CPT 15004: Recipient Site Preparation for Skin Graft
Medicare pays $417 and commercial payers pay $663 on average nationally for this procedure.
CPT code 15004 describes surgical preparation of the skin of a body part with an open wound, burn eschar, or scar contracture to receive a skin graft; this procedure is used to ready recipient sites on areas such as the face, scalp, eyelids, mouth, neck, ears, orbits, genitalia, hands, feet, or multiple digits and is reported for the first 100 cm2 in adults and children 10 and older or the first 1% of body area for infants and children under 10. Service type: surgical recipient site preparation for skin grafting. Typical site of service: operating room, procedure suite, or surgical clinic where debridement, excision, or release of scar contracture is performed prior to graft placement.
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National Reimbursement Benchmarks
Medicare's national mean of $416.90 sits slightly below BUCA’s average commercial mean of $662.70, indicating that BUCA reimbursements are substantially higher than Medicare for CPT 15004 on a national basis. That gap of $245.80 highlights a meaningful commercial premium versus the government rate; stakeholders comparing payers should note the scale of difference rather than individual plan minutiae.
Dispersion measured as the interquartile range (P75 minus P25) varies across payers: Blue Cross Blue Shield shows the widest IQR at $556.80 ($978.50 - $542.70), followed by UnitedHealth Group at $359.20 ($732.90 - $370.00) and BUCA at $379.00 ($826.00 - $447.00). Cigna’s IQR is $291.30 ($649.10 - $319.80) and Aetna’s is $174.30 ($485.80 - $268.50), making Aetna the tightest among these payers.