CPT 15112: Skin Allograft Application, Additional 100 sq cm - OpenPayer

Beta

OpenPayer Beta

Summary & Overview

CPT 15112: Skin Allograft Application, Additional 100 sq cm

CPT code 15112 is a surgical billing code for the application of an allograft, skin, or dermal substitute to the trunk, arms, or legs, covering each additional 100 square centimeters beyond the primary procedure. This code is significant in the national healthcare landscape as it supports advanced wound care for patients with burns, ulcers, and complex open wounds, often performed in outpatient hospital settings. The code is commonly used by surgical, plastic surgery, and surgical oncology physicians, reflecting its importance in multidisciplinary care.

Blue Cross Blue Shield is a key payer covered in this analysis, providing insight into reimbursement and policy considerations for this procedure. Readers will gain an understanding of clinical indications, relevant modifiers such as 59 for distinct procedural service and 51 for multiple procedures, and associated taxonomies. The publication also highlights related CPT codes and ICD-10 diagnoses, offering a comprehensive overview of coding practices and clinical context for skin allograft procedures. Benchmarks and policy updates are included to inform stakeholders about current trends and requirements in medical billing for advanced wound management.

Blue Cross Blue ShieldCPT 15112surgeryoutpatient hospitalskin allograftdermal substitutewound careburn treatmentplastic surgerymedical billingprocedure coding

CPT Code Overview

CPT code 15112 describes the application of an allograft, skin, or dermal substitute to the trunk, arms, or legs for each additional 100 square centimeters, or part thereof. This code is used in addition to the primary procedure and is typically performed as part of surgical interventions to treat complex wounds, burns, or ulcers. The service type is surgery, and the most common site of service is the outpatient hospital setting (Place of Service 22). This procedure is essential for patients requiring advanced wound care and reconstruction, supporting improved healing and recovery outcomes.

Clinical & Coding Specifications

Clinical Context

A patient presents to the outpatient hospital with a large wound on the trunk or lower extremity, such as a burn, chronic ulcer, or open wound. After surgical preparation of the recipient site, the provider applies a skin allograft or dermal substitute to cover the wound. The initial 100 sq cm is coded separately, and for each additional 100 sq cm or part thereof, CPT code 15112 is reported. This scenario is common in cases of extensive burns, pressure ulcers, or chronic wounds requiring staged grafting procedures.

Coding Specifications

Modifier 59: Used to indicate a distinct procedural service, such as when the allograft is applied to a separate anatomical site or in a different session from other procedures.
Modifier 51: Used to denote multiple procedures performed during the same operative session, such as when several grafts or related surgical services are provided.

Provider Taxonomy Code	Specialty Name
`208600000X`

National Reimbursement Benchmarks

For CPT code 15112, the national mean rate for Blue Cross Blue Shield and BUCA (average commercial) is $80.02. Medicare rates are not available in the input for comparison. Both commercial payers show identical mean rates, indicating uniformity in reimbursement levels across these segments.

Rate dispersion is minimal for both Blue Cross Blue Shield and BUCA, with the 25th, 50th, and 75th percentiles all at $80.00. This suggests a very tight distribution, with no variation between the lower and upper quartiles. The table and chart below present the full breakdown of national benchmarks for each payer.

State Benchmarks

State: AK1 / 46

Alaska Benchmarks

For CPT code 15112, reimbursement rates in Alaska are highly consistent across Blue Cross Blue Shield and BUCA, with no spread between the 25th and 75th percentiles. This means all providers receive nearly identical payments, and the rate spread (P75 minus P25) is $0.00. The mean rate in Alaska is $80.82, which is slightly above the national mean of $80.02.

The table and chart below present the full payer breakdown for Alaska, showing that both Blue Cross Blue Shield and BUCA pay at the same rate for this procedure. No other payers have available data for Alaska in this analysis.

Key Insights for Alaska

Blue Cross Blue Shield and BUCA both offer the highest and lowest mean rates for CPT 15112 in Alaska, at $80.82.
There is no rate spread between the 25th and 75th percentiles; all values are $80.00, indicating uniform reimbursement.
Alaska's mean rates are slightly higher than national averages for CPT 15112.

Related Codes

15121

CPT 15121: Split-Thickness Autograft for Sensitive Anatomical Areas

15110

CPT 15110: Epidermal Autograft for Trunk, Arms, or Legs

15105

CPT 15105: Split-Thickness Autograft for Face, Scalp, Neck, or Ears

16024

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

15118

CPT 15118: Skin Substitute Graft Application for Face and Small Areas

15111

CPT 15111: Epidermal Autograft for Trunk, Arms, or Legs

16028

CPT 16028: Dressings and Debridement for Small Partial-Thickness Burns

16025

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

16022

CPT 16022: Dressings and Debridement for Small Partial-Thickness Burns

16020

CPT 16020: Dressings/Debridement for Partial-Thickness Burns

Showing 1–10 of 42

Trek Health ingests and normalizes Transparency in Coverage data and payer policy updates to give provider organizations a clear view of how commercial reimbursement behaves across markets, payers, and services. Our platform transforms raw payer disclosures into structured intelligence that supports contract evaluation, payer negotiations, and service line strategy. By combining market benchmarks with ongoing policy visibility, Trek helps teams identify variability, risk, and opportunity in commercial reimbursement. The result is faster insight, stronger negotiating positions, and more informed financial decisions.

Free Report

See how your rates compare to the market.

Get a free custom competitive market analysis.