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CPT code 15220: Skin graft, scalp, arm, or leg, up to 20 sq cm2026 Medicare rate & RVUs in Puerto Rico

Reports reconstruction of a scalp, arm, or leg skin defect with a full-thickness graft when the recipient area is 20 square centimeters or less.

CMS RVU26DEffective Oct 1, 2026One payment locality9.4K Medicare services in 2024

In Puerto Rico, Medicare pays $787.66 for 15220 in the office and $539.80 when it’s performed in a hospital or facility.

$787.66Office (non-facility)
$539.80Hospital or facility
+0.6%vs the national office rate ($782.92)

Check a contract rate as a % of Medicare · 15220 nationwide

Medicare allowed amount for participating (non-QP) physicians, before deductible, coinsurance and claim adjustments. Not a patient’s bill or a hospital charge.

We’ll open 15220 for the payment locality that covers the ZIP.

On this page 11 sections
  1. Rate in Puerto Rico
  2. What 15220 covers
  3. Compared with other areas
  4. Rate map
  5. How it’s calculated
  6. Payment rules
  7. Related codes
  8. Rate history
  9. Where it applies
  10. Billing questions
  11. Sources

What 15220 covers

This service reconstructs a skin defect by transferring epidermis and the full dermis from a donor site to a recipient site on the scalp, arm, or leg. It may be used to cover a defect after skin-cancer excision, trauma, or another operation when a graft is selected instead of rearranging nearby tissue. The surgeon harvests the graft and directly closes the donor wound; that closure is included. Plastic, dermatologic, and other surgeons may perform the procedure in an office-based or facility setting.

Report this base code when the recipient graft area is 20 square centimeters or less. For additional graft area, report 15221 according to the area treated. Documentation should identify the recipient and donor sites, total graft area, and graft placement. Medicare assigns a 90-day global period, including the day-before preoperative visit and 90 days of related postoperative care. When multiple procedures occur in the same session, the highest-valued procedure is paid in full and others at 50%. Modifier 50 is inappropriate; assistant-at-surgery payment is restricted, and co-surgeon and team-surgery billing are not permitted.

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.

How Puerto Rico compares for 15220

Across 109 of 109 payment localities, the office rate for 15220 runs from $696.82 in Arkansas to $1,007.58 in San Benito County, CA. Puerto Rico pays $787.66. The RVUs are the same everywhere; the geographic indexes change the dollars.

15220 in Puerto Rico vs other payment areas
  1. Puerto Rico · this page$787.66
  2. Los Angeles, CA · California$869.35+$81.69
  3. Washington, DC area · District of Columbia$887.17+$99.51
  4. Miami, FL · Florida$859.88+$72.22
  5. Chicago, IL · Illinois$835.62+$47.96
  6. Manhattan, NY · New York$899.78+$112.12
  7. Alaska · Alaska$929.22+$141.56

Other areas in Puerto Rico first, then benchmark localities. Bars start at $0.

Every other payment area

15220 in every other Medicare payment locality
Payment localityOfficeFacility
AlabamaAlabama$706.43$491.92
ArkansasArkansas$696.82$486.22
ArizonaArizona$762.59$525.03
Bakersfield, CACalifornia$819.57$550.87
Chico, CACalifornia$816.31$547.61
El Centro, CACalifornia$816.50$547.80
Fresno, CACalifornia$816.31$547.61
Hanford, CACalifornia$816.31$547.61

15220 rates by state

Office rate range in each state. Select a state to see its payment localities.

MEWIVTNHMTNDMNMINYMARIWAIDWYSDIAILINOHPANJCTORNVUTCONEMOKYWVVAMDDECAAZNMKSOKARTNNCSCDCTXLAMSALGAFLAKHI

Explore a state

Local rates. Clear comparisons.

Hover or focus a tile to see its rate range. Select it to open the state’s fee schedule.

$696.82

$929.22

Color shows the midpoint of each state’s locality range.

View every state and territory as a table
15220 office rate range by state
State / territoryOffice rate rangeLocalities
AK$929.221
AL$706.431
AR$696.821
AZ$762.591
CA$816.31–$1,007.5829
CO$808.731
CT$833.161
DC$887.171
DE$774.671
FL$780.53–$859.883
GA$738.05–$798.942
GU$833.201
HI$833.201
IA$719.391
ID$724.641
IL$762.05–$835.624
IN$728.501
KS$718.091
KY$726.241
LA$725.92–$759.572
MA$805.08–$883.112
MD$788.27–$887.173
ME$730.22–$764.782
MI$745.81–$791.712
MN$770.561
MO$715.43–$759.863
MS$706.161
MT$782.841
NC$737.121
ND$760.701
NE$722.541
NH$798.001
NJ$841.43–$879.182
NM$750.431
NV$777.151
NY$747.71–$922.945
OH$741.281
OK$723.001
OR$769.88–$831.062
PA$741.34–$814.642
PR$787.661
RI$799.791
SC$740.681
SD$758.081
TN$721.741
TX$736.88–$807.138
UT$750.181
VA$763.73–$887.172
VI$787.661
VT$759.621
WA$802.95–$898.662
WI$736.791
WV$735.901
WY$773.191

See 15220 in every payment locality

How the 15220 rate is calculated

Each of 15220’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 · 15220

RVUs × geographic indexes × conversion factor

Office or facility?

Work7.89

7.89 RVUs× 1.000 GPCI

Practice expense14.43

14.43 RVUs× 1.000 GPCI

Malpractice1.12

1.12 RVUs× 1.000 GPCI

Adjusted RVUs

23.4400

Conversion factor

$33.4009

Medicare rate

$782.92

Every GPCI starts at 1.000, the national rate. Enter a ZIP or drag a slider.

The exact Puerto Rico inputs and CMS source lines

PPRRVU2026_Oct_nonQPP.csv

1,506

Code
15220
Physician work
7.89
Practice expense
14.43
Malpractice
1.12

GPCI2026.csv

91

Locality
Puerto Rico
Physician work
1.000
Practice expense
1.011
Malpractice
0.985
Office calculation for 15220 in Puerto Rico
ComponentRVULocality factorAdjusted
Physician work7.89× 1.0007.8900
Practice expense14.43× 1.01114.5887
Malpractice1.12× 0.9851.1032
Total RVUs23.5819
Conversion factor× 33.4009

Office rate, Puerto Rico$787.66

Office: (7.89 × 1 + 14.43 × 1.011 + 1.12 × 0.985) × $33.4009 = $787.66

Facility: (7.89 × 1 + 7.09 × 1.011 + 1.12 × 0.985) × $33.4009 = $539.80

Open 15220 in the RVU calculator

Payment rules and modifiers for 15220

15220 has a 90-day global period: related visits in that window are included in the surgery payment.

CMS payment indicators · 15220

Skin graft, scalp, arm, or leg, up to 20 sq cm

RuleCMS valueWhat it means
Global period090Major surgery: the day before, the day of, and 90 days after are included.
Multiple procedures2Standard reduction: highest-valued procedure at 100%, others at 50%.
Bilateral (modifier 50)0The 150% bilateral adjustment doesn’t apply.
Assistant at surgery (80/81/82/AS)1Not paid (statutory restriction).
Co-surgeons (62)0Not permitted.
Team surgery (66)0Not permitted.
Professional/technical0Physician service: no professional/technical split.
Split (54/55/56)0.10/0.71/0.19Share of the payment for pre-op, the procedure itself, and post-op care.

Global surgery period · 15220

Skin graft, scalp, arm, or leg, up to 20 sq cm

90-day global period ends

Dec 30, 2026

Covers Sep 30, 2026 through Dec 30, 2026 (92 days, including the day before surgery).

Visit on Oct 31, 2026

Day 30 of the 90-day post-op period: related follow-up care is included in the surgical payment.

  • 24Unrelated E/M visit by the same physician
  • 79Unrelated procedure (starts its own global period)
  • 58Staged, more extensive, or therapy procedure that was planned
  • 78Unplanned return to the operating room for a related complication
SurgeryVisit
Sep 23, 2026Jan 10, 2027

Pre-op dayGlobal period

What modifiers do to the payment

Modifier 51 · payment effect

With and without the modifier

15220 without 51 · national office

$782.92

Skin graft, scalp, arm, or leg, up to 20 sq cm

15220-51 · Second procedure: 50%

$391.46

When this isn’t the highest-valued procedure in the session, Medicare pays 50% of its fee schedule amount (the highest is paid at 100%).

When to use modifier 51

Codes related to 15220

Related codes aren’t interchangeable: bill the code that matches the service performed.

Codes related to 15220
CodeHow it relatesOffice range, Puerto Rico
Add-on codes
15221Skin graft, scalp, arm, or leg; each additional areaReports additional graft area beyond the initial 20 square centimeters.$134.81
Same family
15200Skin graft, trunk, 20 sq cm or lessFull-thickness graft code for a trunk recipient site.$880.83
15240Skin graft, specified sites, 20 sq cm or lessFull-thickness graft code for specified face, neck, hand, foot, and other sites.$942.99
15260Full-thickness graft, nose, ear, eyelid, or lipFull-thickness graft code for the nose, ear, eyelid, or lip.$1,006.73
Used instead
15271Skin substitute graft, first 25 cm², trunk/limbsApplication code for a skin substitute graft on the trunk, arm, or leg.$159.01

How 15220 has changed in Puerto Rico

15220 · Office / nonfacility

$787.66

Effective 2026-10-01

The base rate is $34.08 higher than on 2025-10-01, moving from $753.58 to $787.66 (4.5%).

It is unchanged from the immediately preceding available release, effective 2026-07-01.

Base rate by release · bars start at $0 · select a bar to compare

One bar per available release, ordered by effective date. Missing rates remain gaps. These comparisons hold the code, setting and locality identifiers constant; they do not isolate which policy or input caused a change.

What changed, release by release

  1. January 1, 2026

    RVU26A

    $753.58changed to$787.66

    • Conversion factor 32.3465 changed to 33.4009
    • Work RVU 8.09 changed to 7.89
    • Practice expense RVU 13.98 changed to 14.43
    • Malpractice RVU 1.15 changed to 1.12
    • Practice expense GPCI 1.007 changed to 1.011
    • Malpractice GPCI 0.982 changed to 0.985

    Held through RVU26B, RVU26C, RVU26D.

  2. January 1, 2025

    RVU25A

    $775.14changed to$753.58

    • Conversion factor 33.2875 changed to 32.3465
    • Practice expense RVU 13.93 changed to 13.98
    • Malpractice RVU 1.19 changed to 1.15

    Held through RVU25B, RVU25C, RVU25D.

  3. March 9, 2024

    RVU24AR

    $762.48changed to$775.14

    • Conversion factor 32.7442 changed to 33.2875

    Held through RVU24B, RVU24C, RVU24D.

  4. January 1, 2024

    RVU24A

    $783.55changed to$762.48

    • Conversion factor 33.8872 changed to 32.7442
    • Practice expense RVU 13.81 changed to 13.93
    • Malpractice RVU 1.13 changed to 1.19
    • Practice expense GPCI 1.008 changed to 1.007
    • Malpractice GPCI 0.984 changed to 0.982

  5. October 1, 2023

    RVU23D

    $780.42changed to$783.55

    • Practice expense GPCI 1.000 changed to 1.008
    • Malpractice GPCI 1.000 changed to 0.984

  6. January 1, 2023

    RVU23A

    $789.11changed to$780.42

    • Conversion factor 34.6062 changed to 33.8872
    • Practice expense RVU 13.51 changed to 13.81
    • Malpractice RVU 1.11 changed to 1.13
    • Practice expense GPCI 1.008 changed to 1.000
    • Malpractice GPCI 0.986 changed to 1.000

    Held through RVU23B, RVU23C.

  7. January 1, 2022

    RVU22A

    $792.14changed to$789.11

    • Conversion factor 34.8931 changed to 34.6062
    • Practice expense RVU 13.42 changed to 13.51
    • Malpractice RVU 1.10 changed to 1.11

    Held through RVU22B, RVU22C, RVU22D.

  8. January 1, 2021

    RVU21A

    $796.46changed to$792.14

    • Conversion factor 36.0896 changed to 34.8931
    • Practice expense RVU 12.78 changed to 13.42
    • Malpractice RVU 1.11 changed to 1.10
    • Malpractice GPCI 0.988 changed to 0.986

    Held through RVU21B, RVU21C, RVU21D.

  9. January 1, 2020

    RVU20A

    $797.74changed to$796.46

    • Conversion factor 36.0391 changed to 36.0896
    • Practice expense RVU 12.66 changed to 12.78
    • Malpractice RVU 1.31 changed to 1.11
    • Practice expense GPCI 1.007 changed to 1.008
    • Malpractice GPCI 0.990 changed to 0.988

    Held through RVU20B, RVU20C, RVU20D.

  10. January 1, 2019

    RVU19A

    $793.97changed to$797.74

    • Conversion factor 35.9996 changed to 36.0391
    • Practice expense RVU 12.58 changed to 12.66

    Held through RVU19B, RVU19C, RVU19D.

  11. January 1, 2018

    RVU18AR1

    $706.30changed to$793.97

    • Conversion factor 35.8887 changed to 35.9996
    • Practice expense RVU 12.55 changed to 12.58
    • Malpractice RVU 1.32 changed to 1.31
    • Practice expense GPCI 0.856 changed to 1.007
    • Malpractice GPCI 0.642 changed to 0.990

    Held through RVU18B, RVU18C, RVU18D.

  12. January 1, 2017

    RVU17A

    $618.38changed to$706.30

    • Conversion factor 35.8043 changed to 35.8887
    • Practice expense RVU 12.47 changed to 12.55
    • Malpractice RVU 1.33 changed to 1.32
    • Practice expense GPCI 0.705 changed to 0.856
    • Malpractice GPCI 0.293 changed to 0.642

    Held through RVU17B, RVU17C, RVU17D.

  13. January 1, 2016

    RVU16A

    $620.48changed to$618.38

    • Conversion factor 35.9335 changed to 35.8043
    • Practice expense RVU 12.49 changed to 12.47
    • Malpractice RVU 1.27 changed to 1.33

    Held through RVU16B, RVU16C, RVU16D.

  14. July 1, 2015

    RVU15C

    $617.40changed to$620.48

    • Conversion factor 35.7547 changed to 35.9335

    Held through RVU15D.

  15. January 1, 2015

    RVU15A

    $607.13changed to$617.40

    • Conversion factor 35.8228 changed to 35.7547
    • Practice expense RVU 12.28 changed to 12.49
    • Malpractice RVU 1.33 changed to 1.27
    • Practice expense GPCI 0.692 changed to 0.705
    • Malpractice GPCI 0.271 changed to 0.293

    Held through RVU15B.

  16. January 1, 2014

    RVU14A

    $603.74changed to$607.13

    • Conversion factor 34.0230 changed to 35.8228
    • Practice expense RVU 13.73 changed to 12.28
    • Malpractice RVU 1.39 changed to 1.33
    • Practice expense GPCI 0.678 changed to 0.692
    • Malpractice GPCI 0.249 changed to 0.271

    Held through RVU14B, RVU14C, RVU14D.

  17. January 1, 2013

    RVU13AR

    Earliest loaded release: $603.74

    Held through RVU13B, RVU13C, RVU13D.

Rates in every CMS release
Effective fromOfficeFacilityCMS release
2026-10-01$787.66$539.80RVU26D
2026-07-01$787.66$539.80RVU26C
2026-04-01$787.66$539.80RVU26B
2026-01-01$787.66$539.80RVU26A
2025-10-01$753.58$598.21RVU25D
2025-07-01$753.58$598.21RVU25C
2025-04-01$753.58$598.21RVU25B
2025-01-01$753.58$598.21RVU25A
2024-10-01$775.14$611.89RVU24D
2024-07-01$775.14$611.89RVU24C
2024-04-01$775.14$611.89RVU24B
2024-03-09$775.14$611.89RVU24AR
2024-01-01$762.48$601.90RVU24A
2023-10-01$783.55$616.52RVU23D
2023-07-01$780.42$614.71RVU23C
2023-04-01$780.42$614.71RVU23B
2023-01-01$780.42$614.71RVU23A
2022-10-01$789.11$618.88RVU22D
2022-07-01$789.11$618.88RVU22C
2022-04-01$789.11$618.88RVU22B
2022-01-01$789.11$618.88RVU22A
2021-10-01$792.14$620.15RVU21D
2021-07-01$792.14$620.15RVU21C
2021-04-01$792.14$620.15RVU21B
2021-01-01$792.14$620.15RVU21A
2020-10-01$796.46$632.76RVU20D
2020-07-01$796.46$632.76RVU20C
2020-04-01$796.46$632.76RVU20B
2020-01-01$796.46$632.76RVU20A
2019-10-01$797.74$638.43RVU19D
2019-07-01$797.74$638.43RVU19C
2019-04-01$797.74$638.43RVU19B
2019-01-01$797.74$638.43RVU19A
2018-10-01$793.97$638.45RVU18D
2018-07-01$793.97$638.45RVU18C
2018-04-01$793.97$638.45RVU18B
2018-01-01$793.97$638.45RVU18AR1
2017-10-01$706.30$576.04RVU17D
2017-07-01$706.30$576.04RVU17C
2017-04-01$706.30$576.04RVU17B
2017-01-01$706.30$576.04RVU17A
2016-10-01$618.38$511.86RVU16D
2016-07-01$618.38$511.86RVU16C
2016-04-01$618.38$511.86RVU16B
2016-01-01$618.38$511.86RVU16A
2015-10-01$620.48$513.07RVU15D
2015-07-01$620.48$513.07RVU15C
2015-04-01$617.40$510.52RVU15B
2015-01-01$617.40$510.52RVU15A
2014-10-01$607.13$504.50RVU14D
2014-07-01$607.13$504.50RVU14C
2014-04-01$607.13$504.50RVU14B
2014-01-01$607.13$504.50RVU14A
2013-10-01$603.74$495.09RVU13D
2013-07-01$603.74$495.09RVU13C
2013-04-01$603.74$495.09RVU13B
2013-01-01$603.74$495.09RVU13AR

Price 15220 for an earlier date of service

Where the Puerto Rico rate applies

Puerto Rico is a Medicare payment area, not a city. Our Census mapping connects it to 292 cities and communities in Puerto Rico. Some span more than one payment area; confirm with the service ZIP.

  • Aceitunas
  • Adjuntas
  • Aguada
  • Aguadilla
  • Aguas Buenas
  • Aguas Claras
  • Aguilita
  • Aibonito

Browse all communities in Puerto Rico

15220 billing questions

When should 15220 be chosen instead of 15200?

Use 15220 for a full-thickness graft to the scalp, arm, or leg. Code 15200 is for a graft to the trunk.

What is included in the graft service?

The graft harvest and direct closure of the donor wound are included. Do not separately report that direct donor-site closure as another service.

How is graft area above 20 square centimeters reported?

Use 15220 for the initial area up to 20 square centimeters and report 15221 for additional graft area.

Can modifier 50 be used when grafting both arms or legs?

No. CMS identifies modifier 50 as inappropriate for this code; report the service based on the graft area and documented sites.

What postoperative care is included?

The 90-day global period includes the day-before preoperative visit and 90 days of related postoperative care.

Can an assistant surgeon or co-surgeon be reported?

Assistant-at-surgery payment is restricted for this service. Co-surgeons and team surgery are not permitted.

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.

CMS RVU26D · effective Oct 1, 2026 through the day before Jan 1, 2027

Show the CMS file lines behind this rate
RVUs for 15220PPRRVU2026_Oct_nonQPP.csv, line 1,506 (RVU26D)
Geographic factors for Puerto RicoGPCI2026.csv, line 91 (RVU26D)

Open CMS sourceHow we calculate rates

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