$199.22
Use 15260 for the initial grafted area of 20 square centimeters or less; 15261 represents additional area beyond that base amount.
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CMS RVU26D · Effective 2026-10-01
15260 Full-thickness graft Medicare reimbursement rates in Utah
Reports a full-thickness skin graft of 20 square centimeters or less for a defect of the nose, ear, eyelid, or lip. Compare 15260 office and facility rates across CMS payment localities in Utah.
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 15260 in Utah?
Utah has 1 payment locality in this comparison. Use the service location to choose the applicable amount. These are the supported base rates for the payment area shown below, using the same CMS release.
Office / nonfacility
$961.87
1 of 1 localities have a supported rate.
Payment area: Utah
One mapped payment locality.
Facility setting
$704.73
1 of 1 localities have a supported rate.
Payment area: Utah
One mapped payment locality.
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.
Skin grafting
About 15260: Full-thickness skin graft for facial sites
Reports a full-thickness skin graft of 20 square centimeters or less for a defect of the nose, ear, eyelid, or lip.
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.
CMS billing rules for 15260
- 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 RVU11.35 · 38%
- Practice expense (office) RVU17.31 · 58%
- Malpractice RVU1.31 · 4%
56.2K
Medicare services in 2024 · #742 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.
15260 compared with similar codes
Office rates for Utah, from the same CMS release.
$899.78
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.
$750.18
Use 15220 for full-thickness grafts on the scalp, arms, or legs; 15260 is for the nose, ears, eyelids, or lips.
$153.99
15275 describes application of a skin substitute graft at specified sites. Code 15260 describes an autologous full-thickness skin graft.
Compare 15260 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.
1 of 1 payment localities
Utah →
Office / nonfacility
$961.87
Facility
$704.73
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How this local rate is calculated
Each RVU component is multiplied by its own geographic practice cost index (GPCI). The three adjusted components are added, then multiplied by the conversion factor. These are the inputs used for 15260 in Utah.
PPRRVU2026_Oct_nonQPP.csv
1,510
- Code
- 15260
- Physician work
- 11.35
- Practice expense
- 17.31
- Malpractice
- 1.31
GPCI2026.csv
104
- Locality
- Utah
- Physician work
- 1.000
- Practice expense
- 0.940
- Malpractice
- 0.898
| Component | RVU | Locality factor | Adjusted |
|---|---|---|---|
| Physician work | 11.35 | × 1.000 | 11.3500 |
| Practice expense | 17.31 | × 0.940 | 16.2714 |
| Malpractice | 1.31 | × 0.898 | 1.1764 |
| Total RVUs | 28.7978 | ||
| Conversion factor | × 33.4009 | ||
Office / nonfacility rate, Utah$961.87
Explore RVUs, geographic factors and the full formula
Office / nonfacility
| Component | RVU | Local GPCI |
|---|---|---|
| Work | 11.35 | 1 |
| Practice expense | 17.31 | 0.94 |
| Malpractice | 1.31 | 0.898 |
(11.35 × 1 + 17.31 × 0.94 + 1.31 × 0.898) × $33.4009 = $961.87
Facility
| Component | RVU | Local GPCI |
|---|---|---|
| Work | 11.35 | 1 |
| Practice expense | 9.12 | 0.94 |
| Malpractice | 1.31 | 0.898 |
(11.35 × 1 + 9.12 × 0.94 + 1.31 × 0.898) × $33.4009 = $704.73
The office and facility calculations use their respective practice-expense RVUs. The facility amount here is the physician fee, not a separate hospital or facility bill.
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 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.
1,50715221,,Fth/gft fr s/a/l each addl,A,,1.16,2.65,,0.37,,0.20,4.01,1.73,0,ZZZ,0.00,0.00,0.00,0,0,1,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
1,50815240,,Fth/gft f/c/c/m/n/ax/g/h/f20,A,,10.15,16.59,,9.42,,1.33,28.07,20.90,0,090,0.10,0.71,0.19,2,0,1,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
1,50915241,,Fth/gft f/c/c/m/n/a/g/h/f ea,A,,1.81,3.28,,0.58,,0.29,5.38,2.68,0,ZZZ,0.00,0.00,0.00,0,0,1,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
1,51015260,,Fth/gft fr n/e/e/l 20 sqcm/<,A,,11.35,17.31,,9.12,,1.31,29.97,21.78,0,090,0.10,0.71,0.19,2,0,1,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
1,51115261,,Fth/gft fr n/e/e/l each addl,A,,2.17,3.75,,0.90,,0.30,6.22,3.37,0,ZZZ,0.00,0.00,0.00,0,0,1,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
1,51215271,,Skin sub graft trnk/arm/leg,A,,1.46,3.06,,0.58,,0.21,4.73,2.25,0,000,0.00,0.00,0.00,2,0,1,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
1,51315272,,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
10104412,TX,15,GALVESTON,1.008,0.993,0.828
10204412,TX,18,HOUSTON,1.008,0.993,1.376
10304412,TX,99,REST OF TEXAS,1.000,0.949,0.903
10403502,UT,09,UTAH,1.000,0.940,0.898
10514512,VT,50,VERMONT,1.000,0.990,0.506
10611302,VA,00,VIRGINIA,1.000,0.983,0.706
10709202,VI,50,VIRGIN ISLANDS,1.000,1.011,0.985