CPT code 15261: Skin graft, additional 20 sq cm2026 Medicare rate & RVUs in Massachusetts
Reports each additional 20 sq cm, or fraction, of full-thickness skin grafting to the nose, ears, eyelids, or lips beyond the primary area.
Medicare pays $213.52–$233.92 for 15261 in the office in Massachusetts, from Rest of Massachusetts to Metropolitan Boston, MA. 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 15261 covers
Code 15261 captures additional recipient-area coverage when a free full-thickness skin graft is used on the nose, ears, eyelids, or lips. The surgeon harvests full-thickness skin, transfers it to a defect—often a nasal defect after Mohs excision—and closes the donor site directly. Plastic surgeons, dermatologic surgeons, and other surgeons perform this reconstruction in procedure rooms or operating rooms. This site group is specific to full-thickness skin grafts, not split-thickness grafts or skin-substitute products.
Report 15261 with 15260 when the grafted area exceeds the initial 20 sq cm; each further 20 sq cm or fraction supports an additional unit. Document the recipient site, graft technique, and measured graft area. This is an add-on code, not a standalone service, and CMS pays it within the primary procedure’s global period. Direct closure of the donor site is included in the graft service.
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 15261 pays more and less in Massachusetts
| Payment locality | Office | Facility |
|---|---|---|
| Metropolitan Boston, MA | $233.92 | $120.26 |
| Rest of Massachusetts | $213.52 | $113.28 |
How the 15261 rate is calculated
Each of 15261’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 · 15261
RVUs × geographic indexes × conversion factor
Work2.17
2.17 RVUs× 1.000 GPCI
Practice expense3.75
3.75 RVUs× 1.000 GPCI
Malpractice0.30
0.30 RVUs× 1.000 GPCI
Adjusted RVUs
6.2200
Conversion factor
$33.4009
Medicare rate
$207.75
Every GPCI starts at 1.000, the national rate. Enter a ZIP or drag a slider.
Payment rules and modifiers for 15261
The CMS indicators that decide how 15261 is paid alongside other services.
CMS payment indicators · 15261
Skin graft, additional 20 sq cm
| 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. |
15261 compared with similar codes
Compare codes · National
5 codes, side by side
How to choose
- 15260Full-thickness graftNose, ear, eyelid, or lip
- 15260 reports the primary full-thickness graft area, up to the initial 20 sq cm. Add 15261 for each additional 20 sq cm or fraction.
- 15241Skin graftEach additional 20 cm²
- 15241 is the additional-area code paired with 15240 for its site group. Use 15261 with 15260 for grafts to the nose, ears, eyelids, or lips.
- 15240Skin graftSpecified sites, 20 sq cm or less
- 15240 is the primary code for a different full-thickness graft site group. For grafts to the nose, ears, eyelids, or lips, the primary code is 15260.
- 15276Skin substitute graftAdditional area, selected sites
- 15276 reports additional area treated with a skin-substitute graft at its specified sites. Code 15261 is for additional area treated with a free full-thickness skin graft.
15261 billing questions
Which primary code must accompany 15261?
Report 15261 with 15260, the primary full-thickness graft code for the nose, ears, eyelids, or lips. It is not reported by itself.
How are units of 15261 counted?
After the initial 20 sq cm represented by 15260, each additional 20 sq cm or fraction supports one unit of 15261. Document the grafted recipient area.
Can the donor-site closure be billed separately?
Direct closure of the donor site is included in the full-thickness graft service described by this code family.
Does 15261 describe a skin-substitute graft?
No. It applies to additional area treated with a free full-thickness skin graft, not a skin-substitute product.
What documentation supports reporting 15261?
Document the nose, ear, eyelid, or lip recipient site, the full-thickness graft technique, and the measured graft area supporting the additional units.
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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