CPT code 15278: Skin substitute graft, each additional 100 cm²2026 Medicare rate & RVUs in Missouri
Reports each additional 100 cm², or part of that increment, treated with a skin substitute graft at qualifying face, neck, hand, foot, or genital sites.
Medicare pays $92.50–$98.25 for 15278 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 15278 covers
This add-on reports additional wound area treated with a skin substitute graft at the face, neck, hands, feet, or genitalia. It is used when the treated wound area reaches the large-area threshold for this anatomic group, after the initial area is reported with the primary service. Surgeons and clinicians who provide specialized wound care may perform the application for wounds such as chronic ulcers or other defects requiring graft coverage.
Choose the code based on the total wound surface area treated and the anatomic site, not the number of graft pieces used. The record should identify the wound location, dimensions or calculated surface area, and the area receiving the graft. Report this code only with its primary procedure, 15277, for each additional 100 cm² or part thereof. CMS pays it within the primary 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 15278 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
$92.50 to $98.25
| Payment locality | Office | Facility |
|---|---|---|
| Metropolitan Kansas City, MO | $97.28 | $48.04 |
| Metropolitan St. Louis, MO | $98.25 | $48.33 |
| Rest of Missouri | $92.50 | $47.30 |
How the 15278 rate is calculated
Each of 15278’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 · 15278
RVUs × geographic indexes × conversion factor
Work0.98
0.98 RVUs× 1.000 GPCI
Practice expense1.85
1.85 RVUs× 1.000 GPCI
Malpractice0.20
0.20 RVUs× 1.000 GPCI
Adjusted RVUs
3.0300
Conversion factor
$33.4009
Medicare rate
$101.20
Every GPCI starts at 1.000, the national rate. Enter a ZIP or drag a slider.
Payment rules and modifiers for 15278
The CMS indicators that decide how 15278 is paid alongside other services.
CMS payment indicators · 15278
Skin substitute graft, each additional 100 cm²
| 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. |
15278 compared with similar codes
Compare codes · National
4 codes, side by side
How to choose
- 15277Skin substitute graftLarge area, special sites
- 15277 reports the initial area for the large-area service at the face, neck, hands, feet, or genitalia; 15278 reports each further 100 cm² or part.
- 15276Skin substitute graftAdditional area, selected sites
- 15276 is the additional-area code for the smaller-area service at the same sites. Select between it and 15278 based on the applicable area-size service, not the number of graft pieces.
- 15274Skin substituteEach additional 100 sq cm
- 15274 reports additional area for large-area treatment on the trunk, arms, or legs. Use 15278 for the face, neck, hands, feet, or genitalia.
15278 billing questions
When is 15278 reported instead of 15276?
Use 15278 for additional area after the large-area primary service, 15277, at the face, neck, hands, feet, or genitalia. Code 15276 is for additional area in the smaller-area service group.
Which primary code must accompany 15278?
Report 15278 only with 15277. It accounts for additional treated area beyond the initial area represented by that primary service.
How is the number of units determined?
Base units on the additional wound surface area treated: each 100 cm² or part thereof supports an additional unit. Document the treated area rather than counting graft pieces.
What documentation supports 15278?
Document the anatomic site, wound measurements or calculated surface area, and the area actually treated with the graft. The record should support that the primary large-area service and additional area were performed.
How does CMS treat payment for this add-on?
CMS pays 15278 within the global period of its primary procedure. It is not reported as a stand-alone service.
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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