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 |
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 | $1409.00 | 1235132481 - CYPRESS AMBULATORY SURGERY CENTER | 770568944 - (CA) CYPRESS AMBULATORY SURGERY CEN | CA | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 15958 | $1980.00 | 1154718070 - FERTILITY LAB SCIENCES OF MINNEAPOLIS, LLC | 465432360 - (MN) FERTILITY LAB SCIENCES OF MINN | MN | 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 | $1980.00 | 1407023161 - SOUTHWEST MINNESOTA SURGICAL CENTER, INC. | 261451498 - (MN) SOUTHWEST MINNESOTA SURGICAL CENTER INC | MN | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 15958 | $3500.00 | 1538126362 - WINTER HAVEN AMBULATORY SURGICAL CENTER LLC | 593659906 - (FL) WINTER HAVEN AMBULATORY SURGICAL CENTER, LLC | FL | 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 | $3623.00 | 1043303894 - DOCTORS OUTPATIENT SURGERY CENTER OF JUPITER, LLC, LASER & SURGERY CENTER OF THE PALM BEACHES | 650953183 - (FL) DRS. OUTPATIENT SURGERY CENTER OF JUPITER, LLC | FL | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 15958 | $1484.00 | 1013980317 - LOS ANGELES-INGLEWOOD ENDOSCOPY LP, AIRPORT ENDOSCOPY CENTER | 621814135 - (CA) LOS ANGELESINGLEWOOD ENDOSCOPY LP | CA | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 15958 | $1984.00 | 1306274097 - INTERVENTIONAL PAIN MANAGEMENT LLC | 452192531 - (IN) INTERVENTIONAL PAIN MANAGEMENT LLC | IN | 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 | $2280.00 | 1386647402 - PHYSICIANS DAY SURGERY CENTER, LLC, PHYSICIANS DAY SURGERY CENTER, INC. | 593438026 - (FL) PHYSICIANS DAY SURGERY CENTER, INC. | FL | 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 | $1300.00 | 1487657862 - FILLMORE EYE CLINIC INCORPORATED, FILLMORE EYE CLINIC ASC | 272444464 - (NM) FILLMORE EYE CLINIC, INC. | NM | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 15958 | $3775.00 | 1023182086 - EAST TEXAS MEDICAL CENTER CARTHAGE, ETMC CARTHAGE | 824005981 | TX | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 15958 | $1083.00 | 1174859516 - HERMITAGE TN ENDOSCOPY ASC, LLC, ASSOCIATED ENDOSCOPY | 270986942 | TN | 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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