CPT 15136Surgery

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CPT 15136 covers each additional 100 square centimeters (or less) of dermal autograft tissue placed on the face, scalp, neck, hands, feet, genitals, or mouth. This is an add-on code used when skin grafting exceeds the area covered by the primary code.

Showing rates for

National Average

Base Medicare rate

$94.13

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

1.5

PE RVU (NF)

1.13

MP RVU

0.28

Total RVU

2.91

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

NCCI bundling edits

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Billing tips

Calculate and document exact surface area in square centimeters for each anatomic site; 15136 is reported per each additional 100 sq cm (or part thereof) beyond the first 100 sq cm covered by 15135
Impact: Each properly documented unit yields $94.13 (non-facility); undermeasurement or improper rounding can result in $94+ lost revenue per unreported unit
Always bill 15136 with primary code 15135; this is a mandatory add-on code that cannot be billed independently
Impact: Billing 15136 alone results in 100% claim denial; proper pairing with 15135 ensures both codes are paid
Document donor site location separately and consider billing appropriate donor site codes (15130-15136 covers recipient site only)
Impact: Donor site harvest may be separately billable depending on technique and payer policy, potentially adding $100-300 per procedure
For pediatric patients, calculate body surface area percentage when total burn area exceeds 100 sq cm; 15136 can be reported per each additional 1% TBSA in infants/children
Impact: Proper pediatric calculation method can justify additional units in burn cases, increasing total reimbursement by 15-30% for extensive burns
Submit operative report showing measurements with initial claim for grafts exceeding 200 sq cm total to prevent automatic medical review delays
Impact: Proactive documentation submission reduces payment delays by 15-30 days and decreases denial rate from ~25% to ~8%
Verify anatomic site qualifies for 15135/15136 series (face/scalp/neck/hands/feet/genitals); trunk and arms/legs use different code series (15155/15156)

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Frequently asked questions

What is the difference between CPT 15135 and 15136?

CPT 15135 covers the first 100 square centimeters of dermal autograft to specified anatomic sites (face, scalp, neck, hands, feet, genitals). CPT 15136 is an add-on code reported for each additional 100 sq cm (or part thereof) beyond the first 100 sq cm. You must bill 15135 first, then add units of 15136 for additional area grafted.

How much does Medicare pay for CPT code 15136 in 2025?

Medicare pays $94.13 for CPT 15136 in non-facility settings and $87.01 in facility settings based on the 2025 national average rates. The code has 2.91 total RVUs (1.5 work RVU, varying PE RVUs by setting, and 0.28 malpractice RVU) multiplied by the 2025 conversion factor of 32.3465.

Can CPT 15136 be billed alone without another code?

No, CPT 15136 is an add-on code that must be billed with primary code 15135. It cannot be reported independently. Billing 15136 alone will result in claim denial. Always ensure 15135 is included on the claim for the first 100 sq cm of graft area.

How do I calculate the number of units for CPT 15136?

Measure total grafted surface area in square centimeters. The first 100 sq cm is covered by 15135. Each additional 100 sq cm or portion thereof is one unit of 15136. For example, 250 sq cm total = 15135 x1 plus 15136 x2 (for the additional 150 sq cm). Round partial units up.

What anatomic sites qualify for CPT 15136?

CPT 15136 applies only to grafts on face, scalp, eyelids, mouth, neck, ears, orbits, genitalia, hands, feet, and/or multiple digits. Grafts to the trunk, arms, or legs require different codes (15155/15156 series). Using the wrong code series will result in incorrect reimbursement.

Does CPT 15136 include the donor site harvesting?

CPT 15136 describes only the recipient site where the graft is placed. Donor site harvesting may be separately billable depending on the technique used and payer policy. Check specific payer guidelines as some consider donor site harvesting included while others allow separate reporting with appropriate codes.

What documentation is required to avoid denial of CPT 15136?

Required documentation includes specific anatomic sites grafted, precise surface area measurements in square centimeters, type of graft material, medical necessity for autograft, wound characteristics, and clear calculation showing how total area converts to units billed. Operative report should include detailed measurements and may benefit from diagrams for complex cases.