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See a sample rate comparisonCPT 15738 Fee Schedule
Medicare rates as of October 2026
CPT 15738 is classified under Surgery, in the Surgical Procedures on the Integumentary System subgroup.
Leg Skin Flap, Surgery To Correct A Leg Defect Using A Muscle Flap From The Body. The Tissue Contains Its Own Blood Supply (Artery And Vein) And Is Used To Reconstruct A Part Of The Head Or Neck.
| Key Fact | Detail |
|---|---|
| Service Type | Surgery Surgical Procedures on the Integumentary System |
| Common Place of Service | 21Inpatient Hospital 22On Campus Outpatient Hospital |
| Common Modifiers | LTLeft side of body RTRight side of body |
| Hospital Outpatient Group (APC) | APC 5055 - Level 5 Skin Procedures |
| Surgery Center Payment (ASC) | A2 - Paid separately, from the OPPS relative weight |
| Add-on Codes | 20701 |
| Common Revenue Codes | 03600637Sign up to view all 4 |
| Medicare Fee Schedule | $1,148.32 national non-facility rate (2026)View Medicare rates for 15738 |
| Medicaid Fee Schedule | $915.595 median of the 8 states in the free previewView Medicaid rates for 15738 |
National average reimbursement for CPT 15738 by major payers:
$1,693.27
BCBS / Anthem
$1,751.78
UnitedHealthcare
$1,805.17
Aetna
$2,038.36
Cigna
Compare published rates across providers.
Choose a payer to see a sample of rates for CPT 15738.
CPT 15738
5 of 25 sample ratesHigher to lower in this preview
Basalt Orthopedic Surgery Center, LLC, Bosc
Basalt Orthopedic Surgery Center LLC
$9,486.00Published rateBaptist Plaza Surgicare Lp, Saint Thomas Surgery Center - Midtown
$3,952.00Published rateCardiovascular Center Of Texas, LLC
Cardiovascular Center Of Texas LLC
$3,217.00Published rateCascades Endoscopy Center, LLC, Whitemarsh Endoscopy Center
Cascades Endoscopy Center LLC
$1,255.00Published rateEast Valley Endoscopy LLC
East Valley Endoscopy, PLLC
$956.00Published rate
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See a sample payer proposalCPT 15738 vs. Other Surgical Procedures on the Integumentary System Codes
The table lists codes related to 15738. Select one to see its fee schedule.
| Code | Description |
|---|---|
| 15734-CPT | Reconstructive Skin Flap, Surgery To Create A Reconstructive Flap Out Of Muscle Tissue. The Tissue Contains Its Own Blood Supply (Artery And Vein) And Is Used To Reconstruct A Body Structure. |
| 15736-CPT | Arm Skin Flap, Surgery To Correct An Arm Defect Using A Muscle Flap From The Body. The Tissue Contains Its Own Blood Supply (Artery And Vein) And Is Used To Reconstruct A Part Of The Head Or Neck. |
| 15738-CPT | Leg Skin Flap, Surgery To Correct A Leg Defect Using A Muscle Flap From The Body. The Tissue Contains Its Own Blood Supply (Artery And Vein) And Is Used To Reconstruct A Part Of The Head Or Neck. |
| 15740-CPT | Create Skin Tube, Surgery To Create A Stem Stalk Or Tube (Pedicle) Out Of Skin Transplanted From Another Site On The Body To Support A Structure Being Reconstructed. The Pedicle Contains Blood Vessels That Are Attached At The Reconstruction Site. |
What is a fee schedule?
A fee schedule is a list of fixed prices that healthcare providers charge for specific services, including CPT 15738. These prices vary depending on payer type (Medicare, Medicaid, private insurance), geographic location, and provider contracts.
Understanding the 15738 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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Frequently Asked Questions
What APC is CPT 15738 assigned to?
Medicare's hospital outpatient payment system (OPPS) assigns CPT 15738 to APC 5055 (Level 5 Skin Procedures). An APC groups outpatient services that Medicare pays at the same base rate.
How does Medicare pay for CPT 15738 in an ambulatory surgery center?
CMS lists CPT 15738 with ASC payment indicator A2: Paid separately, from the OPPS relative weight.
Which add-on codes are billed with CPT 15738?
CMS add-on code edits list CPT 15738 as a primary code for these add-on codes: 20701.
Which revenue codes are billed with CPT 15738?
Hospital price transparency files list CPT 15738 under these revenue codes: 0360, 0637, 0761 and 0960. A revenue code names the hospital department or charge category for the line; it does not change what the service is.