CPT 15106: Split-Thickness Autograft for Face/Head/Neck, ≤100 sq cm - OpenPayer

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Summary & Overview

CPT 15106: Split-Thickness Autograft for Face/Head/Neck, ≤100 sq cm

CPT 15106 represents a split-thickness autograft for facial and adjacent head/neck regions measuring 100 square centimeters or less. The procedure is commonly performed by surgical specialties such as plastic surgery and dermatologic surgery to treat full-thickness skin loss, burns, traumatic defects, or complex scar revision where partial-thickness grafting is appropriate. Nationally, this code matters because it captures a focused category of reconstructive skin grafting on high-visibility areas of the head and neck where functional and cosmetic outcomes are critical.

Key payers covered in this brief include Blue Cross Blue Shield. Readers will find a concise overview of the clinical context in which CPT 15106 is used, relevant procedural comparisons to related grafting codes, and common billing considerations such as typical site of service. The publication also outlines common clinical indications and how this code fits within reconstructive surgery service lines.

This executive summary prepares readers to review benchmarks, payer coverage nuances, and coding relationships for head and neck split-thickness autografts. Where input data were incomplete, the notice "Data not available in the input." appears for missing service-line metadata to clarify limitations.

Blue Cross Blue ShieldCPT15106Split-thickness autograftPlastic surgeryDermatologic surgeryOutpatient surgerySkin graftHead and neck reconstruction

CPT Code Overview

CPT 15106 describes a split-thickness autograft procedure for the face, scalp, eyelids, mouth, neck, or ears covering 100 square centimeters or less. This is a surgical procedure typically used to repair or reconstruct skin defects by transplanting a partial-thickness layer of the patient’s own skin to a recipient site. The typical site of service for this CPT code is Outpatient Hospital (POS 22).

Clinical & Coding Specifications

Clinical Context

A patient (adult or pediatric) presents to an outpatient hospital setting for definitive wound coverage after a full-thickness skin loss on the face, scalp, eyelids, mouth, neck, or ears. Typical indications include third-degree burns, extensive open wounds, or scar-related contractures in these anatomic areas requiring split-thickness autograft harvest and placement. Preoperative steps include assessment of wound bed viability, debridement or excision of necrotic tissue or scar, selection of donor site, and informed consent. Intraoperative workflow includes preparation of the recipient site, harvest of a split-thickness skin graft sized up to 100 sq cm from a distant donor site, meshing or securing the graft, and dressing application. Postoperative care includes graft checks for adherence and perfusion, dressing changes, pain control, and instructions for activity restriction and wound monitoring. Typical providers involved include plastic surgeons, dermatologic surgeons, or general surgeons with burn care expertise, supported by perioperative nursing and outpatient wound care teams.

Coding Specifications

Modifier 51 — Multiple Procedures

Use when multiple distinct surgical procedures are performed at the same operative session by the same provider. Apply according to payer rules when 15106 is billed in addition to other procedures performed during the same encounter.
Modifier 59 — Distinct Procedural Service

Use when a service is distinct or independent from other services performed on the same day (separate anatomic sites or separate wounds) and documentation supports that the procedures are not part of the same surgical session.

National Reimbursement Benchmarks

Blue Cross Blue Shield national mean rate for CPT 15106 matches BUCA (average commercial) at $80.02. Medicare data is not available in the input, so a direct Medicare versus BUCA comparison cannot be quantified from the provided values.

Rate dispersion among reported payers is minimal where data exists: for Blue Cross Blue Shield and BUCA the 25th, 50th, and 75th percentiles are all effectively $80.00, indicating no measurable spread (P75–P25 = $0.00). Other major payers have no national values in the input. The table and chart below present the full breakdown of available national benchmarks.

State Benchmarks

State: AK1 / 46

Alaska Benchmarks

For CPT code 15106, reimbursement rates in Alaska from Blue Cross Blue Shield and BUCA are highly consistent, with no spread between the 25th and 75th percentiles; all values are exactly $80.00. This uniformity means providers receive the same rate regardless of percentile, and the mean rate for both payers is $80.82. Compared to national averages, Alaska's mean rates are slightly higher for both payers, but the difference is minimal.

The table and chart below present the full payer breakdown for Alaska, showing the mean rates and percentile values for each payer with available data.

Key Insights for Alaska

Blue Cross Blue Shield and BUCA both offer the highest and lowest mean rates for CPT 15106 in Alaska, at $80.82.
There is no rate spread between the 25th and 75th percentiles for either payer, indicating uniform reimbursement.
Alaska's mean rates are slightly higher than national averages for both payers.

Related Codes

15120

CPT 15120: Split-Thickness Autograft for Sensitive Areas, First 100 sq cm

15101

CPT 15101: Split-Thickness Autograft, Each Additional 100 sq. cm. or Less

15115

CPT 15115: Epidermal Autograft for Sensitive Areas in Infants and Children

16024

CPT 16024: Dressings and Debridement for Small Partial-Thickness Burns

16031

CPT 16031: Initial Treatment of First Degree Burn, Local Care Only

16021

CPT 16021: Dressings and Debridement for Small Partial-Thickness Burns

15108

CPT 15108: Split-Thickness Autograft, Face/Head ≤100 sq cm

15112

CPT 15112: Skin Allograft Application, Additional 100 sq cm

16025

CPT 16025: Dressings and Debridement for Medium Partial-Thickness Burns

15104

CPT 15104: Split-Thickness Autograft for Trunk, Arms, Legs

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