$320.36–$455.92
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.
On this page
CMS RVU26D · Effective 2026-10-01
15278 Skin substitute graft Medicare reimbursement rates
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. Compare 15278 office and facility rates across CMS payment localities.
Amounts below use the non-QP conversion factor for participating physicians. These are base physician payments before claim-level adjustments, not patient costs or total hospital charges.
What does Medicare pay for 15278?
The service location and office or facility setting determine which base rate applies. These are the supported base rates for the 109 payment areas shown below, using the same CMS release.
Office / nonfacility
$89.25–$129.02
109 of 109 localities have a supported rate.
Lowest: Arkansas
Highest: San Jose-Sunnyvale-Santa Clara (San Benito Cnty)
A spread of $39.77 per service.
These are locality ranges, not averages or address-specific quotes. A facility-setting amount covers the physician service; it does not include a hospital’s separate bill. Choose a locality below to inspect its calculation, compare other payment areas, or price a percentage of Medicare.
Where 15278 pays more and less
109 payment localities
$89.25 to $129.02
Wound care
About 15278: Large-area skin substitute graft, additional area
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.
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.
CMS billing rules for 15278
- Global period
- Add-on code: billed only together with a primary procedure and paid within that procedure's global period.
Where the value comes from
- Work RVU0.98 · 32%
- Practice expense (office) RVU1.85 · 61%
- Malpractice RVU0.20 · 7%
3.1K
Medicare services in 2024 · #2160 by national volume
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.
15278 compared with similar codes
Office rate ranges across all CMS payment localities, from the same CMS release.
$30.48–$41.85
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.
$76.32–$111.43
15274 reports additional area for large-area treatment on the trunk, arms, or legs. Use 15278 for the face, neck, hands, feet, or genitalia.
See how rates vary across the country
15278 · Office / nonfacility · Non-QP. Choose a state to explore its payment localities. A range means the amount varies within that state.
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 all state and territory rates as a table
| State / territory | Rate range | Localities |
|---|---|---|
| AK | $118.59 | 1 |
| AL | $90.58 | 1 |
| AR | $89.25 | 1 |
| AZ | $98.33 | 1 |
| CA | $104.59–$129.02 | 29 |
| CO | $104.09 | 1 |
| CT | $108.02 | 1 |
| DC | $114.73 | 1 |
| DE | $99.95 | 1 |
| FL | $101.85–$113.95 | 3 |
| GA | $95.81–$103.63 | 2 |
| GU | $106.86 | 1 |
| HI | $106.86 | 1 |
| IA | $91.92 | 1 |
| ID | $92.74 | 1 |
| IL | $99.59–$110.39 | 4 |
| IN | $93.26 | 1 |
| KS | $91.96 | 1 |
| KY | $93.78 | 1 |
| LA | $93.82–$98.47 | 2 |
| MA | $103.65–$113.80 | 2 |
| MD | $101.73–$114.73 | 3 |
| ME | $93.74–$98.18 | 2 |
| MI | $96.69–$103.62 | 2 |
| MN | $98.29 | 1 |
| MO | $92.50–$98.25 | 3 |
| MS | $90.87 | 1 |
| MT | $101.19 | 1 |
| NC | $94.65 | 1 |
| ND | $97.24 | 1 |
| NE | $92.29 | 1 |
| NH | $102.90 | 1 |
| NJ | $108.85–$113.61 | 2 |
| NM | $97.42 | 1 |
| NV | $100.15 | 1 |
| NY | $96.13–$120.70 | 5 |
| OH | $95.88 | 1 |
| OK | $93.10 | 1 |
| OR | $98.97–$106.88 | 2 |
| PA | $95.77–$105.62 | 2 |
| PR | $101.78 | 1 |
| RI | $103.14 | 1 |
| SC | $95.51 | 1 |
| SD | $96.77 | 1 |
| TN | $92.49 | 1 |
| TX | $95.17–$104.09 | 8 |
| UT | $96.82 | 1 |
| VA | $98.19–$114.73 | 2 |
| VI | $101.78 | 1 |
| VT | $97.29 | 1 |
| WA | $103.31–$115.65 | 2 |
| WI | $93.99 | 1 |
| WV | $95.99 | 1 |
| WY | $99.47 | 1 |
Compare 15278 by payment locality
Find the payment area for your service address, then open its rate page for calculation inputs, release history and the percentage-of-Medicare tool. A city may cross payment-area boundaries; the ZIP lookup above helps resolve the location.
109 of 109 payment localities
| Payment locality | Office | Facility |
|---|---|---|
| Alabama | Office $90.58 | Facility $44.70 |
| Alaska* | Office $118.59 | Facility $62.74 |
| Arizona | Office $98.33 | Facility $47.51 |
| Arkansas | Office $89.25 | Facility $44.21 |
| Atlanta | Office $103.63 | Facility $50.36 |
| Austin | Office $104.09 | Facility $48.61 |
| Bakersfield | Office $105.15 | Facility $47.67 |
| Baltimore/Surr. Cntys | Office $107.82 | Facility $51.55 |
| Beaumont | Office $95.17 | Facility $47.45 |
| Brazoria | Office $99.44 | Facility $47.47 |
| Chicago | Office $110.39 | Facility $57.69 |
| Chico | Office $104.59 | Facility $47.12 |
| Colorado | Office $104.09 | Facility $48.29 |
| Connecticut | Office $108.02 | Facility $51.54 |
| Dallas | Office $100.30 | Facility $48.07 |
| Dc + Md/Va Suburbs | Office $114.73 | Facility $52.95 |
| Delaware | Office $99.95 | Facility $48.14 |
| Detroit | Office $103.62 | Facility $53.02 |
| East St. Louis | Office $103.04 | Facility $54.79 |
| El Centro | Office $104.63 | Facility $47.15 |
| Fort Lauderdale | Office $107.41 | Facility $54.28 |
| Fort Worth | Office $99.77 | Facility $48.07 |
| Fresno | Office $104.59 | Facility $47.12 |
| Galveston | Office $99.89 | Facility $47.81 |
| Hanford-Corcoran | Office $104.59 | Facility $47.12 |
| Hawaii, Guam | Office $106.86 | Facility $47.23 |
| Houston | Office $103.55 | Facility $51.47 |
| Idaho | Office $92.74 | Facility $44.50 |
| Indiana | Office $93.26 | Facility $44.65 |
| Iowa | Office $91.92 | Facility $43.94 |
| Kansas | Office $91.96 | Facility $44.55 |
| Kentucky | Office $93.78 | Facility $47.16 |
| Los Angeles-Long Beach-Anaheim (Los Angeles/Orange Cnty) | Office $111.61 | Facility $49.57 |
| Madera | Office $104.59 | Facility $47.12 |
| Manhattan | Office $117.22 | Facility $56.29 |
| Merced | Office $104.59 | Facility $47.12 |
| Metropolitan Boston | Office $113.80 | Facility $51.19 |
| Metropolitan Kansas City | Office $97.28 | Facility $48.04 |
| Metropolitan Philadelphia | Office $105.62 | Facility $51.03 |
| Metropolitan St. Louis | Office $98.25 | Facility $48.33 |
| Miami | Office $113.95 | Facility $59.36 |
| Minnesota | Office $98.29 | Facility $44.33 |
| Mississippi | Office $90.87 | Facility $45.72 |
| Modesto | Office $104.59 | Facility $47.12 |
| Montana** | Office $101.19 | Facility $48.75 |
| Napa | Office $119.63 | Facility $50.51 |
| Nebraska | Office $92.29 | Facility $43.89 |
| Nevada** | Office $100.15 | Facility $47.66 |
| New Hampshire | Office $102.90 | Facility $48.31 |
| New Mexico | Office $97.42 | Facility $49.33 |
| New Orleans | Office $98.47 | Facility $49.12 |
| North Carolina | Office $94.65 | Facility $45.73 |
| North Dakota** | Office $97.24 | Facility $44.80 |
| Northern Nj | Office $113.61 | Facility $52.78 |
| Nyc Suburbs/Long Island | Office $120.70 | Facility $58.35 |
| Ohio | Office $95.88 | Facility $48.01 |
| Oklahoma | Office $93.10 | Facility $46.27 |
| Oxnard-Thousand Oaks-Ventura | Office $110.85 | Facility $48.87 |
| Portland | Office $106.88 | Facility $48.62 |
| Poughkpsie/N Nyc Suburbs | Office $109.95 | Facility $52.53 |
| Puerto Rico | Office $101.78 | Facility $48.77 |
| Queens | Office $117.50 | Facility $55.51 |
| Redding | Office $104.59 | Facility $47.12 |
| Rest Of California | Office $104.59 | Facility $47.12 |
| Rest Of Florida | Office $101.85 | Facility $51.71 |
| Rest Of Georgia | Office $95.81 | Facility $49.04 |
| Rest Of Illinois | Office $99.59 | Facility $51.71 |
| Rest Of Louisiana | Office $93.82 | Facility $47.41 |
| Rest Of Maine | Office $93.74 | Facility $45.49 |
| Rest Of Maryland | Office $101.73 | Facility $48.66 |
| Rest Of Massachusetts | Office $103.65 | Facility $48.43 |
| Rest Of Michigan | Office $96.69 | Facility $48.81 |
| Rest Of Missouri | Office $92.50 | Facility $47.30 |
| Rest Of New Jersey | Office $108.85 | Facility $51.58 |
| Rest Of New York | Office $96.13 | Facility $46.31 |
| Rest Of Oregon | Office $98.97 | Facility $46.74 |
| Rest Of Pennsylvania | Office $95.77 | Facility $47.63 |
| Rest Of Texas | Office $97.41 | Facility $47.64 |
| Rest Of Washington | Office $103.31 | Facility $48.09 |
| Rhode Island | Office $103.14 | Facility $48.97 |
| Riverside-San Bernardino-Ontario | Office $106.74 | Facility $49.27 |
| Sacramento-Roseville-Folsom | Office $109.36 | Facility $48.37 |
| Salinas | Office $108.94 | Facility $48.17 |
| San Diego-Chula Vista-Carlsbad | Office $111.24 | Facility $48.52 |
| San Francisco-Oakland-Berkeley (Marin Cnty) | Office $126.03 | Facility $52.10 |
| San Francisco-Oakland-Berkeley (San Francisco/San Mateo/Alameda/Contra Costa Cnty) | Office $125.81 | Facility $51.87 |
| San Jose-Sunnyvale-Santa Clara (San Benito Cnty) | Office $129.02 | Facility $53.40 |
| San Jose-Sunnyvale-Santa Clara (Santa Clara Cnty) | Office $128.09 | Facility $52.47 |
| San Luis Obispo-Paso Robles | Office $107.25 | Facility $47.52 |
| Santa Cruz-Watsonville | Office $112.08 | Facility $48.36 |
| Santa Maria-Santa Barbara | Office $109.28 | Facility $48.13 |
| Santa Rosa-Petaluma | Office $113.18 | Facility $48.78 |
| Seattle (King Cnty) | Office $115.65 | Facility $51.30 |
| South Carolina | Office $95.51 | Facility $47.05 |
| South Dakota** | Office $96.77 | Facility $44.33 |
| Southern Maine | Office $98.18 | Facility $46.22 |
| Stockton | Office $104.59 | Facility $47.12 |
| Suburban Chicago | Office $108.26 | Facility $54.40 |
| Tennessee | Office $92.49 | Facility $44.82 |
| Utah | Office $96.82 | Facility $47.52 |
| Vallejo | Office $119.30 | Facility $50.19 |
| Vermont | Office $97.29 | Facility $45.37 |
| Virgin Islands | Office $101.78 | Facility $48.77 |
| Virginia | Office $98.19 | Facility $46.64 |
| Visalia | Office $104.59 | Facility $47.12 |
| West Virginia | Office $95.99 | Facility $50.42 |
| Wisconsin | Office $93.99 | Facility $43.75 |
| Wyoming** | Office $99.47 | Facility $47.03 |
| Yuba City | Office $104.59 | Facility $47.12 |
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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 indices and the applicable conversion factor. Unavailable or separately priced services are labeled rather than assigned a made-up amount.
Source: RVU26D. Effective 2026-10-01 through the day before 2027-01-01.
1,51615275,,Skin sub graft face/nk/hf/g,A,,1.78,2.82,,0.54,,0.20,4.80,2.52,0,000,0.00,0.00,0.00,2,0,1,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
1,51715276,,Skin sub graft f/n/hf/g addl,A,,0.49,0.45,,0.10,,0.07,1.01,0.66,0,ZZZ,0.00,0.00,0.00,0,0,1,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
1,51815277,,Skn sub grft f/n/hf/g child,A,,3.90,6.20,,1.30,,0.71,10.81,5.91,0,000,0.00,0.00,0.00,2,0,1,1,0,9,,33.4009,09,0,99,0.00,0.00,0.00
1,51915278,,Skn sub grft f/n/hf/g ch add,A,,0.98,1.85,,0.28,,0.20,3.03,1.46,0,ZZZ,0.00,0.00,0.00,0,0,1,1,0,9,,33.4009,09,0,99,0.00,0.00,0.00
1,52015570,,Skin pedicle flap trunk,A,,9.95,17.44,,8.20,,1.99,29.38,20.14,0,090,0.10,0.71,0.19,2,0,1,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
1,52115572,,Skin pedicle flap arms/legs,A,,9.87,16.35,,8.43,,1.76,27.98,20.06,0,090,0.10,0.71,0.19,2,0,1,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
1,52215574,,Pedcle fh/ch/ch/m/n/ax/g/h/f,A,,10.43,14.25,,7.19,,1.53,26.21,19.15,0,090,0.10,0.71,0.19,2,0,1,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00