CPT code 15221: Skin graft, scalp, arm, or leg; each additional area2026 Medicare rate & RVUs in Missouri
Reports each additional 20 square centimeters or part of full-thickness skin grafting on the scalp, arms, or legs beyond the initial area.
Medicare pays $121.55–$129.70 for 15221 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 15221 covers
This add-on represents additional recipient-site area treated with a full-thickness skin autograft on the scalp, an arm, or a leg. The graft contains the full skin thickness and is transferred to cover a defect, such as one remaining after lesion removal or injury. Plastic surgeons and other surgeons commonly perform these reconstructions in operating rooms or procedure settings. The primary graft service includes direct closure of the donor site.
Report this code with the primary graft code 15220 when the total grafted area exceeds the initial 20 square centimeters. Each additional 20 square centimeters, or any portion of that increment, supports one unit. Documentation should identify the recipient site, the full-thickness graft technique, and the total area treated so the additional area can be determined. 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 15221 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
$121.55 to $129.70
| Payment locality | Office | Facility |
|---|---|---|
| Metropolitan Kansas City, MO | $128.38 | $56.88 |
| Metropolitan St. Louis, MO | $129.70 | $57.20 |
| Rest of Missouri | $121.55 | $55.90 |
How the 15221 rate is calculated
Each of 15221’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 · 15221
RVUs × geographic indexes × conversion factor
Work1.16
1.16 RVUs× 1.000 GPCI
Practice expense2.65
2.65 RVUs× 1.000 GPCI
Malpractice0.20
0.20 RVUs× 1.000 GPCI
Adjusted RVUs
4.0100
Conversion factor
$33.4009
Medicare rate
$133.94
Every GPCI starts at 1.000, the national rate. Enter a ZIP or drag a slider.
Payment rules and modifiers for 15221
The CMS indicators that decide how 15221 is paid alongside other services.
CMS payment indicators · 15221
Skin graft, scalp, arm, or leg; each additional 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) | 0 | Not permitted. |
| Team surgery (66) | 0 | Not permitted. |
| Professional/technical | 0 | Physician service: no professional/technical split. |
15221 compared with similar codes
Compare codes · National
4 codes, side by side
How to choose
- 15220Skin graftScalp, arm, or leg, up to 20 sq cm
- 15220 covers the initial graft area up to 20 square centimeters on the scalp, arms, or legs; 15221 captures additional area beyond that base amount.
- 15201Skin graftAdditional trunk area
- 15201 captures additional full-thickness graft area on the trunk. Use 15221 for additional area on the scalp, arms, or legs.
- 15272Skin substitute graftAdditional trunk, arm, or leg area
- 15272 is for additional skin substitute graft area on the trunk, arms, or legs; 15221 is for additional area treated with a full-thickness skin autograft.
15221 billing questions
When is 15221 reported instead of 15220?
Use 15220 for the initial grafted area up to 20 square centimeters. Report 15221 for each additional 20 square centimeters or part of that increment.
Can 15221 be billed by itself?
No. It is an add-on code and must be billed with primary code 15220 for the qualifying full-thickness graft.
How are units determined?
Base units on the grafted area beyond the first 20 square centimeters. Each additional 20 square centimeters or fraction supports one unit.
What documentation supports the additional area?
Document the recipient-site location, that a full-thickness skin graft was performed, and the total grafted area. The recorded area should support the units billed beyond the initial area.
How does this differ from a skin substitute graft add-on?
15221 applies to additional area treated with a full-thickness skin autograft on the scalp, arms, or legs. Codes such as 15272 describe an additional area treated with a skin substitute graft.
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
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