CPT 15774Surgery

Gfrg autol fat lipo ea addl

CPT 15774 is an add-on code for harvesting and injecting your own fat (taken from one area of your body) into each additional site beyond the first location, commonly used in cosmetic and reconstructive procedures.

Showing rates for

National Average

Base Medicare rate

$183.40

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

2.41

PE RVU (NF)

2.79

MP RVU

0.47

Total RVU

5.67

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

NCCI bundling edits

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Billing tips

Always bill 15774 with primary code 15773 (first site); 15774 cannot be billed as a standalone code
Impact: Prevents 100% denial; 15774 is designated as an add-on code (+) and will automatically deny without base code
Document each distinct anatomical site with precise anatomical terminology (e.g., 'right malar eminence,' 'left temporal region,' 'superior pole right breast') to justify multiple units
Impact: Supports billing of multiple units at $183.40 per additional site; vague documentation like 'face' risks downcoding to single unit
Calculate appropriate number of units based on truly distinct anatomical sites, not volume of fat injected; cosmetic indications may not be covered by Medicare
Impact: Overcoding can trigger audits; undercoding loses $183.40 per missed site; verify medical necessity for Medicare beneficiaries
For facility billing, be aware the facility rate is $140.06 vs non-facility $183.40—confirm place of service code matches actual location
Impact: Incorrect POS code can result in $43.34 payment differential per unit and potential recoupment demands
When billing with breast reconstruction codes (19357, 19364), ensure fat grafting is to distinct sites not included in primary reconstruction work
Impact: Bundling edits may apply; proper modifier use and documentation prevents denial of $183.40+ per additional site
Track total operative time and correlate with number of sites billed; excessive units without proportional time documentation raises red flags
Impact: Audit risk increases significantly when time documentation doesn't support claimed units; potential for full case recoupment

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Frequently asked questions

What is the Medicare reimbursement rate for CPT code 15774 in 2025?

The 2025 Medicare national average reimbursement for CPT 15774 is $183.40 for non-facility settings and $140.06 for facility settings. Actual payment may vary based on geographic location and MAC-specific adjustments.

Can CPT 15774 be billed alone without another code?

No, CPT 15774 is an add-on code (indicated by the + symbol in CPT) and must always be billed with the primary code 15773. Billing 15774 alone will result in automatic denial as it represents each additional site beyond the first.

How many units of 15774 can be billed for a single procedure?

There is no specific limit on units of 15774, but each unit must represent a truly distinct anatomical site. Documentation must clearly identify each separate location where fat grafting was performed. Billing should reflect actual distinct sites, not volume injected.

Does Medicare cover CPT 15774 for cosmetic fat grafting procedures?

No, Medicare does not cover cosmetic procedures. CPT 15774 is only covered when performed for reconstructive purposes such as post-mastectomy breast reconstruction, correction of traumatic defects, congenital deformities, or disease-related soft tissue loss with appropriate diagnosis coding.

What modifiers are commonly used with CPT code 15774?

Common modifiers include 59 or XS for distinct procedural services at separate anatomical sites, RT/LT for laterality specification, and modifier 50 for bilateral procedures when applicable. Modifier choice depends on payer requirements and specific clinical circumstances.

What is the difference between CPT 15773 and 15774?

CPT 15773 represents autologous fat grafting to the first site and is the primary code. CPT 15774 is the add-on code used for each additional site beyond the first during the same operative session. 15774 has lower RVUs (5.67 vs 8.16) reflecting incremental rather than complete procedure work.

What documentation is needed to support billing multiple units of 15774?

Documentation must include specific anatomical descriptions of each distinct site (not just 'face' or 'breast'), volume of fat injected at each location, medical necessity for treating each site, operative time supporting the work performed, and clear differentiation between sites in the operative report with precise anatomical terminology.