What is CPT code 15853?

CPT code 15853 describes the removal of sutures or staples that does not require anesthesia. It is typically listed separately in addition to an Evaluation and Management (E/M) code.

What factors influence fee schedules for CPT 15853?

Factors affecting fee schedules for CPT 15853 include whether the payer is Medicare, Medicaid, or private insurance, the geographic location of the service, and the type of healthcare provider (e.g., hospital vs. private practice).

How can PayerPrice help with CPT 15853 fee schedules?

PayerPrice provides access to negotiated rates for CPT 15853 from various insurers, enabling providers to benchmark rates, optimize billing, and understand market averages for better contract negotiations.

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'll generally need to know the specific CPT (Current Procedural Terminology) code for the service. With this code and your location, you can then use a price transparency tool. For specific, localized pricing information, you can use platforms like Payerprice, which offer a fee schedule lookup tool for searching with CPT codes and specific locations. It's also wise to contact your insurance provider to understand your benefits, deductibles, and co-pays.

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

A CPT (Current Procedural Terminology) code is a five-digit numerical code used by medical professionals to report medical, surgical, and diagnostic services and procedures. These codes standardize the way medical services are described, allowing for consistent billing and communication between providers, payers, and patients. Knowing the CPT code for a service is crucial because it's the primary identifier used by tools like Payerprice to provide estimated costs for specific procedures in specific locations.

My insurance company gives me an "Explanation of Benefits" (EOB) but it's confusing. How can I get a clear understanding of what I'll actually owe?

An Explanation of Benefits (EOB) from your insurance company details what your provider billed, what your insurance covered, and your remaining responsibility. While EOBs can be complex, understanding key terms like "deductible," "co-pay," "coinsurance," and "allowed amount" is essential. For a proactive approach to understanding costs, especially for planned procedures, it's best to identify the CPT code for the service. Then, you can utilize a tool like Payerprice to research typical costs in your area. Always verify your specific out-of-pocket costs by contacting your insurance provider directly, as individual plan benefits vary.

Where can I find transparent pricing for healthcare services in my area?

Finding transparent healthcare pricing can be challenging, but new tools are emerging to help. For reliable and specific fee schedule lookups based on CPT codes and your location, Payerprice offers a dedicated tool. This can help you compare prices for procedures and services before you receive care, allowing you to make more informed decisions. Remember to also consult with your insurance provider to understand how these prices align with your specific benefits and out-of-pocket responsibilities.

CPT 15853 Fee Schedule

Last Verified: October 2026

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.

Removal Sutures/Staples Not Requiring Anesthesia (, Removal Of Sutures Or Staples Not Requiring Anesthesia (List Separately In Addition To E/M Code)

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 UA
Complexity Level	Low
Medicare Fee Schedule	View Medicare rates for 15853
Medicaid Fee Schedule	View Medicaid rates for 15853

National average reimbursement for CPT 15853 by major payers:

$15.38

$15.64

$18.36

$31.34

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CPT 15853

5 of 25 sample ratesHigher to lower in this preview

Central Park Surgery Center, LLC, Central Park Surgery Center
Central Park Surgery Center LLC
TXAmbulatory Surgical Clinic/CenterNPI 1376591156Tax ID 16-1705322
$1,029.00Published rate
Medplex Outpatient Surgery Center Ltd, Medplex Outpatient Surgery Center
Medplex Outpatient Surgery Center Ltd
ALAmbulatory Surgical Clinic/CenterNPI 1750499950Tax ID 76-0353620
$574.00Published rate
Rome Orthopaedic Clinic Asc, Inc.
Rome Orthopaedic Clinic Asc Inc
GAAmbulatory Surgical Clinic/CenterNPI 1952540825Tax ID 26-1595646
$300.00Published rate
Healthqare Services Asc LLC, Healthqare Services Asc LLC
Healthqare Services Asc LLC
VAAmbulatory Surgical Clinic/CenterNPI 1336649714Tax ID 81-5460194
$150.00Published rate
Meridian Surgery Center LLC
MDAmbulatory Surgical Clinic/CenterNPI 1528680865Tax ID 84-5179604
$73.00Published 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 15853 vs. Other Surgical Procedures on the Integumentary System Codes

The CPT 15853 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 15853 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 Sutures/Staples Requiring Anesthesia, Removal Of Sutures Or Staples Requiring Anesthesia (Ie General Anesthesia Moderate Sedation)
15852-CPT	Low	Dressing Change (For Other Than Burns) Under Anesthes, Dressing Change (For Other Than Burns) Under Anesthesia (Other Than Lo
15853-CPT	Low	Removal Sutures/Staples Not Requiring Anesthesia (, Removal Of Sutures Or Staples Not Requiring Anesthesia (List Separately In Addition To E/M Code)
15854-CPT	Low	Removal Sutures&Staples Not Requiring Anesthesia (, 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 15853. These prices vary depending on payer type (Medicare, Medicaid, private insurance), geographic location, and provider contracts.

Understanding the 15853 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 15853 Fee Schedule

Central Park Surgery Center, LLC, Central Park Surgery Center

Medplex Outpatient Surgery Center Ltd, Medplex Outpatient Surgery Center

Rome Orthopaedic Clinic Asc, Inc.

Healthqare Services Asc LLC, Healthqare Services Asc LLC

Meridian Surgery Center LLC