$33.74–$36.95
15276 is an add-on for additional wound area in the 15275 size tier; it is not the initial application code.
On this page
CMS RVU26D · Effective 2026-10-01
15275 Skin substitute Medicare reimbursement rates in Illinois
Reports skin substitute application to wounds on the face, scalp, hands, feet, genitalia, or other specified sites within the smaller-area tier. Compare 15275 office and facility rates across CMS payment localities in Illinois.
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 15275 in Illinois?
Illinois has 4 payment localities in this comparison. Use the service location to choose the applicable amount. These are the supported base rates for the 4 payment areas shown below, using the same CMS release.
Office / nonfacility
$155.89–$169.86
4 of 4 localities have a supported rate.
Facility setting
$86.36–$93.33
4 of 4 localities have a supported rate.
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 15275 pays more and less in Illinois
4 payment localities
$155.89 to $169.86
Wound care
About 15275: Skin substitute application to specified sites
Reports skin substitute application to wounds on the face, scalp, hands, feet, genitalia, or other specified sites within the smaller-area tier.
This code covers applying a skin substitute graft to wounds on the face, scalp, eyelids, mouth, neck, ears, orbits, genitalia, hands, or feet. Dermatologists, plastic surgeons, and wound care clinicians may use it for wounds such as chronic ulcers or defects after trauma or excision. The code represents the application service, not the skin substitute product itself.
Select this base code when the combined wound surface area at the specified sites is up to 100 square centimeters and the initial area is 25 square centimeters or less. For a larger qualifying area, use the applicable higher-area code; document wound locations, measurements, total area, and the material applied. The 0-day global includes same-day preoperative and postoperative care. When multiple procedures occur in one session, the highest-valued procedure is paid in full and others at 50%. Modifier 50 is inappropriate. Medicare does not pay an assistant at surgery for this service, and co-surgeons and team surgery are not permitted.
CMS billing rules for 15275
- Global period
- Minor procedure with a 0-day global period: same-day preoperative and postoperative care is included.
- Multiple procedures
- Standard multiple procedure reduction: the highest-valued procedure is paid in full and others at 50% when performed in the same session.
- Bilateral procedures
- Bilateral adjustment does not apply; the descriptor or anatomy makes modifier 50 inappropriate.
- Assistant at surgery
- Statutory restriction: assistant at surgery is not paid.
- Co-surgeons
- Co-surgeons not permitted.
- Team surgery
- Team surgery not permitted.
Where the value comes from
- Work RVU1.78 · 37%
- Practice expense (office) RVU2.82 · 59%
- Malpractice RVU0.20 · 4%
198.1K
Medicare services in 2024 · #390 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.
15275 compared with similar codes
Office rates for Illinois, from the same CMS release.
$356.40–$393.72
15277 applies to the same anatomic sites when total wound area is at least 100 square centimeters; 15275 is for the smaller-area tier.
$153.04–$167.92
15271 covers skin substitute application to trunk, arm, or leg wounds. Use 15275 for the specified face, scalp, hand, foot, genital, and related sites.
$914.37–$1,000.24
15240 reports a full-thickness skin graft to specified sites, rather than application of a skin substitute graft.
Compare 15275 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.
4 of 4 payment localities
Chicago →
Office / nonfacility
$169.86
Facility
$93.33
East St. Louis →
Office / nonfacility
$159.56
Facility
$89.50
Rest Of Illinois →
Office / nonfacility
$155.89
Facility
$86.36
Suburban Chicago →
Office / nonfacility
$168.44
Facility
$90.23
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15275 billing questions
When should 15275 be selected instead of 15277?
Use 15275 for the initial area when total wound surface area at the specified sites is up to 100 square centimeters. When the total reaches 100 square centimeters or more, use 15277 for the initial area.
How is additional wound area reported with 15275?
Code 15276 reports each additional 25 square centimeters or part thereof when the total wound area is in the 15275 size tier. For the higher-area tier, 15277 and 15278 provide the initial and additional-area reporting.
Does 15275 include the skin substitute product?
15275 reports the application service, not the product itself. The product may have separate HCPCS coding.
Can modifier 50 be used when wounds are on both hands or feet?
No. Modifier 50 is inappropriate for this code; report the applicable service based on the qualifying sites and wound area.
Can an assistant surgeon or co-surgeon be reported for 15275?
Medicare does not pay an assistant at surgery for this service. Co-surgeons and team surgery are not permitted.
What documentation supports reporting 15275?
Document the specific wound sites, measured wound areas and their total, and the skin substitute application performed. These details support selection of the correct area tier and any additional-area 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 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.
1,51315272,,Skin sub graft t/a/l add-on,A,,0.32,0.40,,0.07,,0.05,0.77,0.44,0,ZZZ,0.00,0.00,0.00,0,0,1,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
1,51415273,,Skin sub grft t/arm/lg child,A,,3.41,5.61,,1.11,,0.62,9.64,5.14,0,000,0.00,0.00,0.00,2,0,1,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
1,51515274,,Skn sub grft t/a/l child add,A,,0.78,1.65,,0.22,,0.17,2.60,1.17,0,ZZZ,0.00,0.00,0.00,0,0,1,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
1,51615275,,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