CPT code 15116: Epidermal graft2026 Medicare rate & RVUs in Ohio
Reports each additional 100 sq cm or part of epidermal autograft placed on the face, scalp, neck, hands, feet, genitalia, or multiple digits.
Medicare pays $159.21 for 15116 in the office in Ohio (Ohio). 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 15116 covers
This add-on represents additional epidermal autograft coverage on the face, scalp, neck, hands, feet, genitalia, or multiple digits. It is used when the recipient area at one of these sites exceeds the initial 100 sq cm covered by the primary service. Plastic surgeons, burn surgeons, and other clinicians performing skin-graft procedures may use it to report the additional treated area in an operating room or other procedural setting.
Report 15116 with 15115, counting each additional 100 sq cm or part thereof beyond the initial 100 sq cm. The operative record should identify the recipient site, epidermal graft type, and area treated so the additional area can be supported. CMS classifies 15116 as an add-on code: it is billed only with a primary procedure and paid within that 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.
15116 in Ohio
| Payment locality | Office | Facility |
|---|---|---|
| Ohio | $159.21 | $120.78 |
How the 15116 rate is calculated
Each of 15116’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 · 15116
RVUs × geographic indexes × conversion factor
Work2.44
2.44 RVUs× 1.000 GPCI
Practice expense1.93
1.93 RVUs× 1.000 GPCI
Malpractice0.56
0.56 RVUs× 1.000 GPCI
Adjusted RVUs
4.9300
Conversion factor
$33.4009
Medicare rate
$164.67
Every GPCI starts at 1.000, the national rate. Enter a ZIP or drag a slider.
Payment rules and modifiers for 15116
The CMS indicators that decide how 15116 is paid alongside other services.
CMS payment indicators · 15116
Epidermal graft
| 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. |
15116 compared with similar codes
Compare codes · National
5 codes, side by side
How to choose
- 15115Epidermal graft
- Use 15115 for the initial 100 sq cm or less of epidermal autograft at the specified sites; use 15116 only for area beyond that amount.
- 15111Epidermal graft
- Both report additional epidermal graft area, but 15111 is for trunk, arms, or legs; 15116 is for the face, scalp, neck, hands, feet, genitalia, or multiple digits.
- 15121Skin graft
- 15121 reports additional split-thickness autograft area at the specified sites. 15116 is for additional epidermal autograft area.
- 15136Dermal autograft
- 15136 reports additional dermal autograft area at the specified sites; 15116 reports additional epidermal autograft area.
15116 billing questions
Can 15116 be reported by itself?
No. It is an add-on code and is reported with 15115, which covers the initial 100 sq cm or less at the specified sites.
How many units of 15116 should be reported?
Report one unit for each additional 100 sq cm or part thereof beyond the initial 100 sq cm. Document the total recipient area treated.
How does 15116 differ from 15115?
15115 covers the initial 100 sq cm or less of epidermal autograft at the specified sites. 15116 reports the additional area beyond that initial amount.
What documentation supports 15116?
The operative note should identify the recipient site, confirm the epidermal autograft, and record the grafted area, including the amount beyond the initial 100 sq cm.
When is 15121 used instead?
15121 reports additional split-thickness autograft area at the same designated sites. Choose the code that matches the graft type documented for the procedure.
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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