CPT 15574 Fee Schedule
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.
| 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 • 59 - Distinct Procedural Service • RT - Right side of body |
| Complexity Level | High |
National average reimbursement for CPT 15574 by major payers:
$1,128.27
$1,144.73
$1,152.41
$1,440.94
| 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 15574 | ||||||
United | 15574 | $750.00 | 1760465207 - PLASTIC SURGICAL CENTER OF RAPID CITY, PROF. L.L.C. | 460441899 - (SD) PLASTIC SURGICAL CENTER OF RAPID CITY PROF LLC | SD | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 15574 | $1981.00 | 1811101439 - SENTARA OBICI AMBULATORY SURGERY, LLC | 260144898 - (VA) SENTARA OBICI AMBULATORY SURGERY, LLC | VA | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 15574 | $734.00 | 1366868572 - PREMIER SURGERY CENTER, LLC | 463321793 - (NC) PREMIER SURGERY CENTER LLC | NC | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 15574 | $1955.00 | 1295702942 - GRAPEVINE SURGICARE PARTNERS LTD, BAYLOR SCOTT & WHITE SURGICARE - SOUTHLAKE | 752854711 - (TX) GRAPEVINE SURGICARE PARTNERS LTD | TX | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 15574 | $1245.00 | 1871774174 - SURGICAL EYE EXPERTS, LLC, SURGICAL EYE EXPERTS OF NEW ENGLAND, LLC | 651321064 - (MA) SURGICAL EYE EXPERTS LLC | MA | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 15574 | $963.00 | 1376605279 - MIDWEST CENTER FOR DAY SURGERY, LLC | 208103522 - (IL) MIDWEST CENTER FOR DAY SURGERY, LLC | IL | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 15574 | $928.00 | 1508438375 - BSC REID PARK LLC | 870858924 - (AZ) BSC REID PARK LLC | AZ | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 15574 | $490.00 | 1811228083 - MESQUITE SURGERY CENTER LLC | 270170010 - (AZ) MESQUITE SURGERY CENTER, LLC | AZ | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 15574 | $2629.00 | 1528016656 - VANTAGE SURGICAL ASSOCIATES, LLC, VANTAGE SURGERY CENTER | 450516750 - (NJ) VANTAGE SURGERY CENTER | NJ | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 15574 | $1233.00 | 1134431323 - BETHESDA CHEVY CHASE SURGERY CENTER, LLC | 272875760 - (MD) BETHESDA CHEVY CHASE SURGERY CEN | MD | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 15574 | $1579.38 | 1154384261 - UMESH JAIRATH | 350593390 - DEACONESS HOSPITAL INC | IN | Interventional Cardiology Physician (207RI0011X) |
United | 15574 | $1579.38 | 1588644744 - DELLA EVANS | 350593390 - DEACONESS HOSPITAL INC | IN | Geriatric Medicine (Family Medicine) Physician (207QG0300X) |
United | 15574 | $2889.00 | 1669748125 - RIVERVIEW SURGERY CENTER LLC | 452951941 - (IN) RIVERVIEW SURGERY CENTER LLC | IN | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 15574 | $1368.00 | 1134183908 - NORTH PALM BEACH COUNTY SURGERY CENTER LLC | 752424900 - (FL) NORTH PALM BEACH COUNTY SURGERY CENTER LLC | FL | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 15574 | $516.00 | 1982745568 - NORTHWEST SURGERY CENTER, INC | 911405577 - (WA) NORTHWEST SURGERY CENTER INC | WA | 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 15574 vs. Other Surgical Procedures on the Integumentary System Codes
The CPT 15574 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 15574 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 |
|---|---|---|
| 15570-CPT | High | Form Direct Tube Pedicle W/Wo Trnsfer Tr |
| 15572-CPT | High | Form Pedicle W/Wo Trnsfer Scalp Ext |
| 15574-CPT | High | Formation Of Direct Or Tubed Pedicle, With Or Without Transfer; Forehead, Cheeks, Chin, Mouth, Neck, Axillae, Genitalia, Hands Or Feet |
| 15576-CPT | Moderate | Form Pedicle W/Wo Trnsfer Eye/Ear |
What is a fee schedule?
A fee schedule is a list of fixed prices that healthcare providers charge for specific services, including CPT 15574. These prices vary depending on payer type (Medicare, Medicaid, private insurance), geographic location, and provider contracts.
Understanding the 15574 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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