HCPCS C5271 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 | • Outpatient PPS • Skin Substitute Graft Application |
| Complexity Level | Moderate |
National average reimbursement for HCPCS C5271 by major payers:
$404.08
$106.91
$42.17
$340.63
| 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 HCPCS C5271 | ||||||
United | C5271 | $405.00 | 1417124959 - NORTH CADDO HOSPITAL SERVICE DISTRICT, NORTH CADDO MEDICAL CENTER | 720594537 - (LA) NORTH CADDO HOSPITAL SERVICE DISTRICT | LA | Critical Access Hospital (282NC0060X) |
United | C5271 | $414.00 | 1497090740 - OLOL PONTCHARTRAIN SURGERY CENTER, LLC, OUR LADY OF THE LAKE PONTCHARTRAIN SURGERY CENTER | 461379031 - (LA) OLOL PONTCHARTRAIN SURGERY CENTE | LA | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | C5271 | $128.00 | 1134590912 - SLENT INVESTMENTS, LLC, SLENT SURGERY CENTER | 472307119 - (LA) SLENT INVESTMENTS LLC | LA | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | C5271 | $574.00 | 1053453134 - ADVANCED SURGICAL CONCEPTS LLC | 331035210 - (LA) ADVANCED SURGICAL CONCEPTS LLC | LA | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | C5271 | $401.00 | 1356399539 - FRANKLIN PARISH HOSPITAL SERVICE DISTRICT NO1, FRANKLIN MEDICAL CENTER | 720685044 - (LA) FRANKLIN MEDICAL CENTER EMPLOYEE BENEFIT PLAN TRUST | LA | Rural Acute Care Hospital (282NR1301X) |
United | C5271 | $809.00 | 1497792527 - UNIVERSITY HEALTHCARE SYSTEM, L.C., TULANE LAKESIDE HOSPITAL | 621596506 | LA | General Acute Care Hospital (282N00000X) |
United | C5271 | $1138.00 | 1487706214 - IASIS GLENWOOD REGIONAL MEDICAL CENTER LP | 205249827 - (LA) IASIS GLENWOOD REGIONAL MEDICAL CENTER LP | LA | General Acute Care Hospital (282N00000X) |
United | C5271 | $136.00 | 1891126728 - STONEBRIDGE HEALTH SYSTEMS, LLC, SOUTH CAMERON MEMORIAL HOSPITAL | 464145136 - (LA) STONEBRIDGE HEALTH SYSTEMS LLC | LA | Rural Acute Care Hospital (282NR1301X) |
United | C5271 | $660.00 | 1497792527 - UNIVERSITY HEALTHCARE SYSTEM, L.C., TULANE LAKESIDE HOSPITAL | 621596506 | LA | General Acute Care Hospital (282N00000X) |
United | C5271 | $2819.00 | 1396761805 - OCHSNER BAYOU LLC, OCHSNER ST. ANNE GENERAL HOSPITAL | 204670876 - (LA) OCHSNER BAYOU, LLC | LA | Critical Access Hospital (282NC0060X) |
United | C5271 | $210.00 | 1548233794 - METAIRIE OPHTHALMOLOGY ASC LLC, AMBULATORY EYE SURGERY CENTER OF LOUISIANA | 621822003 - (LA) THE METAIRIE OPHTHALMOLOGY ASC, LLC DBA AMBULATORY EYE SURGERY CENTER | LA | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | C5271 | $1200.00 | 1639352875 - NATCHITOCHES REGIONAL MEDICAL CENTER | 726013916 - (LA) NATCHITOCHES REGIONAL MEDICAL CENTER | LA | General Acute Care Hospital (282N00000X) |
United | C5271 | $400.00 | 1003925959 - HOSPITAL SERVICE DISTRICT 2 OF THE PARISH OF TANGIPAHOA STATE OF LA., HOOD MEMORIAL HOSPITAL | 720694946 - (LA) HOSPITAL SERVICE DISTRICT 2 OF THE PARISH OF TANGIPAHOA STATE OF LA | LA | Critical Access Hospital (282NC0060X) |
United | C5271 | $1154.00 | 1518924109 - TERREBONNE PARISH HOSPITAL SERVICE DISTRICT #1, TERREBONNE GENERAL MEDICAL CENTER | 720880258 - (LA) TERREBONNE HOSPITAL SERVICE DISTRICT NO 1 | LA | General Acute Care Hospital (282N00000X) |
United | C5271 | $1033.00 | 1912909912 - BRFHH SHREVEPORT LLC, UNIVERSITY HEALTH SHREVEPORT | 831173631 | LA | General Acute Care Hospital (282N00000X) |
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 |
Want to see your competitors' rates?
Start your trial today to unlock complete access to provider rates and fee schedules in your area.
Here's what you can do with PayerPrice
Renegotiate your managed care contracts
Benchmark your current rates against market averages to identify opportunities for rate optimization.
Prospect for new business using fee schedules
Access every provider's negotiated rates for every billing code in your market to inform your prospecting strategies.
Integrate real-time payer data into your workflows
Automatically keep fee schedules up-to-date without adding yet another log-in to your insurance systems. Connect via API or SQL.
PayerPrice shows you the exact negotiated rates that insurers publish under federal transparency rules.
We display the raw data directly from insurers' files, giving you the same information they make public. Learn more about Price Transparency.
HCPCS C5271 vs. Other Skin Substitute Graft Application Codes
The HCPCS C5271 code is part of the Outpatient PPS services used for Skin Substitute Graft Application. 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 HCPCS C5271 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 |
|---|---|---|
| C2699-HCPCS | Low | Brachytherapy source, non-stranded, not otherwise specified, per source |
| C5271-HCPCS | Moderate | Application of low cost skin substitute graft to trunk, arms, legs, total wound surface area up to 100 sq cm; first 25 sq cm or less wound surface area |
| C5272-HCPCS | Low | Application of low cost skin substitute graft to trunk, arms, legs, total wound surface area up to 100 sq cm; each additional 25 sq cm wound surface area, or part thereof (list separately in addition to code for primary procedure) |
What is a fee schedule?
A fee schedule is a list of fixed prices that healthcare providers charge for specific services, including HCPCS C5271. These prices vary depending on payer type (Medicare, Medicaid, private insurance), geographic location, and provider contracts.
Understanding the C5271 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.
Let's review your payer contracts side-by-side with the market.
Bring your top codes (like HCPCS C5271) and we'll show you how you compare in 15 minutes or less.