Billing code 15274: Skin substituteMedicare rate & RVUs in Texas
Reports additional skin substitute graft application area on the trunk, arms, or legs beyond the initial area represented by the primary procedure.
Medicare pays $81.48–$89.44 for 15274 in the office in Texas, from Beaumont to Austin. 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 15274 covers
This add-on represents application of skin substitute graft to additional wound surface area on the trunk, arms, or legs. It is used when the treated area exceeds the initial area represented by the primary procedure, such as when a large wound or multiple wounds require broader graft coverage. Surgeons and clinicians providing wound care may apply these products in hospital outpatient departments, clinics, or other treatment settings.
Report 15274 with the qualifying primary procedure, 15273, for each additional 100 sq cm or part thereof; for infants and children, the corresponding additional unit is each 1% of body surface area. Documentation should identify the treated body site, wound area, and graft application so the additional area and units are supported. CMS classifies 15274 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.
Where 15274 pays more and less in Texas
The same RVUs, adjusted for each area’s costs. Open a locality for its calculation, history and nearby areas.
8 payment localities
$81.48 to $89.44
8 of 8 payment localities
| Payment locality | Office | Facility |
|---|---|---|
| Austin | $89.44 | $38.91 |
| Beaumont | $81.48 | $38.01 |
| Brazoria | $85.31 | $37.97 |
| Dallas | $86.05 | $38.48 |
| Fort Worth | $85.57 | $38.48 |
| Galveston | $85.69 | $38.26 |
| Houston | $88.80 | $41.37 |
| Rest Of Texas | $83.48 | $38.15 |
How the 15274 rate is calculated
Each of 15274’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 · 15274
RVUs × geographic indexes × conversion factor
Work0.78
0.78 RVUs× 1.000 GPCI
Practice expense1.65
1.65 RVUs× 1.000 GPCI
Malpractice0.17
0.17 RVUs× 1.000 GPCI
Adjusted RVUs
2.6000
Conversion factor
$33.4009
Medicare rate
$86.84
Every GPCI starts at 1.000, the national rate. Enter a ZIP or drag a slider.
Payment rules and modifiers for 15274
The CMS indicators that decide how 15274 is paid alongside other services.
CMS payment indicators · 15274
Skin substitute
| 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) | 0 | Not permitted. |
| Team surgery (66) | 0 | Not permitted. |
| Professional/technical | 0 | Physician service: no professional/technical split. |
15274 compared with similar codes
Compare codes · National
4 codes, side by side
How to choose
- 15273Skin substitute graft
- 15273 represents the primary trunk, arm, or leg application area. Use 15274 only for additional qualifying area beyond that primary area.
- 15272Skin substitute graft
- 15272 is the additional-area code paired with 15271. Code 15274 is paired with 15273 for the larger-area case.
- 15278Skin substitute graft
- Both report additional skin substitute graft area, but 15278 is for face, neck, hands, feet, or genitalia; 15274 is for trunk, arms, or legs.
15274 billing questions
When should 15274 be reported instead of 15272?
Use 15274 for additional area with primary code 15273, which represents the larger-area trunk, arm, or leg case. Code 15272 is the additional-area code paired with 15271.
Which primary code must accompany 15274?
Report 15274 with 15273 when additional qualifying wound area is treated. It is not reported as a standalone service.
How is the additional area counted?
Each additional 100 sq cm or part thereof supports a unit. For infants and children, the corresponding unit is each additional 1% of body surface area.
Can 15274 be used for wounds on the face or hands?
No. Code 15274 is for the trunk, arms, and legs; the separate skin substitute graft family for the face, neck, hands, feet, and genitalia includes 15277 and 15278.
What documentation supports reporting 15274?
Document the wound location, treated area, and skin substitute graft application. The record should support the additional area and the number of units reported.
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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