CPT 15852 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 • 21 - Inpatient Hospital |
| Common Modifiers | • None • 58 - Staged or related procedure during postoperative period • 59 - Distinct Procedural Service |
| Complexity Level | Low |
| Medicare Fee Schedule | View Medicare rates for 15852 |
National average reimbursement for CPT 15852 by major payers:

$64.37

$66.29

$62.93

$77.68
| 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 15852 | ||||||
United | 15852 | $560.00 | 1346624665 - WESTGREEN SURGICAL CENTER LLC, HOUSTON ORTHOPEDIC & SPINE SURGERY CENTER | 474468184 | TX | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 15852 | $662.00 | 1730876210 - MEDICAL CITY SURGERY CENTER NORTH TEXAS, LLC | 923326615 | TX | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 15852 | $92.00 | 1316533474 - SANDHILLS ENDOSCOPY CENTER | 851392224 - (SC) SANDHILLS ENDOSCOPY CENTER | SC | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 15852 | $252.00 | 1689682247 - ST. PETERSBURG ENDOSCOPY CENTER LLC | 203046109 - (FL) ST. PETERSBURG ENDOSCOPY CENTER, LLC | FL | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 15852 | $254.00 | 1396738936 - WARREN GASTRO ENDOSCOPY CTR INC | 341850936 - (OH) WARREN GASTRO ENDOSCOPY CTR INC | PA | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 15852 | $555.00 | 1962788059 - SURGCENTER OF SILVER SPRING, LLC | 452950933 - (MD) SURGCENTER OF SILVER SPRING LLC | MD | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 15852 | $125.00 | 1699082875 - PAIN CONSULTANTS ASC LLC | 204929098 | MS | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 15852 | $71.00 | 1356646715 - ZACHARY ASC PARTNERS, LLC, ZACHARY ASC PARTNERS, LLC | 273854435 - (LA) ZACHARY ASC PARTNERS LLC | LA | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 15852 | $164.00 | 1649501073 - SHORE HEALTH SYSTEM, INC., SHORE HEALTH SYSTEM SURGERY CENTER | 520610538 - (MD) SHORE HEALTH SYSTEM INC | MD | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 15852 | $82.00 | 1255314662 - MAZZOCCO AMBULATORY SURGICAL CENTER | 954505995 - (CA) MAZZOCCO AMBULATORY SURGICAL CENTER | CA | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 15852 | $125.00 | 1871593269 - ACADIANA SURGERY CENTER, INC. | 721235496 - (LA) ACADIANA SURGERY CENTER INC | LA | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 15852 | $171.00 | 1083851497 - GEORGIA UROLOGY, PA, GEORGIA UROLOGY ASC GWINNETT | 550846177 | GA | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 15852 | $395.00 | 1649676602 - MILE HIGH SURGERY CENTER, LLC | 830543458 | CO | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 15852 | $143.00 | 1528253523 - MESQUITE TX ENDOSCOPY ASC LLC, TEXAS GI ENDOSCOPY CENTER | 260290859 - (TX) THE MESQUITE TX ENDOSCOPY ASC, LLC D.B.A | TX | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 15852 | $132.00 | 1770004772 - NORTHWEST ATLANTA VASCULAR CARE LLC | 453857694 - (GA) NORTHWEST ATLANTA VASCULAR CARE LLC | GA | 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 15852 vs. Other Surgical Procedures on the Integumentary System Codes
The CPT 15852 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 15852 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 15852. These prices vary depending on payer type (Medicare, Medicaid, private insurance), geographic location, and provider contracts.
Understanding the 15852 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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