CPT 15756 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 | • 21 - Inpatient Hospital • 22 - On Campus Outpatient Hospital |
| Common Modifiers | • None • 62 - Co-Surgeons • GC - Service performed by resident under supervision |
| Complexity Level | High |
| Medicare Fee Schedule | View Medicare rates for 15756 |
National average reimbursement for CPT 15756 by major payers:
$3,062.58
$3,010.92
$3,216.50
$3,778.44
| 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 15756 | ||||||
United | 15756 | $1475.00 | 1992702443 - THE EASTSIDE ENDOSCOPY CENTER LLC | 911665997 - (WA) THE EASTSIDE ENDOSCOPY CENTER LLC | WA | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 15756 | $1500.00 | 1144983990 - MOUNTAIN WEST SURGICAL CENTER, LLC | 844185465 - (NV) MOUNTAIN WEST SURGICAL CENTER LLC | NV | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 15756 | $475.00 | 1285633818 - FOUR CORNERS AMBULATORY SURGICAL CENTER LLC | 522208568 - (MD) FOUR CORNERS AMBULATORY SURGICAL CENTER LLC | MD | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 15756 | $1020.00 | 1619166097 - GPDDC, LLC | 43769350 - (NY) GPDDC, LLC | NY | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 15756 | $5729.00 | 1508837899 - MEMORIAL HERMANN SURGERY CENTER NORTHWEST, LLP, MEMORIAL HERMANN SURGERY CENTER GREATER HEIGHTS | 200689650 - (TX) MEMORIAL HERMANN SURGERY CENTER NORTHWEST LLP | TX | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 15756 | $2323.00 | 1982641064 - PIONEER VALLEY SURGICENTER LLC, PIONEER VALLEY SURGICENTER | 10740204 - (MA) PIONEER VALLEY SURGICENTER, LLC | MA | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 15756 | $1041.00 | 1730113325 - DHA ENDOSCOPY LLC | 43551976 | MA | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 15756 | $1187.00 | 1962580266 - NOVAMED SURGERY CENTER OF WARRENSBURG LLC, EYE SURGERY CENTER OF WARRENSBURG | 205698307 - (MO) NOVAMED SURGERY CENTER OF WARRENSBURG LLC | MO | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 15756 | $845.00 | 1083382154 - TRI-CITY SURGICAL CENTERS, LLC | 825357044 - (AZ) TRICITY SURGICAL CENTERS LLC | AZ | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 15756 | $2311.00 | 1508851213 - FROEDTERT SURGERY CENTER, LLC | 201499345 - (WI) FROEDTERT SURGERY CENTER, LLC | WI | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 15756 | $1700.00 | 1295897106 - WESTMONT SURGERY CENTER LLC, SALT CREEK SURGERY CENTER | 364419691 - WESTMONT SURGERY CENTER, LLC DBA SALT CREEK SURGERY CENTER | IL | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 15756 | $1150.00 | 1386300119 - LEE HEALTHCARE INVESTMENTS, LLC, LEE HEALTH UROLOGY SURGERY CENTER | 843798404 | FL | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 15756 | $1272.00 | 1265964050 - SCHAUMBURG SURGERY CENTER, LLC | 813061805 - (IL) SCHAUMBURG SURGERY CENTER LLC | IL | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 15756 | $2859.00 | 1912434697 - SUMMIT AMBULATORY SURGICAL CENTER, LLC | 522148280 | MD | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 15756 | $908.00 | 1043497019 - PIKESVILLE MD ENDOSCOPY ASC LLC, ENDOCENTRE OF BALTIMORE | 261467040 | MD | 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 15756 vs. Other Surgical Procedures on the Integumentary System Codes
The CPT 15756 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 15756 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 |
|---|---|---|
| 15733-CPT | High | Muscle, Myocutaneous, Or Fasciocutaneous Flap; Head And Neck With Named Vascular Pedicle (Ie, Buccinators, Genioglossus, Temporalis, Masseter, Sternocleidomastoid, Levator Scapulae) |
| 15734-CPT | High | Muscle Myo/Fasciocutaneous Flap Trunk |
| 15750-CPT | High | Flap Neurovascular Pedicle |
| 15756-CPT | High | Free Muscle Flap W/Without Skin Graft With Microvascular Anastomosis |
What is a fee schedule?
A fee schedule is a list of fixed prices that healthcare providers charge for specific services, including CPT 15756. These prices vary depending on payer type (Medicare, Medicaid, private insurance), geographic location, and provider contracts.
Understanding the 15756 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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