2025 CPT code 15276
(Active) Effective Date: N/A Revision Date: N/A Surgery - Surgical Procedures on the Integumentary System Surgery Feed
Application of skin substitute graft (add-on code); each additional 25 sq cm wound surface area.
Modifiers may be applicable depending on the circumstances of the procedure, such as modifier 59 for distinct procedural service if additional procedures are performed.
Medical necessity is established by the presence of a wound requiring skin substitute grafting for appropriate healing, preventing infection, and improving cosmetic outcome. Documentation should justify the extent of the wound area requiring grafting.
The physician's responsibility includes preparing the wound site, selecting and preparing the appropriate skin substitute graft, applying the graft, and ensuring its proper adhesion to the wound bed. This also includes post-operative care and monitoring for complications.
In simple words: This code is for extra charges when a doctor uses a special skin patch (like a skin graft) to cover a wound. This code is only used if the doctor already used a similar code (15275) for the first part of the treatment and is only for each extra 25 square centimeters of wound needing the patch.
This CPT code, 15276, represents the application of a skin substitute graft to wounds on the face, scalp, eyelids, mouth, neck, ears, orbits, genitalia, hands, feet, and/or multiple digits.It's an add-on code, meaning it must be used in conjunction with the primary procedure code 15275, and it covers each additional 25 square centimeters (cm²) of wound surface area after the initial 25 cm² treated during the same encounter. The total wound surface area should not exceed 100 cm².If the total area is 100 cm² or greater, codes 15277 or 15278 should be used instead.The skin substitute may be an allograft or xenograft.The procedure involves preparing the wound, applying the graft, and ensuring proper adhesion.
Example 1: A patient presents with a full-thickness burn injury to the face, covering a total area of 75 cm². The physician uses code 15275 for the initial 25 cm² and code 15276 for the remaining 50 cm² (two additional 25 cm² units)., A patient suffers a severe laceration to the hand involving 40 cm².The physician uses 15275 for the initial 25 cm² and 15276 for the additional 15 cm²., A child sustains multiple small lacerations during a fall, resulting in a total wound area of 60 cm². The physician uses 15275 for the first 25 cm² and 15276 to account for the remaining 35 cm² (one additional 25 cm² and a 10 cm² portion).
Detailed wound assessment including size and location, type of skin substitute used (allograft or xenograft),photographic documentation of the wound before and after the procedure, and operative notes describing the procedure performed.
** This code should only be reported when the total wound surface area is less than 100 cm².For larger areas, codes 15277 or 15278 are more appropriate.Ensure accurate measurement of the wound and proper documentation.
- Revenue Code: P5A (AMBULATORY PROCEDURES - SKIN)
- RVU: Information not available in source.Refer to CMS guidelines and local payer rates for RVU data.
- Global Days: Not applicable. This is an add-on code for skin grafting.
- Payment Status: Active
- Modifier TC rule: Not applicable for this add-on code.
- Fee Schedule: Information not available in source. Refer to historical CPT fee schedules for historical data.
- Specialties:Plastic Surgery, Burn Surgery, General Surgery
- Place of Service:Office, Ambulatory Surgical Center, Hospital (Inpatient or Outpatient)