CPT code 15157: Skin substitute graft, additional 1% body area2026 Medicare rate & RVUs in Missouri
Reports each additional 1% of body surface area treated with a cultured allogeneic skin substitute graft on specified sites in an infant or child.
Medicare pays $179.42–$185.99 for 15157 in the office in Missouri, from Rest of Missouri to Metropolitan St. Louis, MO. Which amount applies depends on the service address.
Medicare allowed amount for participating (non-QP) physicians, before deductible, coinsurance and claim adjustments. Not a patient’s bill or a hospital charge.
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What 15157 covers
This add-on represents an additional 1% of an infant’s or child’s body surface area treated with a tissue-cultured allogeneic skin substitute graft on the face, scalp, neck, hands, feet, or genitalia. A burn or reconstructive surgeon may apply the graft during operative wound coverage, including treatment of extensive burns or other wounds requiring skin replacement. The site and the patient’s age and body size affect how the treated area is measured within this code family.
Report 15157 with the applicable primary graft code, such as 15155, when the treated area extends beyond the initial area and the additional area is measured in 1% body-surface increments. The operative record should support the treated site, graft application, and total area covered, with enough detail to distinguish each additional increment. CMS classifies this as an add-on code: it is billed only with a primary procedure and paid within that procedure’s global period.
This summary was written with AI assistance from CMS physician fee schedule data and checked against the CMS billing rules shown here. Rates on this page come directly from CMS files.
Where 15157 pays more and less in Missouri
The same RVUs, adjusted for each area’s costs. Open a locality for its calculation, history and nearby areas.
3 payment localities
$179.42 to $185.99
| Payment locality | Office | Facility |
|---|---|---|
| Metropolitan Kansas City, MO | $184.49 | $145.91 |
| Metropolitan St. Louis, MO | $185.99 | $146.88 |
| Rest of Missouri | $179.42 | $144.01 |
How the 15157 rate is calculated
Each of 15157’s three RVUs is multiplied by a geographic index (GPCI) for the payment locality, added up, and multiplied by the conversion factor. Drag the indexes or enter a ZIP to see what moves the rate.
How the rate is built · 15157
RVUs × geographic indexes × conversion factor
Work2.93
2.93 RVUs× 1.000 GPCI
Practice expense1.94
1.94 RVUs× 1.000 GPCI
Malpractice0.79
0.79 RVUs× 1.000 GPCI
Adjusted RVUs
5.6600
Conversion factor
$33.4009
Medicare rate
$189.05
Every GPCI starts at 1.000, the national rate. Enter a ZIP or drag a slider.
Payment rules and modifiers for 15157
The CMS indicators that decide how 15157 is paid alongside other services.
CMS payment indicators · 15157
Skin substitute graft, additional 1% body area
| Rule | CMS value | What it means |
|---|---|---|
| Global period | ZZZ | Add-on code: falls within the primary procedure’s global period. |
| Multiple procedures | 0 | No multiple-procedure reduction. |
| Bilateral (modifier 50) | 0 | The 150% bilateral adjustment doesn’t apply. |
| Assistant at surgery (80/81/82/AS) | 1 | Not paid (statutory restriction). |
| Co-surgeons (62) | 1 | Permitted with supporting documentation. |
| Team surgery (66) | 0 | Not permitted. |
| Professional/technical | 0 | Physician service: no professional/technical split. |
15157 compared with similar codes
Compare codes · National
4 codes, side by side
How to choose
- 15156Cultured skin graftAdditional 100 sq cm
- Both report additional cultured allogeneic graft area on the specified sites. Choose 15157 for each additional 1% of an infant’s or child’s body surface area; 15156 uses 100-square-centimeter increments.
- 15155Cultured allograftFace and other special sites
- 15155 reports the initial graft area on the specified sites. Use 15157 only for additional 1% body-area increments beyond the initial area.
- 15152Cultured skin graftEach additional 1% body area
- Both represent additional 1% body-area increments for infants or children, but 15152 applies to the trunk, arms, or legs; 15157 applies to the face, scalp, neck, hands, feet, or genitalia.
15157 billing questions
When is 15157 used instead of 15156?
Use 15157 for each additional 1% of body surface area in an infant or child. Code 15156 represents additional area measured in 100-square-centimeter increments.
Which primary code is reported with 15157?
Report it with the applicable initial graft code for the specified sites, such as 15155. It is an add-on code and is not reported by itself.
Which sites qualify for this code?
The code family covers graft application on the face, scalp, neck, hands, feet, or genitalia. The documentation should identify the treated site and support the additional 1% increment.
How many units should be reported?
Report a unit for each additional 1% of body surface area treated in an infant or child. Document the total area grafted so the reported increments can be supported.
How does CMS treat payment for 15157?
CMS treats 15157 as an add-on code billed only with a primary procedure. Payment is within that primary procedure’s global period.
Where these rates come from
FeeBase calculates base physician payments from CMS work, practice-expense and malpractice RVUs, adjusted by each locality’s geographic indexes and the conversion factor. Services without a published rate are labeled, never given a made-up amount. Amounts are Medicare allowed amounts before claim adjustments: not a patient’s bill or a commercial rate.
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