CPT 15241Surgery

Fth/gft f/c/c/m/n/a/g/h/f ea

CPT 15241 is an add-on code for additional full thickness skin grafts performed on the face, scalp, neck, hands, feet, or genitalia beyond the first graft. Each additional 20 square centimeters (or part thereof) is reported separately with this code.

Showing rates for

National Average

Base Medicare rate

$167.55

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

1.86

PE RVU (NF)

3.03

MP RVU

0.29

Total RVU

5.18

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

NCCI bundling edits

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Billing tips

Always bill 15241 with primary code 15240 - never as standalone
Impact: Prevents 100% claim denial as 15241 is an add-on code requiring base procedure; ensures $167.55 payment per additional graft
Document exact graft measurements in square centimeters in operative report with diagram
Impact: Justifies number of units billed; each additional 20 sq cm or portion equals one unit at $167.55; prevents downcoding
Bill facility vs non-facility based on actual place of service
Impact: Payment difference of $64.36 per unit ($167.55 non-facility vs $103.19 facility); verify POS code matches claim
Report donor site preparation and closure separately only if extensive and documented as distinct procedure
Impact: Donor site closure is bundled into 15241; unbundling may trigger audit and recoupment of payments
Use multiple units of 15241 rather than mixing with incorrect primary codes
Impact: Each 20 sq cm increment warrants one unit; improper code selection may reduce reimbursement by 30-60%
Append modifier 59 when grafting anatomically distinct sites during same session
Impact: Prevents NCCI bundling edits; secures full payment for each distinct graft application rather than bundled single payment

Common denials

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Frequently asked questions

What is CPT code 15241 used for?

CPT 15241 is an add-on code for each additional 20 square centimeters (or portion thereof) of full thickness skin graft on specialized areas including face, scalp, eyelids, mouth, neck, ears, genitalia, hands, and feet. It must be billed with primary code 15240 and cannot be reported alone.

How much does Medicare pay for CPT 15241 in 2025?

Medicare pays $167.55 for CPT 15241 in non-facility settings and $103.19 in facility settings for 2025, based on the national average rate. Actual payment may vary by geographic locality and MAC jurisdiction.

How many units of 15241 can I bill?

Bill one unit of 15241 for each additional 20 square centimeters or portion thereof beyond the first 20 sq cm (covered by primary code 15240). For example, a 55 sq cm graft requires 15240 plus two units of 15241. Always document exact measurements to support units billed.

Can CPT 15241 be billed alone without 15240?

No, CPT 15241 is an add-on code and cannot be billed without primary code 15240. Claims submitted with only 15241 will be denied. The codes must be submitted together on the same claim to represent the complete graft procedure.

What is the RVU value for CPT 15241?

CPT 15241 has a total RVU of 5.18 for 2025, consisting of 1.86 work RVU, 3.03 non-facility practice expense RVU (1.04 facility PE RVU), and 0.29 malpractice RVU. This translates to Medicare payment rates using the 2025 conversion factor of 32.3465.

What modifiers are commonly used with CPT 15241?

Common modifiers include 59 (distinct procedural service for separate anatomical sites), 58 (staged procedure during global period), 78 (return to OR for complications), LT/RT (laterality for bilateral structures), and 22 (increased procedural services for unusual complexity). Modifier 51 may be auto-applied by payers but is not required for add-on codes.

What documentation is required to bill CPT 15241?

Required documentation includes precise measurements in square centimeters, specific anatomical locations of both recipient and donor sites, medical necessity justification, confirmation of full thickness graft technique, total defect size calculations supporting units billed, and clear linkage to primary code 15240. Operative diagrams or photographs strengthen claims.