CPT 15958 Fee Schedule
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.
| Key Fact | Detail |
|---|---|
| Service Type | • Surgery • Surgical Procedures on the Integumentary System |
| Common Place of Service | • 21 - Inpatient Hospital • 22 - On Campus Outpatient Hospital |
| Common Modifiers | • None • 51 - Multiple procedures • 59 - Distinct Procedural Service |
| Complexity Level | High |
| Medicare Fee Schedule | View Medicare rates for 15958 |
National average reimbursement for CPT 15958 by major payers:
$1,566.39
$1,518.89
$1,470.76
$1,918.12
| 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 15958 | ||||||
United | 15958 | $6855.00 | 1013548833 - ASCENSION WISCONSIN SURGERY CENTER-MOUNT PLEASANT LLC, ASCENSION WISCONSIN SURGERY CENTER-MOUNT PLEASANT | 843972619 - (WI) ASCENSION WISCONSIN SURGERY CENTERMOUNT PLEASANT LLC | WI | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 15958 | $2277.00 | 1487604500 - CYPRESSWOOD SURGERY CENTER LLC, LEGENT SURGERY CENTER CYPRESSWOOD | 680600120 - (TX) CYPRESSWOOD SURGERY CENTER LLC | TX | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 15958 | $1720.00 | 1457387771 - FOOT & ANKLE SURGERY CENTER | 582658964 - (GA) FOOT ANKLE SURGERY CENTER | GA | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 15958 | $696.00 | 1487651956 - TRI-STATE GASTROENTEROLOGY ASSOCIATES, PSC, TRI-STATE DIGESTIVE DISORDER CENTER | 611192347 - (KY) TRI-STATE GASTROENTEROLOGY ASSOCIATES, PSC | KY | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 15958 | $8958.16 | 1538223714 - SAINT VINCENT HLTH CTR SPU | 250965547 - (PA) HIGHMARK HEALTH | PA | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 15958 | $2380.00 | 1457976383 - VHC-I | 851094630 - (AZ) VHCI | AZ | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 15958 | $3350.00 | 1144275900 - MT LAUREL ENDOSCOPY CENTER L P | 562350370 - (NJ) MT LAUREL ENDOSCOPY CENTER L P | NJ | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 15958 | $2050.00 | 1437623626 - PRIME SURGICAL SUITES, LLC, SCSV, LLC | 463556921 - (NC) PRIME SURGICAL SUITES LLC | NC | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 15958 | $1245.00 | 1679602544 - TGH SURGERY CENTER AT MORSANI, LLC, TGH SURGERY CENTER | 812203868 | FL | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 15958 | $2116.00 | 1043271604 - NORTH FULLERTON SURGERY CENTER, LLC | 223849885 - (NJ) NORTH FULLERTON SURGERY CENTER, LLC | NJ | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 15958 | $3570.00 | 1427003052 - EYE SURGERY CENTER OF NASHVILLE LLC | 621872622 - (TN) EYE SURGERY CENTER OF NASHVILLE LLC | TN | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 15958 | $1699.00 | 1295256295 - SOUTHWEST ATLANTA VASCULAR CARE, LLC | 820825564 - (GA) SOUTHWEST ATLANTA VASCULAR CARE LLC | GA | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 15958 | $4584.00 | 1952874182 - SAME DAY SC OF CENTRAL NJ LLC | 831832261 - (NJ) SAME DAY SC OF CENTRAL NJ LLC | NJ | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 15958 | $1980.00 | 1205171295 - VANCE THOMPSON VISION SURGERY CENTER PROF LLC, VANCE THOMPSON VISION SURGERY CENTER | 455323939 | SD | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 15958 | $575.00 | 1396899191 - ALTERNACARE | 311487187 - ALTERNACARE | OH | 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 15958 vs. Other Surgical Procedures on the Integumentary System Codes
The CPT 15958 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 15958 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 |
|---|---|---|
| 15958-CPT | High | Excision, Trochanteric Pressure Ulcer, In Preparation For Muscle Or Myocutaneous Flap Or Skin Graft Closure; With Ostectomy |
| 15999-CPT | High | Unlisted Procedure, Excision Decubitus Ulcer |
| 16000-CPT | Low | Init Treat 1st Degree Burn Local |
| 17110-CPT | Low | Destruction (Eg, Laser Surgery, Electrosurgery, Cryosurgery, Chemosurgery, Surgical Curettement), Of Benign Lesions Other Than Skin Tags Or Cutaneous Vascular Proliferative Lesions; Up To 14 Lesions |
What is a fee schedule?
A fee schedule is a list of fixed prices that healthcare providers charge for specific services, including CPT 15958. These prices vary depending on payer type (Medicare, Medicaid, private insurance), geographic location, and provider contracts.
Understanding the 15958 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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