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CPT 15758 Fee Schedule

Last Verified: January 2026

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.

Free Fascial Flap With Microvascular Anastomosis
Key FactDetail
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

LT - Left side of body

Complexity LevelHigh
Medicare Fee ScheduleView Medicare rates for 15758

National average reimbursement for CPT 15758 by major payers:

bcbs

$2,959.94

uhc

$2,999.72

aetna

$3,102.72

cigna

$3,747.51

Preview provider-level rates for...
For billing codeCPT 15758
PayerCodeRateNPITax IDStateSpecialty

Select a payer to view fee schedule data

Choose a payer from the options above to see rates for CPT 15758

United
15758$1090.001871260554 - JOHNS HOPKINS SURGERY CENTERS SERIES208707724 - (MD) JOHNS HOPKINS SURGERY CENTER SERIESMDAmbulatory Surgical Clinic/Center (261QA1903X)
United
15758$1011.001497869267 - DOCTORS SURGERY CENTER, INC752545398 - (TX) DOCTORS SURGERY CENTER INCTXAmbulatory Surgical Clinic/Center (261QA1903X)
United
15758$565.001265538151 - SUFFOLK SURGERY CENTER LLC200080609 - (NY) SUFFOLK SURGERY CENTER LLCNYAmbulatory Surgical Clinic/Center (261QA1903X)
United
15758$1062.001558456459 - PORTLAND ENDOSCOPY CENTER10432678 - (ME) PORTLAND ENDOSCOPY CENTERMEAmbulatory Surgical Clinic/Center (261QA1903X)
United
15758$8705.001245287697 - EAGLE HIGHLANDS SURGERY CENTER LLC, EAGLE HIGHLANDS SURGERY CENTER352072586INAmbulatory Surgical Clinic/Center (261QA1903X)
United
15758$1000.001346662186 - NATIONAL SURGICAL CENTERS OF AMERICA LLC, NSCOA PORT ST. LUCIE264278807 - (FL) NATIONAL SURGICAL CENTERS OF AMERICA LLCFLAmbulatory Surgical Clinic/Center (261QA1903X)
United
15758$3150.001609870336 - DESOTO SURGICARE PARTNERS, LTD, NORTH TEXAS SURGERY CENTER752592508 - (TX) DESOTO SURGICARE PARTNERS LTDTXAmbulatory Surgical Clinic/Center (261QA1903X)
United
15758$1546.001306249453 - MARK FROMER, LLC, EYE SURGERY CENTERS OF NEW YORK274212773 - (NY) MARK FROMER LLCNYAmbulatory Surgical Clinic/Center (261QA1903X)
United
15758$886.001740413400 - ATLANTIC SURGERY & LASER CENTER LLC262041000 - (FL) ATLANTIC SURGERY LASER CENTER LLCFLAmbulatory Surgical Clinic/Center (261QA1903X)
United
15758$753.001396828323 - EYE CARE SURGERY CENTER OF MEMPHIS, LLC470920340TNAmbulatory Surgical Clinic/Center (261QA1903X)
United
15758$1802.001003260498 - NORTHWEST ENDO CENTER LLC812338623 - (IL) NORTHWEST ENDO CENTER LLCILAmbulatory Surgical Clinic/Center (261QA1903X)
United
15758$2055.001962568725 - BRECKENRIDGE SURGERY CENTER LP201177785 - (TX) BRECKENRIDGE SURGERY CENTER LPTXAmbulatory Surgical Clinic/Center (261QA1903X)
United
15758$3383.001841234150 - HINSDALE SURGICAL CENTER, LLC364264488ILAmbulatory Surgical Clinic/Center (261QA1903X)
United
15758$5729.001518344043 - MEMORIAL HERMANN SURGERY CENTER KIRBY, LLC, MEMORIAL HERMANN SURGERY CENTER KIRBY GLEN364801162TXAmbulatory Surgical Clinic/Center (261QA1903X)
United
15758$2795.001477584621 - HANOVER NJ ENDOSCOPY ASC LLC, HANOVER ENDOSCOPY CENTER201272329 - (NJ) HANOVER NJ ENDOSCOPY ASC LLCNJAmbulatory Surgical Clinic/Center (261QA1903X)
United
99202$100.0012345678901234567890CACardiologist
United
99202$100.0012345678901234567890CACardiologist
United
99202$100.0012345678901234567890CACardiologist
United
99202$100.0012345678901234567890CACardiologist
United
99202$100.0012345678901234567890CACardiologist
United
99202$100.0012345678901234567890CACardiologist
United
99202$100.0012345678901234567890CACardiologist
United
99202$100.0012345678901234567890CACardiologist
United
99202$100.0012345678901234567890CACardiologist
United
99202$100.0012345678901234567890CACardiologist

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CPT 15758 vs. Other Surgical Procedures on the Integumentary System Codes

The CPT 15758 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 15758 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.

CodeComplexityDescription
15731-CPTHighForeheard Flap W/Preservation Of Vascular Pedicle
15734-CPTHighMuscle Myo/Fasciocutaneous Flap Trunk
15750-CPTHighFlap Neurovascular Pedicle
15758-CPTHighFree Fascial Flap 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 15758. These prices vary depending on payer type (Medicare, Medicaid, private insurance), geographic location, and provider contracts.

Understanding the 15758 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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