No office rate
Use 15769 for other autologous soft tissue harvested by direct excision. Use 15770 when the graft is specifically a dermis-fat-fascia graft.
On this page
CMS RVU26D · Effective 2026-10-01
15769 Soft-tissue graft Medicare reimbursement rates in Pennsylvania
Reports placement of a patient's own soft tissue harvested by direct excision to restore volume or fill a defect during reconstructive surgery. Compare 15769 office and facility rates across CMS payment localities in Pennsylvania.
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 15769 in Pennsylvania?
Pennsylvania has 2 payment localities in this comparison. Use the service location to choose the applicable amount. These are the supported base rates for the 2 payment areas shown below, using the same CMS release.
Office / nonfacility
No supported rate
Facility setting
$436.34–$474.98
2 of 2 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.
Reconstructive surgery
About 15769: Autologous soft-tissue graft by excision
Reports placement of a patient's own soft tissue harvested by direct excision to restore volume or fill a defect during reconstructive surgery.
The surgeon excises the patient's own soft tissue, such as fat, dermis, or fascia, and grafts it to another site. This service may be part of reconstruction for a contour defect after trauma, tumor removal, or prior surgery. Plastic and reconstructive surgeons and other surgeons performing the repair typically provide it in an operating room or another procedural setting.
Report the service when documentation supports both direct-excision harvest and graft placement; the harvest and placement are integral to the grafting service, not separate services under this code. The record should identify the tissue, harvest method, recipient site, and reconstructive purpose. Medicare assigns a 90-day global period, including the day-before preoperative visit and 90 days of related postoperative care. When multiple procedures are performed in one session, the highest-valued is paid in full and other procedures are subject to the standard 50% multiple-procedure reduction. Modifier 50 is inappropriate. Medicare does not pay an assistant-at-surgery claim for this service, and co-surgeons and team surgery are not permitted.
CMS billing rules for 15769
- Global period
- Major surgery with a 90-day global period: the day-before preoperative visit and 90 days of related postoperative care are 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 RVU6.51 · 48%
- Practice expense (office) RVU5.77 · 42%
- Malpractice RVU1.33 · 10%
5.6K
Medicare services in 2024 · #1805 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.
15769 compared with similar codes
Office rates for Pennsylvania, from the same CMS release.
$627.41–$691.05
Use 15771 for autologous fat grafting to the trunk, breasts, scalp, arms, or legs when fat is harvested by liposuction and the code's volume criteria are met.
$594.16–$652.51
Use 15773 for liposuction-harvested autologous fat grafting to the specified head and neck sites when its volume criteria are met; direct-excision harvest supports 15769 instead.
Compare 15769 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.
2 of 2 payment localities
Metropolitan Philadelphia →
Office / nonfacility
Unavailable
Facility
$474.98
Rest Of Pennsylvania →
Office / nonfacility
Unavailable
Facility
$436.34
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15769 billing questions
How does this differ from 15771 or 15773?
This code is for soft tissue harvested by direct excision. Codes 15771 and 15773 describe autologous fat grafting when the fat is harvested by liposuction; select the code based on the documented harvest method and applicable site and volume criteria.
Can the harvest be billed separately?
The direct-excision harvest and graft placement are part of this grafting service. Do not report the harvest separately as though it were an independent service under this code.
Should modifier 50 be used for grafting on both sides?
No. Modifier 50 is inappropriate for this service. Report the service based on the documented grafting performed.
What postoperative care is included?
The 90-day global period includes the day-before preoperative visit and 90 days of related postoperative care.
Can an assistant surgeon or co-surgeon be reported?
Medicare does not pay an assistant-at-surgery claim for this service. Co-surgeon and team-surgery reporting are not permitted.
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.
1,53815757,,Free skin flap microvasc,A,,36.22,16.32,NA,16.32,,5.71,58.25,58.25,0,090,0.10,0.71,0.19,2,0,2,2,0,9,,33.4009,09,0,99,0.00,0.00,0.00
1,53915758,,Free fascial flap microvasc,A,,35.98,16.41,NA,16.41,,5.73,58.12,58.12,0,090,0.10,0.71,0.19,2,0,2,2,0,9,,33.4009,09,0,99,0.00,0.00,0.00
1,54015760,,Composite skin graft,A,,9.61,14.73,,7.36,,1.33,25.67,18.30,0,090,0.10,0.71,0.19,2,0,1,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
1,54115769,,Grfg autol soft tiss dir exc,A,,6.51,5.77,NA,5.77,,1.33,13.61,13.61,0,090,0.10,0.69,0.21,2,0,1,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
1,54215770,,Derma-fat-fascia graft,A,,8.74,8.00,NA,8.00,,1.41,18.15,18.15,0,090,0.10,0.71,0.19,2,0,2,1,0,9,,33.4009,09,0,99,0.00,0.00,0.00
1,54315771,,Grfg autol fat lipo 50 cc/<,A,,6.56,12.05,,6.39,,1.23,19.84,14.18,0,090,0.10,0.69,0.21,2,0,1,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
1,54415772,,Grfg autol fat lipo ea addl,A,,2.44,3.27,,0.89,,0.45,6.16,3.78,0,ZZZ,0.00,0.00,0.00,0,0,1,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00