CPT 15851 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 | • 11 - Office • 20 - Urgent Care Facility |
| Common Modifiers | • None • 59 - Distinct Procedural Service • 58 - Staged or related procedure during postoperative period |
| Complexity Level | Low |
| Medicare Fee Schedule | View Medicare rates for 15851 |
National average reimbursement for CPT 15851 by major payers:
$101.86
$124.90
$113.78
$127.16
| 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 15851 | ||||||
United | 15851 | $589.00 | 1174571970 - DCR SURGERY CENTER, LLC | 200019313 - (OH) DCR SURGERY CENTER LLC | OH | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 15851 | $551.00 | 1598270951 - ARIZONA SURGICAL SPECIALISTS CENTER, LLC, NORTH PHOENIX ASSOCIATES | 760737449 - (AZ) ARIZONA SURGICAL SPECIALISTS CENTER LLC | AZ | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 15851 | $600.00 | 1396266441 - EYE SURGERY CENTER OF EAST TEXAS LLC | 811881035 - (TX) EYE SURGERY CENTER OF EAST TEXAS LLC | TX | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 15851 | $632.50 | 1093771073 - ARTEL LLC | 263513966 - (CA) ARTEL, LLC | CA | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 15851 | $416.00 | 1356621239 - MIDLAND TEXAS SURGICAL CENTER, LLC, TEXAS SURGICAL CENTER, AN AFFILIATE OF MIDLAND MEMORIAL HOSPITAL | 453047741 | TX | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 15851 | $364.00 | 1043367196 - SURGICAL SPECIALISTS GROUP, LLC, ALABAMA OUTPATIENT SURGERY CENTER | 201398879 - (AL) SURGICAL SPECIALISTS GROUP, LLC | AL | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 15851 | $515.00 | 1669720439 - OCALA SURGICAL CENTER, OCALA SURGICAL CENTER, LLC | 842579958 | FL | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 15851 | $1179.00 | 1801146535 - SURGCENTER AT PARADISE VALLEY, LLC, SURGCENTER AT PIMA CROSSING | 455364868 - (AZ) SURGCENTER AT PARADISE VALLEY | AZ | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 15851 | $643.00 | 1306274097 - INTERVENTIONAL PAIN MANAGEMENT LLC | 452192531 - (IN) INTERVENTIONAL PAIN MANAGEMENT LLC | IN | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 15851 | $1233.00 | 1750363461 - BARKLEY SURGICENTER, LLC | 650428622 - (FL) BARKLEY SURGICENTER LLC | FL | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 15851 | $947.00 | 1366873515 - BANNER ESTRELLA SURGERY CENTER | 901183954 | AZ | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 15851 | $565.00 | 1841711942 - MACON VASCULAR CARE, LLC | 320415161 - (GA) MACON VASCULAR CARE LLC | GA | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 15851 | $523.00 | 1295948339 - WILMINGTON GASTROENTEROLOGY ENDOSCOPY CENTER, INC | 463956703 - (NC) WILMINGTON GASTROENTEROLOGY ENDOSCOPY CENTER INC | NC | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 15851 | $1063.00 | 1194718056 - MARIN ENDOSCOPY CENTER, LLC, ENDOSCOPY CENTER OF MARIN | 680407706 - (CA) MARIN ENDOSCOPY CENTER LLC | CA | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 15851 | $416.00 | 1275532889 - COAST SURGERY CENTER L P, COAST SURGERY CENTER OF SOUTH BAY | 450463066 - (CA) COAST SURGERY CENTER L P | 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 15851 vs. Other Surgical Procedures on the Integumentary System Codes
The CPT 15851 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 15851 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 |
|---|---|---|
| 15851-CPT | Low | Removal Of Sutures Or Staples Requiring Anesthesia (Ie General Anesthesia Moderate Sedation) (Desc Rvsd 1/1/23) |
| 15852-CPT | Low | Dress Change Not Burn Under Anes |
| 15853-CPT | Low | Removal Of Sutures Or Staples Not Requiring Anesthesia (List Separately In Addition To E/M Code) |
| 15854-CPT | Low | Removal Of Sutures And Staples Not Requiring Anesthesia (List Separately In Addition To E/M Code) |
What is a fee schedule?
A fee schedule is a list of fixed prices that healthcare providers charge for specific services, including CPT 15851. These prices vary depending on payer type (Medicare, Medicaid, private insurance), geographic location, and provider contracts.
Understanding the 15851 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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