CPT 15274 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 • 22 - On Campus Outpatient Hospital |
| Common Modifiers | • None • 58 - Staged or related procedure during postoperative period • 59 - Distinct Procedural Service |
| Complexity Level | Low |
| Medicare Fee Schedule | View Medicare rates for 15274 |
National average reimbursement for CPT 15274 by major payers:
$94.96
$99.46
$101.79
$136.37
| 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 15274 | ||||||
United | 15274 | $574.00 | 1659517019 - SURGERY CENTER OF PEMBROKE PINES, LLC | 263364068 - (FL) SURGERY CENTER OF PEMBROKE | FL | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 15274 | $182.00 | 1194209437 - PRECISION SURGICAL CENTER OF NORTHWEST ARKANSAS, LLC | 830659399 - (AR) PRECISION SURGICAL CENTER OF NORTHWEST ARKANSAS LLC | AR | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 15274 | $531.00 | 1437419660 - ADVANCED SURGERY CENTER OF METAIRIE LLC | 453386956 - (LA) ADVANCED SURGERY CENTER OF METAIRIE | LA | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 15274 | $85.00 | 1124559679 - MIDATLANTIC ENDOSCOPY LLC, MID-ATLANTIC GASTROINTESTINAL CENTER III | 814079161 | PA | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 15274 | $291.00 | 1700661212 - PUYALLUP AMBULATORY SURGERY CENTER, LLC | 931376698 - (WA) PUYALLUP AMBULATORY SURGERY CENTER LLC | WA | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 15274 | $325.00 | 1508400920 - NAZARETH ENDOSCOPY CENTER, LLC | 824072967 - (PA) NAZARETH ENDOSCOPY CENTER LLC | PA | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 15274 | $115.00 | 1407812860 - THE SURGICAL CENTER OF THE TREASURE COAST, LLC | 371446353 - (FL) SURGICAL CENTER OF THE TREASURE COAST | FL | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 15274 | $82.00 | 1740413400 - ATLANTIC SURGERY & LASER CENTER LLC | 262041000 - (FL) ATLANTIC SURGERY LASER CENTER LLC | FL | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 15274 | $400.00 | 1336553833 - CENTER FOR CARDIOVASCULAR RESEARCH AND EDUCATION LLC | 465327973 - (AZ) CENTER FOR CARDIOVASCULAR RESEARCH AND EDUCATION LLC | AZ | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 15274 | $85.00 | 1336255827 - ROCKVILLE EYE SURGERY CENTER, LLC, PALISADES EYE SURGERY CENTER | 43713185 - (MD) PALISADES EYE SURGERY CENTER | MD | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 15274 | $200.00 | 1962668319 - BOULDER MEDICAL CENTER, PC, BOULDER MEDICAL CENTER ASC | 840834835 - BOULDER MEDICAL CENTER, P.C. | CO | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 15274 | $200.00 | 1659885325 - GOLDEN SPRINGS SURGICAL CENTER | 814517992 - (CA) GOLDEN SPRINGS SURGICAL CENTER | CA | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 15274 | $531.00 | 1184714214 - GAINESVILLE ENDOSCOPY CENTER, LLC | 10750801 - (GA) GAINESVILLE ENDOSCOPY CENTER LLC | GA | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 15274 | $67.00 | 1770570467 - DELAWARE EYE SURGERY CENTER, LLC | 510412455 | DE | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 15274 | $1301.00 | 1245657840 - SURGCENTER OF PLANO LLC | 462873916 - (TX) SURGCENTER OF PLANO, LLC | TX | 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 15274 vs. Other Surgical Procedures on the Integumentary System Codes
The CPT 15274 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 15274 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 15274. These prices vary depending on payer type (Medicare, Medicaid, private insurance), geographic location, and provider contracts.
Understanding the 15274 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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