What factors affect the fee schedule for CPT 15839?

Factors affecting the fee schedule for CPT 15839 include Medicare & Medicaid rates (government-set), private insurance rates (negotiated), geographic location (higher costs in urban areas), and provider type (hospital vs. private practice).

How does CPT 15839 compare to other codes for surgical procedures on the integumentary system?

CPT 15839 is a high-complexity code involving more provider time and moderate medical decision-making compared to lower-level codes. It typically includes multiple diagnoses, medication management, or test interpretation, leading to higher reimbursement and more detailed documentation.

Where can I view Medicare rates for CPT 15839?

You can view Medicare rates for CPT 15839 on the PayerPrice website through their Medicare Fee Schedule Lookup tool: https://payerprice.com/medicare-fee-schedule-lookup?codes=15839&year=2025,2026&medicareType=physician_ffs

How can I find out the cost of a medical procedure before I get it?

To understand the potential cost of a medical procedure, you can start by asking your healthcare provider for an estimate. For more specific, localized pricing information based on CPT codes, you can utilize tools like Payerprice. They offer a fee schedule lookup tool that allows you to search with CPT codes and your specific location to see what various payers are paying.

What is a CPT code and why is it important for understanding medical costs?

CPT stands for Current Procedural Terminology. CPT codes are a set of medical codes used to describe medical, surgical, and diagnostic services performed by healthcare providers. They are crucial for understanding medical costs because they standardize the billing process, allowing insurance companies and patients to know exactly what services were rendered. When researching costs, knowing the specific CPT code for a procedure will enable you to get much more accurate price estimates.

Why do medical costs vary so much between different hospitals or clinics?

Medical costs can vary significantly due to several factors, including the type of facility (e.g., hospital vs. outpatient clinic), geographical location, the specific insurance contracts negotiated by providers, technology used, and the provider's individual fee schedule. These differences can make it challenging to predict out-of-pocket expenses without specific tools.

Where can I look up specific medical procedure prices for my location and CPT code?

For specific medical procedure prices tailored to your location and CPT code, it is recommended to use a specialized tool. Payerprice offers a fee schedule lookup tool where you can search using a CPT code and your specific location to find relevant pricing information. This can help you understand the cost landscape for your particular needs.

CPT 15839 Fee Schedule

Q: What is CPT code 15839?

CPT code 15839 is used by healthcare providers to document and receive reimbursement for visits addressing high-level medical decision-making, often including multiple diagnoses or prescription management. It falls under Surgical Procedures on the Integumentary System for 'Exc Excess Skin Other Area'.

Last Verified: October 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.

Removal Of Excess Skin And Fat, Surgery To Remove Excess Skin And Fat From A Body Area. The Procedure Involves Tightening Muscles If Necessary.

Key Fact	Detail
Service Type	Surgery Surgical Procedures on the Integumentary System
Common Place of Service	22 - On Campus Outpatient Hospital 24 - Ambulatory Surgical Center
Common Modifiers	None 51 - Multiple procedures 59 - Distinct Procedural Service
Complexity Level	High
Medicare Fee Schedule	View Medicare rates for 15839
Medicaid Fee Schedule	View Medicaid rates for 15839

National average reimbursement for CPT 15839 by major payers:

$1,066.23

$1,109.69

$1,151.91

$1,169.25

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CPT 15839

5 of 25 sample ratesHigher to lower in this preview

Los Gatos Surgical Center, A California Limited Partnership
CAAmbulatory Surgical Clinic/CenterNPI 1801859970Tax ID 94-2909203
$3,933.00Published rate
Holly Springs Surgery Center, LLC
Holly Springs Surgery Center LLC
NCAmbulatory Surgical Clinic/CenterNPI 1386190957Tax ID 47-3460976
$1,534.00Published rate
Las Vegas Surgicare Ltd
NVAmbulatory Surgical Clinic/CenterNPI 1467415513Tax ID 88-0244070
$945.00Published rate
Lake Mary Surgery Center LLC
Lake Mary Surgery Center
FLAmbulatory Surgical Clinic/CenterNPI 1174530752Tax ID 13-4215228
$600.00Published rate
Three Rivers Endoscopy Center, Inc.
Three Rivers Endoscopy Center Inc
PAAmbulatory Surgical Clinic/CenterNPI 1386602332Tax ID 25-1788887
$488.00Published rate

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Summit Women's CareDenver, Colorado

September 2, 2026

Contracting Manager
UnitedHealthcare
Commercial PPO

Re: Request for fee schedule renegotiation

We request a formal review of our Commercial PPO fee schedule. The comparison below summarizes our current rate alongside published rates for comparable Denver-area practices.

Market evidence · CPT 59485

Current rate: $152.40
Market median: $147.00
Market position: 61st percentile

The comparison includes 1,284 published rates from 96 provider groups, scoped to OB/GYN providers in a professional, office-based setting.

We would welcome a discussion of our fee schedule and the supporting July 2026 market analysis. Please let us know a suitable time to review the comparison together.

Sincerely,
Summit Women's Care

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CPT 15839 vs. Other Surgical Procedures on the Integumentary System Codes

The CPT 15839 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 15839 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
15832-CPT	High	Cosmetic Surgery On A Thigh, Plastic Surgery To Remove Excess Skin And Fat And To Tighten The Muscles Of The Thigh. This Surgery Usually Is Done Along With Abdominoplasty And Buttock Lift As A Part Of Body Contouring (Body Lift) After A Massive Weight Loss.
15834-CPT	High	Cosmetic Surgery On A Hip, Plastic Surgery To Remove Excess Skin And Fat And To Tighten The Muscles In The Hips. This Surgery Typically Is Done As A Part Of Either A Thigh Or Buttock Lift After A Massive Weight Loss.
15838-CPT	Moderate	Xcision Excess Skin & Subcutane Tissue (Inclu Lipectomy);, Excision Excessive Skin And Subcutaneous Tissue (Includes Lipectomy);
15839-CPT	High	Removal Of Excess Skin And Fat, Surgery To Remove Excess Skin And Fat From A Body Area. The Procedure Involves Tightening Muscles If Necessary.

What is a fee schedule?

A fee schedule is a list of fixed prices that healthcare providers charge for specific services, including CPT 15839. These prices vary depending on payer type (Medicare, Medicaid, private insurance), geographic location, and provider contracts.

Understanding the 15839 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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CPT 15839 Fee Schedule

Los Gatos Surgical Center, A California Limited Partnership

Holly Springs Surgery Center, LLC

Las Vegas Surgicare Ltd

Lake Mary Surgery Center LLC

Three Rivers Endoscopy Center, Inc.