2025 CPT code 15274
(Active) Effective Date: N/A Revision Date: N/A Surgery - Skin Grafts Integumentary System Feed
Application of skin substitute graft to trunk, arms, legs; each additional 100 sq cm wound surface area, or part thereof, or each additional 1% of body area of infants and children, or part thereof (List separately in addition to code for primary procedure).
Modifiers may be applicable in certain situations such as multiple procedures (modifier 59) or reduced services (modifier 52). Refer to the CPT manual and payer-specific guidelines.
Medical necessity for 15274 is established when the patient has a significant wound requiring skin substitute grafting exceeding the initial 100 sq cm (or 1% body surface area for children under 10) covered by 15273, and the additional grafting is necessary for wound healing, infection prevention, or improved cosmetic outcome. Supporting documentation should demonstrate the size and depth of the wound, and the rationale for using a skin substitute.
The physician's clinical responsibility includes preparing the wound site, selecting and preparing the appropriate skin substitute graft (allograft or xenograft), meticulously applying the graft to the wound, ensuring proper adhesion, and completing any necessary post-operative wound care steps.
In simple words: This code covers the cost of extra skin grafts used to heal large wounds on the body (trunk, arms, or legs).It's only used if a doctor has already used a primary code to cover the first part of the wound.This code adds to the initial cost for each extra section of the wound that requires a skin graft.
This CPT code, 15274, represents the application of an additional skin substitute graft (allograft or xenograft) to wounds on the trunk, arms, or legs.It is an add-on code and must be reported in conjunction with the primary procedure code (15273) for the initial 100 sq cm (or 1% body surface area for infants/children under 10) of skin substitute grafting. This code is used for each additional 100 sq cm or part thereof of wound surface area needing coverage in patients 10 years and older, or for each additional 1% of body surface area or part thereof in infants and children under 10 years of age. The procedure includes surgical preparation of the wound, application of the graft and securing it in place.
Example 1: A patient sustains a severe burn injury affecting 150 sq cm of their leg.The initial 100 sq cm is covered using 15273. The remaining 50 sq cm requires an additional application of the skin substitute, billed using 15274., A child under 10 years old has a wound covering 2% of their body surface area. The first 1% is covered using 15273. Code 15274 is used to cover the additional 1%., A patient undergoes a complex reconstructive surgery that leaves a large wound requiring extensive skin grafting. The initial 100 sq cm is covered using 15273, followed by multiple applications of additional grafts each reported using 15274.
Detailed documentation should include the size of the wound (in sq cm or % body surface area for children under 10), the type of skin substitute used (allograft, xenograft), the location of the wound, photographic evidence of the wound before and after the procedure, operative report detailing the procedure, and any post-operative complications or follow-up care.
** Payers may have specific requirements for documentation and may not reimburse for this code without supporting clinical documentation.Always refer to your payer's specific guidelines.
- Revenue Code: P5A (AMBULATORY PROCEDURES - SKIN)
- Payment Status: Active
- Modifier TC rule: This add-on code does not have a technical component (TC) modifier.
- Specialties:Plastic Surgery, General Surgery, Burn Surgery
- Place of Service:Office, Ambulatory Surgical Center, Hospital Inpatient, Hospital Outpatient