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CPT 15101: Split-Thickness Autograft, Additional 100 cm2
CPT code 15101 represents a split‑thickness autograft harvested from the trunk, arms, or legs for each additional 100 cm² (or each additional 1% of body area in infants/children) beyond the primary graft. The code is used to bill incremental graft area when more tissue transfer is required during reconstructive or burn care procedures. Nationally, accurate reporting of this incremental graft code affects case-level surgical documentation, resource accounting, and aggregate utilization metrics for burn and reconstructive surgery.
This analysis covers major commercial and public payers including Aetna, Blue Cross Blue Shield, Cigna Health, United Healthcare, and Medicare. Readers will find a concise explanation of clinical context for incremental split‑thickness autografting, common procedural settings, and how 15101 relates to the primary graft code 15100. The publication summarizes payer coverage patterns and allowed‑service considerations, highlights common modifiers and coding relationships (for reference), and provides benchmark context for utilization and billing of additional graft area. The content is designed for hospital coding teams, surgical services, and payer relations staff seeking a national‑level briefing on reporting and clinical context for incremental split‑thickness autografts.
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Billing Code Overview
CPT code 15101 describes a split‑thickness skin autograft harvested from the trunk, arms, or legs and placed for each additional 100 cm² (or each additional 1% body area for an infant or child) beyond the primary graft quantity. This code is intended to be reported in addition to the primary split‑thickness autograft code for extra graft surface area.
Service type: Skin grafting / surgical autograft procedure
Typical site of service: Operating room or procedural suite in an inpatient or outpatient surgical setting
National Reimbursement Benchmarks
Medicare’s mean rate of $207.5 sits well below BUCA’s mean commercial benchmark of $1473.6, indicating a substantial gap between federal payment levels and the BUCA commercial average. Blue Cross Blue Shield and BUCA exhibit the highest mean levels overall, while Aetna, Cigna, and UnitedHealth Group have mean rates that fall between Medicare and the highest commercial averages; this highlights how Medicare reimbursement remains considerably lower than certain commercial markets.
Dispersion measured as P75 minus P25 is widest for Blue Cross Blue Shield at $3,129.0 (P75 $3,866.7 minus P25 $736.7), followed by BUCA at $1,850.2 (P75 $2,325.4 minus P25 $474.2). UnitedHealth Group shows substantial spread of $164.4 (P75 $340.0 minus P25 $169.6). The tightest distributions are Aetna with $112.0 (P75 $168.0 minus P25 $54.0) and Cigna with $184.4 (P75 $303.4 minus P25 $149.0), indicating notably less variability for those payers compared with the largest commercial plans.