2025 CPT code 15272
(Active) Effective Date: N/A Revision Date: N/A Surgical Procedures on the Integumentary System - Skin Replacement Surgery Surgery Feed
Application of skin substitute graft to trunk, arms, and legs; each additional 25 sq cm wound surface area.
Modifiers may be applicable depending on the circumstances of the procedure.Consult the CPT manual and payer-specific guidelines.
The medical necessity for skin substitute grafting is typically established by the presence of a wound that is not healing properly and poses a risk of infection or other complications. Documentation should support the severity and nature of the wound.
The physician prepares the wound site (cleaning and sterilizing), prepares the skin substitute graft to fit the wound, and applies the graft, ensuring proper adherence to prevent infection and promote healing, leading to improved cosmetic outcome.
In simple words: This code is used when a doctor applies a special skin covering (like a skin graft) to a wound on your torso, arms, or legs.If the wound is bigger than the first 25 square centimeters, the doctor bills for each extra 25 square centimeters using this code along with another code for the initial area.
This CPT code, 15272, represents the application of each additional 25 square centimeters (sq cm) of skin substitute graft to wounds located on the patient's trunk, arms, or legs.It is an add-on code and must be reported in addition to the primary procedure code (15271) for the initial 25 sq cm or less of wound surface area. This code is applicable when the total wound surface area is up to 100 sq cm. For wounds exceeding 100 sq cm, codes 15273 and 15274 are used.
Example 1: A patient presents with a 75 sq cm wound on their leg following a motorcycle accident.The initial 25 sq cm is billed using 15271, and the remaining 50 sq cm is billed using two units of 15272., A patient has a chronic wound on their trunk (50 sq cm) requiring skin substitute grafting.The physician bills 15271 for the initial 25 sq cm and 15272 for the additional 25 sq cm., A child with a burn covering 1% of their body surface area (approximately 100 sq cm for a child under 10) on their arm would require the primary code 15271, and additional area could be billed with 15272 (only if total area is less than 100 sq cm).
Detailed medical record documenting wound size and location, type of skin substitute used,pre-operative and post-operative photographs and notes, and any complications encountered.Include justification for medical necessity.
** Always confirm payer-specific policies and guidelines before submitting claims.Improper use of this add-on code can lead to claim denials.Ensure accurate wound measurement documentation.
- Revenue Code: P5A (Ambulatory Procedures - Skin)
- RVU: RVUs vary depending on geographic location and other factors. Consult a local fee schedule or Medicare's Physician Fee Schedule for current values.
- Global Days: 0-day global billing period (applies to physicians, not facilities).
- Payment Status: Active
- Modifier TC rule: TC modifier is not applicable for this code since it's an add-on code.
- Fee Schedule: Fee schedules vary by payer and geographic location.Consult fee schedules from specific payers.
- Specialties:Plastic Surgery, General Surgery, Wound Care
- Place of Service:Office, Ambulatory Surgical Center, Hospital (Inpatient or Outpatient)