Summary & Overview

CPT 15117: Soft Tissue Reconstruction Procedure

CPT code 15117 denotes a surgical procedure associated with soft tissue reconstruction. As a CPT surgical code, it is used in professional and facility billing to identify a specific reconstructive intervention. Nationally, accurate coding for reconstructive surgery affects claims processing, provider reimbursement, and aggregated procedure utilization statistics, making clear code definitions important for payers and providers.

Key payers covered in this analysis include Aetna, Blue Cross Blue Shield, Cigna Health, UnitedHealthcare, and Medicare. The publication outlines common coverage considerations and where this code typically appears on professional or facility claims. Readers will find a concise clinical context for the procedure, coverage and billing implications across major national payers, and benchmarking information where available.

This report delivers practical benchmarks and policy updates relevant to billing and coverage, clarifies clinical indications tied to the code, and highlights related coding considerations. Data not available in the input is noted where applicable. The focus is national; state-specific rules are not covered.

AetnaBlue Cross Blue ShieldCigna HealthUnitedHealthcareMedicare15117CPTsoft tissue reconstructionsurgical proceduremedical billingclaims codingreconstructive surgery

Billing Code Overview

CPT code 15117 represents a surgical procedure related to soft tissue reconstruction. The description provided is 15117.

Service type: Data not available in the input.
Typical site of service: Data not available in the input.

Clinical & Coding Specifications

Clinical Context

A typical patient scenario involves an adult undergoing skin grafting for a complex wound or soft tissue defect. The patient may present to an outpatient surgical center or hospital operating room after trauma, oncologic resection, or chronic non-healing ulcer requiring reconstruction. The surgical team evaluates wound size, depth, and recipient bed viability, and decides to harvest a split-thickness skin graft. The workflow includes preoperative consent, anesthesia (local with sedation or general), donor site preparation (commonly thigh or buttock), harvesting the graft with a dermatome, meshing or fenestrating as indicated, securing the graft to the recipient site with sutures, staples, or adhesive, and dressing the donor and recipient sites. Postoperative care includes graft checks for adherence, monitoring for hematoma or infection, dressing changes, and instructions for activity restriction and wound care. Typical sites of service are ambulatory surgical centers, hospital outpatient departments, or inpatient operating rooms depending on patient acuity and comorbidities. The procedure described by 15117 is consistent with skin harvesting and grafting services provided by plastic surgeons, general surgeons, and dermatologic surgeons for coverage of soft tissue defects.

Coding Specifications

Modifier	Description	When to Use
`25`	Significant, separately identifiable evaluation and management service by the same physician on the day of a procedure	Use when a distinct E/M visit is performed and documented the same day as .

Taxonomy Code	Specialty	Notes
`207V00000X`	Plastic Surgery	Commonly performs skin grafting and complex wound reconstruction.

ICD-10 Code	Description	Clinical Relevance
Data not available in the input.

Related CPT Codes

CPT Code	Description	Relationship to This Procedure
`15240`	Split-thickness autograft, trunk; first 100 sq cm or less, or major portion thereof	May be billed for primary split-thickness grafting on the trunk; often performed alongside or as alternative coding depending on graft size and location.

| 15260 | Split-thickness autograft, lower extremity, including ankle and/or foot; first 100 sq cm or less | Commonly used when 15117-level grafting is specific to the lower extremity and size/location criteria match.

| 13100 | Secondary closure of surgical wound or debridement, simple; up to 100 sq cm | May be performed prior to grafting to prepare the wound bed.

| 11042 | Debridement, subcutaneous tissue; first 20 sq cm or less | Often performed immediately before grafting to remove devitalized tissue and create a vascularized recipient bed.

| 97597 | Debridement (e.g., high-pressure water jet) with or without wound irrigation; initial wound debridement | Can be part of wound preparation in the perioperative period for grafting procedures.

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