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CPT 15120: Split-Thickness Autograft for Face, Hands, Feet and Specialized Sites
CPT code 15120 represents a split‑thickness autograft procedure used for reconstruction of specialized and high‑visibility anatomic sites — including the face, scalp, eyelids, mouth, neck, ears, orbits, genitalia, hands, feet, and multiple digits. It applies to the excision and placement of the graft for the initial 100 square centimeters or less, or 1% of body area for an infant or child. The code is clinically important in burn care, reconstructive plastic surgery, and complex wound management where donor skin is needed for functional and cosmetic restoration.
Key payers in the analysis include Aetna, Blue Cross Blue Shield, Cigna Health, United Healthcare, and Medicare. Readers will find national context on clinical applicability and coding scope, comparisons to related skin graft codes, and the typical settings where the procedure is billed. The publication outlines common diagnostic scenarios that align with the code, describes related procedural codes for additional graft area or different graft types, and identifies common billing modifiers and taxonomy specialties associated with providers who commonly report this service.
This summary is intended for coding professionals, revenue cycle staff, and clinical leaders seeking a concise reference to CPT 15120's clinical definition, billing context, and related coding relationships at a national level.
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Billing Code Overview
CPT code 15120 describes a split‑thickness autograft procedure for reconstruction of the face, scalp, eyelids, mouth, neck, ears, orbits, genitalia, hands, feet, and/or multiple digits. The code covers excision and placement of the graft for the first 100 square centimeters or less, or 1% of body area for an infant or child.
Service type: Skin grafting — split‑thickness autograft for complex or specialized anatomic sites.
Typical site of service: Operating room or procedural suite for reconstructive plastic surgery or burn reconstruction on the head, neck, hands, feet, genitalia, and other specified small or specialized regions.
National Reimbursement Benchmarks
National averages show a clear gap between Medicare and commercial-block averages: Medicare’s mean of $898.80 sits well below BUCA’s average commercial mean of $1,968.40, indicating commercial reimbursements on average are roughly $1,069.60 higher than Medicare for CPT 15120. This gap highlights that commercial payers collectively pay materially more than the Medicare baseline, with BUCA near the top of commercial means and Medicare concentrated around its mid-$800s mean across 47 localities. Dispersion varies noticeably across payers. Blue Cross Blue Shield displays the widest interquartile spread (IQR = $2,987.90), reflecting substantial regional or contract variability, while Aetna shows a relatively tight IQR ($620.10). UnitedHealth Group and Cigna have moderate spreads ($838.90 and $720.90 respectively), and BUCA’s IQR ($1,016.80) sits between the extremes. These differences imply varied pricing consistency across payers, with Blue Cross Blue Shield the most dispersed and Aetna the most concentrated around its central tendency.