CPT 15772Surgery

Grfg autol fat lipo ea addl

CPT 15772 covers the harvesting and injection of a patient's own fat tissue for grafting into an additional body site beyond the first. This is an add-on code used for autologous fat transfer procedures performed in multiple locations.

Showing rates for

National Average

Base Medicare rate

$187.93

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

2.5

PE RVU (NF)

2.83

MP RVU

0.48

Total RVU

5.81

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

NCCI bundling edits

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Billing tips

Always bill 15772 in conjunction with primary code 15771; never bill 15772 as a standalone code
Impact: Prevents automatic denial; 15772 is an add-on code with zero reimbursement if billed alone
Document each anatomical site separately with specific anatomical landmarks and volume of fat injected per site
Impact: Justifies multiple units of 15772; each additional site adds $187.93 (non-facility) or $144.59 (facility) to total reimbursement
Verify LCD/NCD coverage policies for cosmetic versus reconstructive indications; link appropriate ICD-10 codes for medical necessity
Impact: Reconstructive cases (post-mastectomy, trauma, congenital defects) have 85-95% coverage rate versus 0-5% for purely cosmetic indications
Use precise anatomical terminology (e.g., 'left breast upper outer quadrant' rather than 'left breast') when documenting multiple sites
Impact: Reduces audit risk and supports payment for each unit; vague documentation results in 40-60% denial rate for multiple units
For facility billing, understand the $43.34 differential between facility and non-facility rates when determining optimal site of service
Impact: Non-facility setting yields 30% higher physician reimbursement per additional site ($187.93 vs $144.59)
Bill maximum supported units based on operative report; there is no CMS-imposed limit on number of additional sites for 15772
Impact: Cases with 3-5 additional sites are commonly supported; underbilling loses $144.59-$187.93 per unreported site

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Frequently asked questions

What is the difference between CPT 15771 and 15772?

CPT 15771 is the primary code for the first site of autologous fat grafting via liposuction, while 15772 is an add-on code reported for each additional site beyond the first. You must bill 15771 first, then add 15772 for each subsequent anatomical site grafted during the same session. Medicare pays $187.93 per additional site (15772) in non-facility settings for 2025.

How many units of CPT 15772 can I bill?

There is no CMS-imposed maximum limit on units of 15772, but each unit must represent a distinct anatomical site with clear documentation. Typically 2-5 additional sites are supported in reconstructive cases. Each site must be separately identified with specific anatomical landmarks, and the medical necessity for grafting each site must be documented in the operative report.

Does Medicare cover CPT 15772 for cosmetic fat grafting?

No, Medicare and most payers exclude coverage for purely cosmetic fat grafting procedures. CPT 15772 is covered only for reconstructive purposes such as post-mastectomy breast reconstruction, correction of congenital deformities, post-traumatic defects, HIV-related lipodystrophy, or other medically necessary volume restoration. Documentation must clearly establish reconstructive medical necessity.

What RVU value does CPT 15772 have in 2025?

CPT 15772 has a total RVU of 5.81 for 2025, consisting of 2.5 work RVUs, 2.83 practice expense RVUs (non-facility), 1.49 practice expense RVUs (facility), and 0.48 malpractice RVUs. With the 2025 conversion factor of 32.3465, this yields $187.93 for non-facility settings and $144.59 for facility settings.

Can CPT 15772 be billed bilaterally with modifier 50?

Yes, modifier 50 can be applied when fat grafting is performed on bilateral anatomical structures like both breasts or both buttocks. However, documentation must clearly demonstrate that each side represents a distinct anatomical site meeting the definition of 'additional site' under CPT guidelines. Payer policies vary on bilateral reimbursement for add-on codes, so verify specific payer rules.

What documentation prevents denials for multiple units of 15772?

Critical documentation includes: operative report with detailed description of each anatomical site using specific landmarks, volume of fat injected per site, medical necessity for each site, clear separation between sites, and pre/post-operative diagnosis codes supporting reconstructive need. Anatomical diagrams, photos, and procedural notes detailing distinct recipient sites significantly reduce denial rates.

Is CPT 15772 subject to the multiple procedure payment reduction?

No, CPT 15772 is an add-on code (designated with '+' in CPT manual) and is exempt from the multiple procedure payment reduction (MPPR) under Medicare rules. Add-on codes are paid at 100% of the fee schedule amount regardless of how many other procedures are performed. However, 15772 can only be billed when the primary code 15771 is also reported.