$973.63
15260 reports the primary full-thickness graft area, up to the initial 20 sq cm. Add 15261 for each additional 20 sq cm or fraction.
On this page
CMS RVU26D · Effective 2026-10-01
15261 Skin graft Medicare reimbursement rates in Vermont
Reports each additional 20 sq cm, or fraction, of full-thickness skin grafting to the nose, ears, eyelids, or lips beyond the primary area. Compare 15261 office and facility rates across CMS payment localities in Vermont.
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 15261 in Vermont?
Vermont 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
$201.55
1 of 1 localities have a supported rate.
Payment area: Vermont
One mapped payment locality.
Facility setting
$107.31
1 of 1 localities have a supported rate.
Payment area: Vermont
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 15261: Additional full-thickness skin graft area
Reports each additional 20 sq cm, or fraction, of full-thickness skin grafting to the nose, ears, eyelids, or lips beyond the primary area.
Code 15261 captures additional recipient-area coverage when a free full-thickness skin graft is used on the nose, ears, eyelids, or lips. The surgeon harvests full-thickness skin, transfers it to a defect—often a nasal defect after Mohs excision—and closes the donor site directly. Plastic surgeons, dermatologic surgeons, and other surgeons perform this reconstruction in procedure rooms or operating rooms. This site group is specific to full-thickness skin grafts, not split-thickness grafts or skin-substitute products.
Report 15261 with 15260 when the grafted area exceeds the initial 20 sq cm; each further 20 sq cm or fraction supports an additional unit. Document the recipient site, graft technique, and measured graft area. This is an add-on code, not a standalone service, and CMS pays it within the primary procedure’s global period. Direct closure of the donor site is included in the graft service.
CMS billing rules for 15261
- Global period
- Add-on code: billed only together with a primary procedure and paid within that procedure's global period.
Where the value comes from
- Work RVU2.17 · 35%
- Practice expense (office) RVU3.75 · 60%
- Malpractice RVU0.30 · 5%
377
Medicare services in 2024 · #3784 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.
15261 compared with similar codes
Office rates for Vermont, from the same CMS release.
$173.82
15241 is the additional-area code paired with 15240 for its site group. Use 15261 with 15260 for grafts to the nose, ears, eyelids, or lips.
$910.08
15240 is the primary code for a different full-thickness graft site group. For grafts to the nose, ears, eyelids, or lips, the primary code is 15260.
$32.43
15276 reports additional area treated with a skin-substitute graft at its specified sites. Code 15261 is for additional area treated with a free full-thickness skin graft.
Compare 15261 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
Vermont →
Office / nonfacility
$201.55
Facility
$107.31
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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 15261 in Vermont.
PPRRVU2026_Oct_nonQPP.csv
1,511
- Code
- 15261
- Physician work
- 2.17
- Practice expense
- 3.75
- Malpractice
- 0.30
GPCI2026.csv
105
- Locality
- Vermont
- Physician work
- 1.000
- Practice expense
- 0.990
- Malpractice
- 0.506
| Component | RVU | Locality factor | Adjusted |
|---|---|---|---|
| Physician work | 2.17 | × 1.000 | 2.1700 |
| Practice expense | 3.75 | × 0.990 | 3.7125 |
| Malpractice | 0.30 | × 0.506 | 0.1518 |
| Total RVUs | 6.0343 | ||
| Conversion factor | × 33.4009 | ||
Office / nonfacility rate, Vermont$201.55
Explore RVUs, geographic factors and the full formula
Office / nonfacility
| Component | RVU | Local GPCI |
|---|---|---|
| Work | 2.17 | 1 |
| Practice expense | 3.75 | 0.99 |
| Malpractice | 0.3 | 0.506 |
(2.17 × 1 + 3.75 × 0.99 + 0.3 × 0.506) × $33.4009 = $201.55
Facility
| Component | RVU | Local GPCI |
|---|---|---|
| Work | 2.17 | 1 |
| Practice expense | 0.9 | 0.99 |
| Malpractice | 0.3 | 0.506 |
(2.17 × 1 + 0.9 × 0.99 + 0.3 × 0.506) × $33.4009 = $107.31
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.
15261 billing questions
Which primary code must accompany 15261?
Report 15261 with 15260, the primary full-thickness graft code for the nose, ears, eyelids, or lips. It is not reported by itself.
How are units of 15261 counted?
After the initial 20 sq cm represented by 15260, each additional 20 sq cm or fraction supports one unit of 15261. Document the grafted recipient area.
Can the donor-site closure be billed separately?
Direct closure of the donor site is included in the full-thickness graft service described by this code family.
Does 15261 describe a skin-substitute graft?
No. It applies to additional area treated with a free full-thickness skin graft, not a skin-substitute product.
What documentation supports reporting 15261?
Document the nose, ear, eyelid, or lip recipient site, the full-thickness graft technique, and the measured graft area supporting the additional units.
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.
1,50815240,,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
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
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
10802402,WA,02,SEATTLE (KING CNTY),1.050,1.227,0.817