CPT 15838 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 | • 22 - On Campus Outpatient Hospital • 21 - Inpatient Hospital |
| Common Modifiers | • None • 51 - Multiple procedures • 59 - Distinct Procedural Service |
| Complexity Level | Moderate |
| Medicare Fee Schedule | View Medicare rates for 15838 |
National average reimbursement for CPT 15838 by major payers:

$765.89

$788.37

$781.56

$1,026.45
| 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 15838 | ||||||
United | 15838 | $955.00 | 1063007573 - GEORGIA EYE SURGICENTER, LLC, GEORGIA EYE INSTITUTE SURGERY CENTER | 861925762 | GA | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 15838 | $1070.00 | 1336852854 - BAPTIST BEACHES SURGERY CENTER LLC, HORIZON SURGERY CENTER BEACHES | 884322867 - (FL) BAPTIST BEACHES SURGERY CENTER LLC | FL | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 15838 | $1295.00 | 1972223394 - BRONSON AMBULATORY SURGERY CENTER, LLC, BRONSON ORTHOPEDIC SURGERY CENTER | 842884815 - (MI) BRONSON AMBULATORY SURGERY CENTER LLC | MI | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 15838 | $1200.00 | 1164460812 - BLUEGRASS ORTHOPAEDICS SURGICAL DIVISION LLC | 203916788 - (KY) BLUEGRASS SPECIALTY SURGERY CENTER, LLC | KY | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 15838 | $725.00 | 1962916577 - FREEWAY SURGICENTER OF HOUSTON, LLC, SURGERY CENTER OF SOUTHWEST HOUSTON | 823453993 - (TX) FREEWAY SURGICENTER OF HOUSTON LLC | TX | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 15838 | $755.00 | 1659625101 - ENDOSCOPY CENTER OF GRAND JUNCTION LLC | 461251610 | CO | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 15838 | $1155.00 | 1477572675 - MOOTHEDATH A MENON, WIKA ENDOSCOPY CENTER | 363164643 - (CA) M.A. MENON, M.D. | CA | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 15838 | $675.00 | 1417294745 - COAL CREEK AMBULATORY SURGERY CENTER PC, COAL CREEK AMBULATORY SURGERY CENTER | 474079291 - (CO) COAL CREEK AMBULATORY SURGERY CENTER PC | CO | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 15838 | $2392.00 | 1134663677 - CASTLE HILLS SURGICARE, LLC | 813020487 - (TX) CASTLE HILLS SURGICARE LLC | TX | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 15838 | $1640.00 | 1225469356 - SHRINERS HOSPITALS FOR CHILDREN, SHRINERS FOR CHILDREN AMBULATORY SURGICAL CENTER | 362193608 - SHRINERS HOSPITALS FOR CHILDREN | CA | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 15838 | $2629.00 | 1184752305 - SEASHORE SURGICAL INSTITUTE, LLC | 223660141 - (NJ) SEASHORE SURGICAL INSTITUTE | NJ | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 15838 | $610.00 | 1093726796 - ROCKY MOUNTAIN EYE SURGERY CENTER INC | 810493712 - (MT) ROCKY MOUNTAIN EYE SURGERY CENTER INC | MT | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 15838 | $795.00 | 1235695891 - BONE AND JOINT INSTITUTE OF TENNESSEE SURGERY CENTER LLC | 832750618 - (TN) BONE AND JOINT INSTITUTE OF TENNESSEE SURGERY CENTER LLC | TN | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 15838 | $625.00 | 1942540851 - THE ORTHOPAEDIC AND SPINE CENTER OF SOUTHERN COLORADO, LLC | 461852637 - (CO) THE ORTHOPAEDIC & SPINE CENTER OF S COLORADO | CO | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 15838 | $1155.00 | 1740491422 - PV PENINSULA PLASTIC SURGERY CENTER | 208545497 - (CA) PV PENINSULA PLASTIC SURGERY CENTER | CA | 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 15838 vs. Other Surgical Procedures on the Integumentary System Codes
The CPT 15838 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 15838 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.
What is a fee schedule?
A fee schedule is a list of fixed prices that healthcare providers charge for specific services, including CPT 15838. These prices vary depending on payer type (Medicare, Medicaid, private insurance), geographic location, and provider contracts.
Understanding the 15838 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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