.
Understanding the 15272 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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