CPT code 15260: Full-thickness graft, nose, ear, eyelid, or lip2026 Medicare rate & RVUs in South Dakota
Reports a full-thickness skin graft of 20 square centimeters or less for a defect of the nose, ear, eyelid, or lip.
In South Dakota, Medicare pays $971.97 for 15260 in the office and $698.42 when it’s performed in a hospital or facility.
Check a contract rate as a % of Medicare · 15260 nationwide
Medicare allowed amount for participating (non-QP) physicians, before deductible, coinsurance and claim adjustments. Not a patient’s bill or a hospital charge.
On this page 11 sections
What 15260 covers
This code covers placing a full-thickness skin graft on a defect of the nose, ear, eyelid, or lip when the grafted area is 20 square centimeters or less. Plastic surgeons, dermatologic surgeons, otolaryngologists, and oculoplastic surgeons may use it to reconstruct a defect after skin cancer removal, including Mohs surgery, or after trauma. The graft is harvested from another site, and the donor site is closed.
Select the code by the recipient site and grafted area, not the donor site. Document the recipient location, measured area, graft harvest and placement, and any separately performed recipient-site preparation. Code 15261 is used for additional area beyond the base amount. The 90-day global period includes the day-before preoperative visit and related postoperative care. In a same-session multiple-procedure claim, the highest-valued procedure is paid in full and other procedures are reduced to 50%. Modifier 50 is inappropriate; assistant-at-surgery payment is restricted, and co-surgeon and team-surgery payment 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 South Dakota compares for 15260
Across 109 of 109 payment localities, the office rate for 15260 runs from $898.28 in Arkansas to $1,277.97 in San Benito County, CA. South Dakota pays $971.97. The RVUs are the same everywhere; the geographic indexes change the dollars.
- South Dakota · this page$971.97
- Los Angeles, CA · California$1,107.67+$135.70
- Washington, DC area · District of Columbia$1,129.35+$157.38
- Miami, FL · Florida$1,091.63+$119.66
- Chicago, IL · Illinois$1,063.23+$91.26
- Manhattan, NY · New York$1,144.59+$172.62
- Alaska · Alaska$1,208.51+$236.54
Other areas in South Dakota first, then benchmark localities. Bars start at $0.
Every other payment area
| Payment locality | Office | Facility |
|---|---|---|
| AlabamaAlabama | $909.76 | $670.40 |
| ArkansasArkansas | $898.28 | $663.30 |
| ArizonaArizona | $976.80 | $711.73 |
| Bakersfield, CACalifornia | $1,046.62 | $746.81 |
| Chico, CACalifornia | $1,042.67 | $742.86 |
| El Centro, CACalifornia | $1,042.89 | $743.08 |
| Fresno, CACalifornia | $1,042.67 | $742.86 |
| Hanford, CACalifornia | $1,042.67 | $742.86 |
| Madera, CACalifornia | $1,042.67 | $742.86 |
| Merced, CACalifornia | $1,042.67 | $742.86 |
| Modesto, CACalifornia | $1,042.67 | $742.86 |
| Napa, CACalifornia | $1,187.24 | $826.70 |
| Oxnard, CACalifornia | $1,100.37 | $777.03 |
| Redding, CACalifornia | $1,042.67 | $742.86 |
| Rest of CaliforniaCalifornia | $1,042.67 | $742.86 |
| Riverside, CACalifornia | $1,056.92 | $757.11 |
| Sacramento, CACalifornia | $1,088.61 | $770.47 |
| Salinas, CACalifornia | $1,084.40 | $767.36 |
| San Diego, CACalifornia | $1,105.68 | $778.51 |
| Marin County, CACalifornia | $1,250.42 | $864.71 |
| San Francisco, CACalifornia | $1,248.93 | $863.22 |
| San Benito County, CACalifornia | $1,277.97 | $883.51 |
| Santa Clara County, CACalifornia | $1,271.89 | $877.43 |
| San Luis Obispo, CACalifornia | $1,067.53 | $755.96 |
| Santa Cruz, CACalifornia | $1,112.99 | $780.62 |
| Santa Maria, CACalifornia | $1,087.31 | $768.35 |
| Santa Rosa, CACalifornia | $1,123.92 | $787.99 |
| Stockton, CACalifornia | $1,042.67 | $742.86 |
| Vallejo, CACalifornia | $1,185.09 | $824.55 |
| Visalia, CACalifornia | $1,042.67 | $742.86 |
| Yuba City, CACalifornia | $1,042.67 | $742.86 |
| ColoradoColorado | $1,032.99 | $741.93 |
| ConnecticutConnecticut | $1,062.31 | $767.70 |
| DelawareDelaware | $991.56 | $721.29 |
| Fort Lauderdale, FLFlorida | $1,043.90 | $766.79 |
| Rest of FloridaFlorida | $997.59 | $736.08 |
| Atlanta, GAGeorgia | $1,020.21 | $742.28 |
| Rest of GeorgiaGeorgia | $946.98 | $702.97 |
| Hawaii, Guam, HIHawaii | $1,061.81 | $750.78 |
| IowaIowa | $925.50 | $675.19 |
| IdahoIdaho | $931.71 | $680.04 |
| East St. Louis, ILIllinois | $999.14 | $747.47 |
| Rest of IllinoisIllinois | $975.36 | $725.60 |
| Suburban Chicago, ILIllinois | $1,053.07 | $772.13 |
| IndianaIndiana | $936.33 | $682.74 |
| KansasKansas | $923.82 | $676.53 |
| KentuckyKentucky | $933.13 | $689.94 |
| New Orleans, LALouisiana | $972.86 | $715.45 |
| Rest of LouisianaLouisiana | $932.70 | $690.60 |
| Metropolitan Boston, MAMassachusetts | $1,123.92 | $797.30 |
| Rest of MassachusettsMassachusetts | $1,028.85 | $740.80 |
| Baltimore area, MDMaryland | $1,059.67 | $766.14 |
| Rest of MarylandMaryland | $1,008.17 | $731.33 |
| Rest of MaineMaine | $938.23 | $686.56 |
| Southern Maine, MEMaine | $979.68 | $708.58 |
| Detroit, MIMichigan | $1,010.81 | $746.83 |
| Rest of MichiganMichigan | $956.37 | $706.61 |
| MinnesotaMinnesota | $986.99 | $705.50 |
| Metropolitan Kansas City, MOMissouri | $964.75 | $707.88 |
| Metropolitan St. Louis, MOMissouri | $973.36 | $712.94 |
| Rest of MissouriMissouri | $920.10 | $684.30 |
| MississippiMississippi | $909.24 | $673.71 |
| MontanaMontana | $1,000.94 | $727.38 |
| North CarolinaNorth Carolina | $946.49 | $691.27 |
| North DakotaNorth Dakota | $975.03 | $701.48 |
| NebraskaNebraska | $929.29 | $676.80 |
| New HampshireNew Hampshire | $1,019.26 | $734.49 |
| Northern New JerseyNew Jersey | $1,120.39 | $803.07 |
| Rest of New JerseyNew Jersey | $1,073.62 | $774.90 |
| New MexicoNew Mexico | $961.83 | $710.98 |
| NevadaNevada | $994.30 | $720.47 |
| NYC suburbs and Long Island, NYNew York | $1,172.06 | $846.80 |
| Poughkeepsie and northern NYC suburbs, NYNew York | $1,082.20 | $782.66 |
| Queens, NYNew York | $1,149.85 | $826.51 |
| Rest of New YorkNew York | $959.12 | $699.25 |
| OhioOhio | $951.07 | $701.32 |
| OklahomaOklahoma | $929.40 | $685.12 |
| Portland, OROregon | $1,060.07 | $756.15 |
| Rest of OregonOregon | $985.72 | $713.26 |
| Metropolitan Philadelphia, PAPennsylvania | $1,040.00 | $755.23 |
| Rest of PennsylvaniaPennsylvania | $951.21 | $700.09 |
| Puerto RicoPuerto Rico | $1,006.73 | $730.17 |
| Rhode IslandRhode Island | $1,022.58 | $740.00 |
| South CarolinaSouth Carolina | $950.52 | $697.76 |
| TennesseeTennessee | $928.15 | $679.49 |
| Austin, TXTexas | $1,030.33 | $740.91 |
| Beaumont, TXTexas | $945.88 | $696.95 |
| Brazoria, TXTexas | $989.23 | $718.14 |
| Dallas, TXTexas | $995.91 | $723.45 |
| Fort Worth, TXTexas | $990.70 | $720.97 |
| Galveston, TXTexas | $992.48 | $720.85 |
| Houston, TXTexas | $1,016.46 | $744.82 |
| Rest of TexasTexas | $967.29 | $707.69 |
| UtahUtah | $961.87 | $704.73 |
| VirginiaVirginia | $978.33 | $709.43 |
| Virgin Islands, VIUnited States Virgin Islands | $1,006.73 | $730.17 |
| VermontVermont | $973.63 | $702.81 |
| Rest of WashingtonWashington | $1,026.14 | $738.09 |
| King County, WAWashington | $1,143.22 | $807.57 |
| WisconsinWisconsin | $946.46 | $684.40 |
| West VirginiaWest Virginia | $944.14 | $706.43 |
| WyomingWyoming | $989.65 | $716.10 |
15260 rates by state
Office rate range in each state. Select a state to see its payment localities.
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.
$898.28
$1,208.51
Color shows the midpoint of each state’s locality range.
View every state and territory as a table
| State / territory | Office rate range | Localities |
|---|---|---|
| AK | $1,208.51 | 1 |
| AL | $909.76 | 1 |
| AR | $898.28 | 1 |
| AZ | $976.80 | 1 |
| CA | $1,042.67–$1,277.97 | 29 |
| CO | $1,032.99 | 1 |
| CT | $1,062.31 | 1 |
| DC | $1,129.35 | 1 |
| DE | $991.56 | 1 |
| FL | $997.59–$1,091.63 | 3 |
| GA | $946.98–$1,020.21 | 2 |
| GU | $1,061.81 | 1 |
| HI | $1,061.81 | 1 |
| IA | $925.50 | 1 |
| ID | $931.71 | 1 |
| IL | $975.36–$1,063.23 | 4 |
| IN | $936.33 | 1 |
| KS | $923.82 | 1 |
| KY | $933.13 | 1 |
| LA | $932.70–$972.86 | 2 |
| MA | $1,028.85–$1,123.92 | 2 |
| MD | $1,008.17–$1,129.35 | 3 |
| ME | $938.23–$979.68 | 2 |
| MI | $956.37–$1,010.81 | 2 |
| MN | $986.99 | 1 |
| MO | $920.10–$973.36 | 3 |
| MS | $909.24 | 1 |
| MT | $1,000.94 | 1 |
| NC | $946.49 | 1 |
| ND | $975.03 | 1 |
| NE | $929.29 | 1 |
| NH | $1,019.26 | 1 |
| NJ | $1,073.62–$1,120.39 | 2 |
| NM | $961.83 | 1 |
| NV | $994.30 | 1 |
| NY | $959.12–$1,172.06 | 5 |
| OH | $951.07 | 1 |
| OK | $929.40 | 1 |
| OR | $985.72–$1,060.07 | 2 |
| PA | $951.21–$1,040.00 | 2 |
| PR | $1,006.73 | 1 |
| RI | $1,022.58 | 1 |
| SC | $950.52 | 1 |
| SD | $971.97 | 1 |
| TN | $928.15 | 1 |
| TX | $945.88–$1,030.33 | 8 |
| UT | $961.87 | 1 |
| VA | $978.33–$1,129.35 | 2 |
| VI | $1,006.73 | 1 |
| VT | $973.63 | 1 |
| WA | $1,026.14–$1,143.22 | 2 |
| WI | $946.46 | 1 |
| WV | $944.14 | 1 |
| WY | $989.65 | 1 |
How the 15260 rate is calculated
Each of 15260’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 · 15260
RVUs × geographic indexes × conversion factor
Work11.35
11.35 RVUs× 1.000 GPCI
Practice expense17.31
17.31 RVUs× 1.000 GPCI
Malpractice1.31
1.31 RVUs× 1.000 GPCI
Adjusted RVUs
29.9700
Conversion factor
$33.4009
Medicare rate
$1,001.02
Every GPCI starts at 1.000, the national rate. Enter a ZIP or drag a slider.
The exact South Dakota inputs and CMS source lines
PPRRVU2026_Oct_nonQPP.csv
1,510
- Code
- 15260
- Physician work
- 11.35
- Practice expense
- 17.31
- Malpractice
- 1.31
GPCI2026.csv
94
- Locality
- South Dakota
- Physician work
- 1.000
- Practice expense
- 1.000
- Malpractice
- 0.336
| Component | RVU | Locality factor | Adjusted |
|---|---|---|---|
| Physician work | 11.35 | × 1.000 | 11.3500 |
| Practice expense | 17.31 | × 1.000 | 17.3100 |
| Malpractice | 1.31 | × 0.336 | 0.4402 |
| Total RVUs | 29.1002 | ||
| Conversion factor | × 33.4009 | ||
Office rate, South Dakota$971.97
Office: (11.35 × 1 + 17.31 × 1 + 1.31 × 0.336) × $33.4009 = $971.97
Facility: (11.35 × 1 + 9.12 × 1 + 1.31 × 0.336) × $33.4009 = $698.42
Payment rules and modifiers for 15260
15260 has a 90-day global period: related visits in that window are included in the surgery payment.
CMS payment indicators · 15260
Full-thickness graft, nose, ear, eyelid, or lip
| Rule | CMS value | What it means |
|---|---|---|
| Global period | 090 | Major surgery: the day before, the day of, and 90 days after are included. |
| Multiple procedures | 2 | Standard reduction: highest-valued procedure at 100%, others at 50%. |
| 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. |
| Split (54/55/56) | 0.10/0.71/0.19 | Share of the payment for pre-op, the procedure itself, and post-op care. |
Global surgery period · 15260
Full-thickness graft, nose, ear, eyelid, or lip
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.
Pre-op dayGlobal period
What modifiers do to the payment
Modifier 51 · payment effect
With and without the modifier
15260 without 51 · national office
$1,001.02
Full-thickness graft, nose, ear, eyelid, or lip
15260-51 · Second procedure: 50%
$500.51
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%).
How 15260 has changed in South Dakota
15260 · Office / nonfacility
$971.97
Effective 2026-10-01
The base rate is $21.72 higher than on 2025-10-01, moving from $950.25 to $971.97 (2.3%).
It is unchanged from the immediately preceding available release, effective 2026-07-01.
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
January 1, 2026
RVU26A
$950.25changed to$971.97
- Conversion factor 32.3465 changed to 33.4009
- Work RVU 11.64 changed to 11.35
- Practice expense RVU 17.21 changed to 17.31
- Malpractice RVU 1.38 changed to 1.31
- Malpractice GPCI 0.382 changed to 0.336
Held through RVU26B, RVU26C, RVU26D.
January 1, 2025
RVU25A
$973.36changed to$950.25
- Conversion factor 33.2875 changed to 32.3465
- Practice expense RVU 17.07 changed to 17.21
- Malpractice RVU 1.39 changed to 1.38
Held through RVU25B, RVU25C, RVU25D.
March 9, 2024
RVU24AR
$957.47changed to$973.36
- Conversion factor 32.7442 changed to 33.2875
Held through RVU24B, RVU24C, RVU24D.
January 1, 2024
RVU24A
$982.31changed to$957.47
- Conversion factor 33.8872 changed to 32.7442
- Practice expense RVU 16.86 changed to 17.07
- Malpractice RVU 1.34 changed to 1.39
- Malpractice GPCI 0.364 changed to 0.382
January 1, 2023
RVU23A
$985.52changed to$982.31
- Conversion factor 34.6062 changed to 33.8872
- Practice expense RVU 16.38 changed to 16.86
- Malpractice RVU 1.32 changed to 1.34
- Malpractice GPCI 0.347 changed to 0.364
Held through RVU23B, RVU23C, RVU23D.
January 1, 2022
RVU22A
$987.97changed to$985.52
- Conversion factor 34.8931 changed to 34.6062
- Practice expense RVU 16.23 changed to 16.38
- Malpractice RVU 1.28 changed to 1.32
Held through RVU22B, RVU22C, RVU22D.
January 1, 2021
RVU21A
$1000.04changed to$987.97
- Conversion factor 36.0896 changed to 34.8931
- Practice expense RVU 15.61 changed to 16.23
- Malpractice RVU 1.25 changed to 1.28
- Malpractice GPCI 0.368 changed to 0.347
Held through RVU21B, RVU21C, RVU21D.
January 1, 2020
RVU20A
$1003.60changed to$1000.04
- Conversion factor 36.0391 changed to 36.0896
- Practice expense RVU 15.55 changed to 15.61
- Malpractice RVU 1.69 changed to 1.25
- Malpractice GPCI 0.389 changed to 0.368
Held through RVU20B, RVU20C, RVU20D.
January 1, 2019
RVU19A
$1002.50changed to$1003.60
- Conversion factor 35.9996 changed to 36.0391
Held through RVU19B, RVU19C, RVU19D.
January 1, 2018
RVU18AR1
$999.20changed to$1002.50
- Conversion factor 35.8887 changed to 35.9996
- Practice expense RVU 15.53 changed to 15.55
- Malpractice RVU 1.70 changed to 1.69
- Malpractice GPCI 0.395 changed to 0.389
Held through RVU18B, RVU18C, RVU18D.
January 1, 2017
RVU17A
$994.43changed to$999.20
- Conversion factor 35.8043 changed to 35.8887
- Practice expense RVU 15.45 changed to 15.53
- Malpractice RVU 1.71 changed to 1.70
- Malpractice GPCI 0.400 changed to 0.395
Held through RVU17B, RVU17C, RVU17D.
January 1, 2016
RVU16A
$996.51changed to$994.43
- Conversion factor 35.9335 changed to 35.8043
- Practice expense RVU 15.46 changed to 15.45
- Malpractice RVU 1.58 changed to 1.71
Held through RVU16B, RVU16C, RVU16D.
July 1, 2015
RVU15C
$991.55changed to$996.51
- Conversion factor 35.7547 changed to 35.9335
Held through RVU15D.
January 1, 2015
RVU15A
$985.95changed to$991.55
- Conversion factor 35.8228 changed to 35.7547
- Practice expense RVU 15.18 changed to 15.46
- Malpractice RVU 1.69 changed to 1.58
- Malpractice GPCI 0.416 changed to 0.400
Held through RVU15B.
January 1, 2014
RVU14A
$999.75changed to$985.95
- Conversion factor 34.0230 changed to 35.8228
- Practice expense RVU 16.98 changed to 15.18
- Malpractice RVU 1.77 changed to 1.69
- Malpractice GPCI 0.432 changed to 0.416
Held through RVU14B, RVU14C, RVU14D.
January 1, 2013
RVU13AR
Earliest loaded release: $999.75
Held through RVU13B, RVU13C, RVU13D.
| Effective from | Office | Facility | CMS release |
|---|---|---|---|
| 2026-10-01 | $971.97 | $698.42 | RVU26D |
| 2026-07-01 | $971.97 | $698.42 | RVU26C |
| 2026-04-01 | $971.97 | $698.42 | RVU26B |
| 2026-01-01 | $971.97 | $698.42 | RVU26A |
| 2025-10-01 | $950.25 | $799.84 | RVU25D |
| 2025-07-01 | $950.25 | $799.84 | RVU25C |
| 2025-04-01 | $950.25 | $799.84 | RVU25B |
| 2025-01-01 | $950.25 | $799.84 | RVU25A |
| 2024-10-01 | $973.36 | $815.24 | RVU24D |
| 2024-07-01 | $973.36 | $815.24 | RVU24C |
| 2024-04-01 | $973.36 | $815.24 | RVU24B |
| 2024-03-09 | $973.36 | $815.24 | RVU24AR |
| 2024-01-01 | $957.47 | $801.94 | RVU24A |
| 2023-10-01 | $982.31 | $822.03 | RVU23D |
| 2023-07-01 | $982.31 | $822.03 | RVU23C |
| 2023-04-01 | $982.31 | $822.03 | RVU23B |
| 2023-01-01 | $982.31 | $822.03 | RVU23A |
| 2022-10-01 | $985.52 | $823.21 | RVU22D |
| 2022-07-01 | $985.52 | $823.21 | RVU22C |
| 2022-04-01 | $985.52 | $823.21 | RVU22B |
| 2022-01-01 | $985.52 | $823.21 | RVU22A |
| 2021-10-01 | $987.97 | $824.32 | RVU21D |
| 2021-07-01 | $987.97 | $824.32 | RVU21C |
| 2021-04-01 | $987.97 | $824.32 | RVU21B |
| 2021-01-01 | $987.97 | $824.32 | RVU21A |
| 2020-10-01 | $1,000.04 | $844.14 | RVU20D |
| 2020-07-01 | $1,000.04 | $844.14 | RVU20C |
| 2020-04-01 | $1,000.04 | $844.14 | RVU20B |
| 2020-01-01 | $1,000.04 | $844.14 | RVU20A |
| 2019-10-01 | $1,003.60 | $851.15 | RVU19D |
| 2019-07-01 | $1,003.60 | $851.15 | RVU19C |
| 2019-04-01 | $1,003.60 | $851.15 | RVU19B |
| 2019-01-01 | $1,003.60 | $851.15 | RVU19A |
| 2018-10-01 | $1,002.50 | $853.10 | RVU18D |
| 2018-07-01 | $1,002.50 | $853.10 | RVU18C |
| 2018-04-01 | $1,002.50 | $853.10 | RVU18B |
| 2018-01-01 | $1,002.50 | $853.10 | RVU18AR1 |
| 2017-10-01 | $999.20 | $852.41 | RVU17D |
| 2017-07-01 | $999.20 | $852.41 | RVU17C |
| 2017-04-01 | $999.20 | $852.41 | RVU17B |
| 2017-01-01 | $999.20 | $852.41 | RVU17A |
| 2016-10-01 | $994.43 | $847.99 | RVU16D |
| 2016-07-01 | $994.43 | $847.99 | RVU16C |
| 2016-04-01 | $994.43 | $847.99 | RVU16B |
| 2016-01-01 | $994.43 | $847.99 | RVU16A |
| 2015-10-01 | $996.51 | $848.46 | RVU15D |
| 2015-07-01 | $996.51 | $848.46 | RVU15C |
| 2015-04-01 | $991.55 | $844.24 | RVU15B |
| 2015-01-01 | $991.55 | $844.24 | RVU15A |
| 2014-10-01 | $985.95 | $843.02 | RVU14D |
| 2014-07-01 | $985.95 | $843.02 | RVU14C |
| 2014-04-01 | $985.95 | $843.02 | RVU14B |
| 2014-01-01 | $985.95 | $843.02 | RVU14A |
| 2013-10-01 | $999.75 | $845.29 | RVU13D |
| 2013-07-01 | $999.75 | $845.29 | RVU13C |
| 2013-04-01 | $999.75 | $845.29 | RVU13B |
| 2013-01-01 | $999.75 | $845.29 | RVU13AR |
Where the South Dakota rate applies
South Dakota is a Medicare payment area, not a city. Our Census mapping connects it to 485 cities and communities in South Dakota. Some span more than one payment area; confirm with the service ZIP.
- Aberdeen
- Agar
- Agency Village
- Akaska
- Albee
- Alcester
- Alexandria
- Allen
15260 billing questions
When is 15260 appropriate instead of 15240?
Use 15260 for a full-thickness graft on the nose, ear, eyelid, or lip. Code 15240 covers a different site group, including the forehead, cheeks, chin, mouth, neck, axillae, genitalia, hands, and feet.
When should 15261 be reported with 15260?
Report 15261 for additional grafted area beyond the first 20 square centimeters, using the applicable additional-area units. Document the total grafted area and the portion represented by the add-on code.
Does 15260 include harvesting the graft and closing the donor site?
Yes. The full-thickness graft service includes harvesting the graft and direct closure of the donor site.
Can recipient-site preparation be billed separately?
Separately performed surgical preparation of the recipient site may be reported when supported by the operative record. For the nose, ear, eyelid, or lip site group, code 15004 describes that preparation.
Should modifier 50 be appended for grafts on both sides?
No. CMS identifies bilateral adjustment as inappropriate for this code. Report the service according to the grafted site and area rather than applying modifier 50.
How does the global period affect postoperative billing?
The 90-day global period includes the day-before preoperative visit and related postoperative care. CMS also restricts assistant-at-surgery payment and does not permit co-surgeon or team-surgery payment for this code.
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
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