Billing code 15260: Full-thickness graftMedicare rate & RVUs in Georgia
Reports a full-thickness skin graft of 20 square centimeters or less for a defect of the nose, ear, eyelid, or lip.
Medicare pays $946.98–$1,020.21 for 15260 in the office in Georgia, from Rest Of Georgia to Atlanta. 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.
On this page 9 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.
Where 15260 pays more and less in Georgia
| Payment locality | Office | Facility |
|---|---|---|
| Atlanta | $1,020.21 | $742.28 |
| Rest Of Georgia | $946.98 | $702.97 |
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.
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
| 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
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
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%).
15260 compared with similar codes
Compare codes · National
5 codes, side by side
How to choose
- 15261Skin graft
- Use 15260 for the initial grafted area of 20 square centimeters or less; 15261 represents additional area beyond that base amount.
- 15240Skin graft
- Both describe full-thickness skin grafting, but 15240 applies to its own recipient-site group, such as the forehead, cheek, chin, or hand—not the nose, ear, eyelid, or lip.
- 15220Skin graft
- Use 15220 for full-thickness grafts on the scalp, arms, or legs; 15260 is for the nose, ears, eyelids, or lips.
- 15275Skin substitute
- 15275 describes application of a skin substitute graft at specified sites. Code 15260 describes an autologous full-thickness skin graft.
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
Show the CMS file lines behind this rate
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