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CPT code 15278: Skin substitute graft, each additional 100 cm²2026 Medicare rate & RVUs in Montana

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.

CMS RVU26DEffective Oct 1, 2026One payment locality3.1K Medicare services in 2024

In Montana, Medicare pays $101.19 for 15278 in the office and $48.75 when it’s performed in a hospital or facility.

$101.19Office (non-facility)
$48.75Hospital or facility
−0.0%vs the national office rate ($101.20)

Check a contract rate as a % of Medicare · 15278 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 15278 for the payment locality that covers the ZIP.

On this page 11 sections
  1. Rate in Montana
  2. What 15278 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 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.

How Montana compares for 15278

Across 109 of 109 payment localities, the office rate for 15278 runs from $89.25 in Arkansas to $129.02 in San Benito County, CA. Montana pays $101.19. The RVUs are the same everywhere; the geographic indexes change the dollars.

15278 in Montana vs other payment areas
  1. Montana · this page$101.19
  2. Los Angeles, CA · California$111.61+$10.42
  3. Washington, DC area · District of Columbia$114.73+$13.54
  4. Miami, FL · Florida$113.95+$12.76
  5. Chicago, IL · Illinois$110.39+$9.20
  6. Manhattan, NY · New York$117.22+$16.03
  7. Alaska · Alaska$118.59+$17.40

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

Every other payment area

15278 in every other Medicare payment locality
Payment localityOfficeFacility
AlabamaAlabama$90.58$44.70
ArkansasArkansas$89.25$44.21
ArizonaArizona$98.33$47.51
Bakersfield, CACalifornia$105.15$47.67
Chico, CACalifornia$104.59$47.12
El Centro, CACalifornia$104.63$47.15
Fresno, CACalifornia$104.59$47.12
Hanford, CACalifornia$104.59$47.12

15278 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.

$89.25

$118.59

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

View every state and territory as a table
15278 office rate range by state
State / territoryOffice rate rangeLocalities
AK$118.591
AL$90.581
AR$89.251
AZ$98.331
CA$104.59–$129.0229
CO$104.091
CT$108.021
DC$114.731
DE$99.951
FL$101.85–$113.953
GA$95.81–$103.632
GU$106.861
HI$106.861
IA$91.921
ID$92.741
IL$99.59–$110.394
IN$93.261
KS$91.961
KY$93.781
LA$93.82–$98.472
MA$103.65–$113.802
MD$101.73–$114.733
ME$93.74–$98.182
MI$96.69–$103.622
MN$98.291
MO$92.50–$98.253
MS$90.871
MT$101.191
NC$94.651
ND$97.241
NE$92.291
NH$102.901
NJ$108.85–$113.612
NM$97.421
NV$100.151
NY$96.13–$120.705
OH$95.881
OK$93.101
OR$98.97–$106.882
PA$95.77–$105.622
PR$101.781
RI$103.141
SC$95.511
SD$96.771
TN$92.491
TX$95.17–$104.098
UT$96.821
VA$98.19–$114.732
VI$101.781
VT$97.291
WA$103.31–$115.652
WI$93.991
WV$95.991
WY$99.471

See 15278 in every payment locality

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

Office or facility?

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.

The exact Montana inputs and CMS source lines

PPRRVU2026_Oct_nonQPP.csv

1,519

Code
15278
Physician work
0.98
Practice expense
1.85
Malpractice
0.20

GPCI2026.csv

71

Locality
Montana
Physician work
1.000
Practice expense
1.000
Malpractice
0.998
Office calculation for 15278 in Montana
ComponentRVULocality factorAdjusted
Physician work0.98× 1.0000.9800
Practice expense1.85× 1.0001.8500
Malpractice0.20× 0.9980.1996
Total RVUs3.0296
Conversion factor× 33.4009

Office rate, Montana$101.19

Office: (0.98 × 1 + 1.85 × 1 + 0.2 × 0.998) × $33.4009 = $101.19

Facility: (0.98 × 1 + 0.28 × 1 + 0.2 × 0.998) × $33.4009 = $48.75

Open 15278 in the RVU calculator

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

RuleCMS valueWhat it means
Global periodZZZAdd-on code: falls within the primary procedure’s global period.
Multiple procedures0No multiple-procedure reduction.
Bilateral (modifier 50)0The 150% bilateral adjustment doesn’t apply.
Assistant at surgery (80/81/82/AS)1Not paid (statutory restriction).
Co-surgeons (62)1Permitted with supporting documentation.
Team surgery (66)0Not permitted.
Professional/technical0Physician service: no professional/technical split.

Codes related to 15278

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

Codes related to 15278
CodeHow it relatesOffice range, Montana
Add-on codes
15277Skin substitute graft, large area, special sitesRequired primary service for additional large-area treatment at the same anatomic sites.$361.02
Same family
15276Skin substitute graft, additional area, selected sitesAdditional-area sibling for the smaller-area service at the same anatomic sites.$33.73
15275Skin substitute, face and other specified sitesPrimary service for the smaller-area wound treatment at the same anatomic sites.$160.31
Used instead
15274Skin substitute, each additional 100 sq cmAdditional-area code for large-area treatment on the trunk, arms, or legs.$86.83
15272Skin substitute graft, additional trunk, arm, or leg areaAdditional-area code for smaller-area treatment on the trunk, arms, or legs.$25.72

How 15278 has changed in Montana

15278 · Office / nonfacility

$101.19

Effective 2026-10-01

The base rate is $10.12 higher than on 2025-10-01, moving from $91.07 to $101.19 (11.1%).

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

    $91.07changed to$101.19

    • Conversion factor 32.3465 changed to 33.4009
    • Work RVU 1.00 changed to 0.98
    • Practice expense RVU 1.61 changed to 1.85
    • Malpractice RVU 0.21 changed to 0.20
    • Malpractice GPCI 0.978 changed to 0.998

    Held through RVU26B, RVU26C, RVU26D.

  2. January 1, 2025

    RVU25A

    $94.39changed to$91.07

    • Conversion factor 33.2875 changed to 32.3465
    • Practice expense RVU 1.64 changed to 1.61
    • Malpractice RVU 0.20 changed to 0.21

    Held through RVU25B, RVU25C, RVU25D.

  3. March 9, 2024

    RVU24AR

    $92.85changed to$94.39

    • Conversion factor 32.7442 changed to 33.2875

    Held through RVU24B, RVU24C, RVU24D.

  4. January 1, 2024

    RVU24A

    $96.78changed to$92.85

    • Conversion factor 33.8872 changed to 32.7442
    • Practice expense RVU 1.67 changed to 1.64
    • Malpractice RVU 0.19 changed to 0.20

  5. January 1, 2023

    RVU23A

    $100.20changed to$96.78

    • Conversion factor 34.6062 changed to 33.8872
    • Practice expense RVU 1.70 changed to 1.67
    • Malpractice RVU 0.20 changed to 0.19
    • Malpractice GPCI 0.977 changed to 0.978

    Held through RVU23B, RVU23C, RVU23D.

  6. January 1, 2022

    RVU22A

    $99.28changed to$100.20

    • Conversion factor 34.8931 changed to 34.6062
    • Practice expense RVU 1.65 changed to 1.70

    Held through RVU22B, RVU22C, RVU22D.

  7. January 1, 2021

    RVU21A

    $98.66changed to$99.28

    • Conversion factor 36.0896 changed to 34.8931
    • Practice expense RVU 1.46 changed to 1.65
    • Malpractice RVU 0.21 changed to 0.20
    • Malpractice GPCI 1.304 changed to 0.977

    Held through RVU21B, RVU21C, RVU21D.

  8. January 1, 2020

    RVU20A

    $96.09changed to$98.66

    • Conversion factor 36.0391 changed to 36.0896
    • Practice expense RVU 1.34 changed to 1.46
    • Malpractice RVU 0.20 changed to 0.21
    • Malpractice GPCI 1.631 changed to 1.304

    Held through RVU20B, RVU20C, RVU20D.

  9. January 1, 2019

    RVU19A

    $92.02changed to$96.09

    • Conversion factor 35.9996 changed to 36.0391
    • Practice expense RVU 1.23 changed to 1.34

    Held through RVU19B, RVU19C, RVU19D.

  10. January 1, 2018

    RVU18AR1

    $90.65changed to$92.02

    • Conversion factor 35.8887 changed to 35.9996
    • Practice expense RVU 1.24 changed to 1.23
    • Malpractice GPCI 1.429 changed to 1.631

    Held through RVU18B, RVU18C, RVU18D.

  11. January 1, 2017

    RVU17A

    $88.26changed to$90.65

    • Conversion factor 35.8043 changed to 35.8887
    • Practice expense RVU 1.22 changed to 1.24
    • Malpractice GPCI 1.226 changed to 1.429

    Held through RVU17B, RVU17C, RVU17D.

  12. January 1, 2016

    RVU16A

    $88.50changed to$88.26

    • Conversion factor 35.9335 changed to 35.8043
    • Practice expense RVU 1.23 changed to 1.22
    • Malpractice RVU 0.19 changed to 0.20

    Held through RVU16B, RVU16C, RVU16D.

  13. July 1, 2015

    RVU15C

    $88.06changed to$88.50

    • Conversion factor 35.7547 changed to 35.9335

    Held through RVU15D.

  14. January 1, 2015

    RVU15A

    $84.18changed to$88.06

    • Conversion factor 35.8228 changed to 35.7547
    • Practice expense RVU 1.21 changed to 1.23
    • Malpractice RVU 0.12 changed to 0.19
    • Malpractice GPCI 1.165 changed to 1.226

    Held through RVU15B.

  15. January 1, 2014

    RVU14A

    $74.97changed to$84.18

    • Conversion factor 34.0230 changed to 35.8228
    • Practice expense RVU 1.06 changed to 1.21
    • Malpractice RVU 0.13 changed to 0.12
    • Malpractice GPCI 1.103 changed to 1.165

    Held through RVU14B, RVU14C, RVU14D.

  16. January 1, 2013

    RVU13AR

    Earliest loaded release: $74.97

    Held through RVU13B, RVU13C, RVU13D.

Rates in every CMS release
Effective fromOfficeFacilityCMS release
2026-10-01$101.19$48.75RVU26D
2026-07-01$101.19$48.75RVU26C
2026-04-01$101.19$48.75RVU26B
2026-01-01$101.19$48.75RVU26A
2025-10-01$91.07$53.87RVU25D
2025-07-01$91.07$53.87RVU25C
2025-04-01$91.07$53.87RVU25B
2025-01-01$91.07$53.87RVU25A
2024-10-01$94.39$54.78RVU24D
2024-07-01$94.39$54.78RVU24C
2024-04-01$94.39$54.78RVU24B
2024-03-09$94.39$54.78RVU24AR
2024-01-01$92.85$53.88RVU24A
2023-10-01$96.78$55.77RVU23D
2023-07-01$96.78$55.77RVU23C
2023-04-01$96.78$55.77RVU23B
2023-01-01$96.78$55.77RVU23A
2022-10-01$100.20$57.63RVU22D
2022-07-01$100.20$57.63RVU22C
2022-04-01$100.20$57.63RVU22B
2022-01-01$100.20$57.63RVU22A
2021-10-01$99.28$57.76RVU21D
2021-07-01$99.28$57.76RVU21C
2021-04-01$99.28$57.76RVU21B
2021-01-01$99.28$57.76RVU21A
2020-10-01$98.66$62.57RVU20D
2020-07-01$98.66$62.57RVU20C
2020-04-01$98.66$62.57RVU20B
2020-01-01$98.66$62.57RVU20A
2019-10-01$96.09$64.37RVU19D
2019-07-01$96.09$64.37RVU19C
2019-04-01$96.09$64.37RVU19B
2019-01-01$96.09$64.37RVU19A
2018-10-01$92.02$64.66RVU18D
2018-07-01$92.02$64.66RVU18C
2018-04-01$92.02$64.66RVU18B
2018-01-01$92.02$64.66RVU18AR1
2017-10-01$90.65$63.01RVU17D
2017-07-01$90.65$63.01RVU17C
2017-04-01$90.65$63.01RVU17B
2017-01-01$90.65$63.01RVU17A
2016-10-01$88.26$60.70RVU16D
2016-07-01$88.26$60.70RVU16C
2016-04-01$88.26$60.70RVU16B
2016-01-01$88.26$60.70RVU16A
2015-10-01$88.50$60.83RVU15D
2015-07-01$88.50$60.83RVU15C
2015-04-01$88.06$60.53RVU15B
2015-01-01$88.06$60.53RVU15A
2014-10-01$84.18$56.95RVU14D
2014-07-01$84.18$56.95RVU14C
2014-04-01$84.18$56.95RVU14B
2014-01-01$84.18$56.95RVU14A
2013-10-01$74.97$52.85RVU13D
2013-07-01$74.97$52.85RVU13C
2013-04-01$74.97$52.85RVU13B
2013-01-01$74.97$52.85RVU13AR

Price 15278 for an earlier date of service

Where the Montana rate applies

Montana is a Medicare payment area, not a city. Our Census mapping connects it to 497 cities and communities in Montana. Some span more than one payment area; confirm with the service ZIP.

  • Absarokee
  • Acton
  • Alberton
  • Alder
  • Alzada
  • Amsterdam
  • Anaconda-Deer Lodge County
  • Antelope

Browse all communities in Montana

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

Show the CMS file lines behind this rate
RVUs for 15278PPRRVU2026_Oct_nonQPP.csv, line 1,519 (RVU26D)
Geographic factors for MontanaGPCI2026.csv, line 71 (RVU26D)

Open CMS sourceHow we calculate rates

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