2025 CPT code 15277
(Active) Effective Date: N/A Revision Date: N/A Surgical Procedures on the Integumentary System - Skin Substitute Grafts Surgery Feed
Application of skin substitute graft (allograft or xenograft) to face, scalp, eyelids, mouth, neck, ears, orbits, genitalia, hands, feet, and/or multiple digits; total wound surface area ≥100 sq cm (or 1% body surface area for children <10 years).
Modifiers may apply depending on the circumstances (e.g., 59 for multiple procedures, 22 for increased procedural services).Consult the CPT manual for appropriate modifier usage.
Medical necessity is established when the patient has a significant wound that requires coverage to prevent infection, promote healing, and improve cosmetic appearance.The size of the wound must meet the criteria for CPT 15277.Documentation should explicitly justify the need for a skin substitute graft.
The physician is responsible for preparing the wound, selecting and preparing the appropriate skin substitute graft, applying the graft to the wound, and ensuring proper adherence.Post-operative care and follow-up are also the physician's responsibility.
In simple words: The doctor uses a special skin replacement (like a skin graft from another person or animal) to cover a large wound on the face, head, or other sensitive areas.This is for wounds larger than a certain size.
This CPT code encompasses the application of a skin substitute graft, such as an allograft or xenograft, to cover wounds on the face, scalp, eyelids, mouth, neck, ears, orbits, genitalia, hands, feet, and/or multiple digits.The procedure involves preparing the wound surface, preparing the skin substitute graft to the appropriate size and shape, and transplanting the graft to ensure proper adherence. The total wound surface area must be greater than or equal to 100 square centimeters for patients 10 years and older, or 1% of the body surface area for children under 10.This code covers the initial 100 sq cm or 1% of body surface area; additional areas require add-on code 15278.
Example 1: A patient sustains a severe facial laceration in a motor vehicle accident, requiring a skin substitute graft to cover a wound area of 120 sq cm. Code 15277 would be reported for the initial 100 sq cm, and code 15278 would be reported for the additional 20 sq cm., A child suffers from a significant burn on their arm and hand, necessitating a skin substitute graft. The total wound surface area is 1% of their body surface area.Code 15277 is used., A patient undergoes a complex reconstructive procedure of the face after cancer resection and requires a skin substitute graft to cover a large defect of 150 sq cm. 15277 would be reported with 15278 for the additional area and the primary procedure code.
Detailed medical history, physical examination findings, operative report (including graft type, size, and location), wound photographs, and post-operative progress notes are essential.
** Ensure accurate measurement of the wound surface area is documented.The use of add-on code 15278 is crucial for appropriate reimbursement when the wound area exceeds the base code's criteria.Always refer to the most up-to-date CPT manual and payer guidelines for accurate coding.
- Revenue Code: P5A (Ambulatory Procedures - Skin)
- RVU: This information is not available in the provided source. RVUs vary by payer and geographic location. Consult your local Medicare fee schedule or payer-specific guidelines for accurate RVU values.
- Global Days : The global period for this procedure is not specified in the provided source.The global period will likely depend on the payer and complexity of the case.
- Payment Status: Active
- Modifier TC rule: The provided text does not explicitly mention a TC modifier.Consider the technical components of the procedure to determine appropriate modifier use.
- Fee Schedule : The provided data lacks specific fee schedule information. Consult the payer-specific fee schedules for historical fee data.
- Specialties:Plastic Surgery, Burns Surgery, General Surgery
- Place of Service:Office, Ambulatory Surgical Center, Hospital Inpatient, Hospital Outpatient