CPT 15120Surgery

Splt agrft f/s/n/h/f/g/m 1st

CPT 15120 covers split-thickness skin grafts taken from areas like the face, scalp, neck, hands, feet, or genitalia for the first 100 square centimeters. This is a surgical procedure where healthy skin is harvested and transplanted to cover wounds or burns.

Showing rates for

National Average

Base Medicare rate

$824.19

This calculator gives a typical-case estimate using standard Medicare modifier rules. Actual payment depends on payer policies, documentation, code-specific CMS status indicators, and locality. Verify before billing.

RVU breakdown

Work RVU

10.15

PE RVU (NF)

13.69

MP RVU

1.64

Total RVU

25.48

Conversion factor: 32.3465 · Source: CMS MPFS RVU25A · Confidence: High

NCCI bundling edits

Loading bundling edits…

Billing tips

Document exact surface area in square centimeters in operative report, not just percentages or general descriptions
Impact: Prevents downcoding or denials; difference between 15120 ($824.19) and incorrect coding can mean 100% claim denial
Bill add-on code 15121 for each additional 100 sq cm beyond the first when total graft exceeds initial measurement
Impact: Add-on code 15121 adds significant revenue per additional unit; failure to bill loses substantial legitimate reimbursement
Verify donor site location qualifies as face/scalp/neck/hands/feet/genitalia; if from trunk/arms/legs use 15100/15101 instead
Impact: 15120 reimburses $148.80 more than 15100 ($675.39 facility rate); incorrect site documentation triggers RAC audits
Separately bill recipient site preparation (15002/15003) when performed, using modifier 59 if necessary to override edits
Impact: 15002 adds $348.60 to claim when properly documented; commonly overlooked revenue opportunity
Link appropriate diagnosis codes showing medical necessity (burns T20-T25, wounds L89-L98, or traumatic defects S00-S99)
Impact: Cosmetic or elective indicators trigger automatic denials; proper ICD-10 linkage critical for payment
For facility billing, confirm place of service code matches where procedure performed (21=inpatient, 22=outpatient, 24=ASC)
Impact: Incorrect POS code creates $148.80 payment differential between facility ($675.39) and non-facility ($824.19) rates

Common denials

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Frequently asked questions

What is the difference between CPT 15120 and 15100?

CPT 15120 is for split-thickness grafts from complex anatomical donor sites (face, scalp, neck, hands, feet, genitalia) and reimburses $824.19 non-facility, while 15100 covers grafts from simpler sites like trunk, arms, or legs and pays $675.39. The donor site location, not recipient site, determines code selection.

How much does Medicare pay for CPT 15120 in 2025?

Medicare pays $824.19 for CPT 15120 in non-facility settings and $675.39 in facility settings under the 2025 national average rates. Actual payment varies by geographic locality and MAC jurisdiction.

Can I bill 15120 and 15002 together?

Yes, CPT 15120 (graft harvest) and 15002 (recipient site preparation) can be billed together when both procedures are performed and documented. You may need modifier 59 to override NCCI edits demonstrating distinct procedural services.

What is the RVU for CPT code 15120?

CPT 15120 has a total RVU of 25.48 for 2025, comprised of 10.15 work RVU, 13.69 non-facility PE RVU (9.09 facility), and 1.64 malpractice RVU.

How do I measure square centimeters for skin graft billing?

Measure the graft size using a sterile ruler during surgery and document length × width in the operative report. For irregular shapes, measure the greatest dimensions. Document exact square centimeters, not estimates, as this determines whether additional units of 15121 are billable.

Is CPT 15120 bundled with other skin procedures?

CPT 15120 has multiple NCCI edits and may bundle with debridement codes (11042-11047), some flap procedures, and lesion excisions when performed on the same anatomical site. Use modifier 59 only when procedures are truly distinct and separately documented.

What diagnosis codes support medical necessity for 15120?

Medically necessary diagnosis codes include burns (T20-T32), chronic wounds (L89.x, L97.x, L98.4), traumatic injuries (S00-S99), post-surgical defects, infection sequelae (L02-L08), and necrotizing conditions. Cosmetic or elective indications typically result in denials.