CPT 15775Surgery

Hair trnspl 1-15 punch grfts

CPT code 15775 covers hair transplantation using 1-15 punch grafts, a surgical technique where small circular sections of hair-bearing scalp are removed and transplanted to areas of hair loss. This is the smallest quantity tier for punch graft hair restoration.

Showing rates for

National Average

Base Medicare rate

$365.52

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

3.95

PE RVU (NF)

6.63

MP RVU

0.72

Total RVU

11.3

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

NCCI bundling edits

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Billing tips

Document medical necessity with detailed clinical notes describing traumatic injury, burn scarring, surgical defect, or disease-related alopecia rather than androgenetic alopecia
Impact: Difference between full reimbursement ($365.52 non-facility) and complete denial; cosmetic hair restoration is categorically excluded from Medicare coverage
Bill in the non-facility setting when performed in office-based surgical suite to capture the higher payment rate and full practice expense RVUs
Impact: Non-facility rate pays $116.78 more per procedure ($365.52 vs $248.74), representing 47% higher reimbursement for the same service
Count punch grafts precisely and bill the correct quantity code tier (15775 for 1-15, 15776 for 16+ grafts) based on actual grafts placed, not grafts harvested
Impact: Undercoding by staying at 15775 when 16+ grafts performed leaves significant revenue on the table; overcoding without documentation creates fraud risk and audit exposure
Link to appropriate ICD-10 codes indicating traumatic or disease-related alopecia (L65.0, L66.4, T20.35, etc.) rather than androgenetic alopecia codes
Impact: Medical necessity diagnosis codes are critical for coverage determination; cosmetic diagnosis codes trigger automatic denials regardless of procedure documentation
Submit detailed operative report with graft count, donor site location, recipient site description, and medical reconstruction rationale within 24-48 hours of claim submission
Impact: Proactive documentation submission reduces initial denials by approximately 60-70% for procedures with potential cosmetic vs reconstructive questions
When billing multiple hair restoration codes in same session, sequence 15775 appropriately with modifier 51 on secondary procedures to ensure correct multiple procedure payment reduction

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Frequently asked questions

What is the Medicare reimbursement rate for CPT code 15775 in 2025?

The 2025 Medicare national average payment for CPT 15775 is $365.52 in non-facility settings and $248.74 in facility settings. These rates are based on the CMS Physician Fee Schedule with a conversion factor of 32.3465 and total RVUs of 11.3.

Does Medicare cover hair transplant procedures under CPT 15775?

Medicare typically does not cover hair transplantation for cosmetic purposes such as male or female pattern baldness. However, 15775 may be covered when medically necessary for reconstruction following burns, traumatic injuries, surgical defects, or disease-related scarring alopecia. Medical necessity must be thoroughly documented with appropriate diagnosis codes.

What is the difference between CPT 15775 and 15776?

CPT 15775 covers hair transplantation using 1-15 punch grafts, while 15776 covers each additional 15 punch grafts beyond the first 15. For procedures involving 16-30 grafts, you would bill both 15775 and 15776. The graft count threshold determines which code(s) to use, and precise documentation of grafts placed is essential.

How many work RVUs is CPT code 15775 worth?

CPT code 15775 has 3.95 work RVUs, 6.63 practice expense RVUs (non-facility), 3.02 practice expense RVUs (facility), and 0.72 malpractice RVUs, for a total of 11.3 RVUs in the non-facility setting according to the 2025 CMS Physician Fee Schedule.

Can CPT 15775 be billed bilaterally with modifier 50?

Yes, modifier 50 can be applied to CPT 15775 when punch graft hair transplantation is performed bilaterally on both sides of the scalp during the same surgical session. Documentation must clearly support bilateral procedures with separate grafting on each side, and the medical necessity for bilateral treatment must be established.

What diagnosis codes are appropriate for billing CPT 15775?

Appropriate ICD-10 codes for 15775 include traumatic alopecia codes (L65.0), cicatricial alopecia codes (L66.x series), burn-related scarring (T20-T25 series with seventh character for sequela), and surgical defect codes. Avoid androgenetic alopecia codes (L64.x) as these indicate cosmetic intent and will result in denial.

What is the global period for CPT code 15775?

CPT code 15775 has a 90-day global surgical period. This means that routine follow-up care for 90 days post-procedure is included in the reimbursement. To bill for related procedures during this period, modifier 58 (staged procedure) or 78 (return to operating room) may be required depending on the circumstances.