CPT 15120: Split‑Thickness Autograft, Face/Scalp (first 100 sq cm)

Medicare pays $899 and commercial payers pay $1968 on average nationally for this procedure.

CPT code 15120 describes a split-thickness skin autograft procedure for reconstruction of the face, scalp, eyelids, mouth, neck, ears, orbits, genitalia, hands, feet, and/or multiple digits, covering the first 100 square centimeters or less (or 1% body area for an infant or child); the service is a surgical skin graft harvest and placement and the typical site of service is an operating room or ambulatory surgery center for reconstructive treatment of burns, trauma, or soft tissue defects of the listed anatomic areas.

For related coverage guidance, see recent payer policy updates: Mohs Micrographic Surgery, Mohs Micrographic Surgery, Mohs Micrographic Surgery.

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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.

National Payer Mean Reimbursement Rates

State Reimbursement Rates

State: Alaska1 / 51

Rate by payer

Clinical & Coding Specifications

Clinical Context

A 6-year-old child presents to the burn service after sustaining deep partial- and full-thickness thermal burns to the face and left hand. After initial resuscitation and wound debridement in the operating room, the surgical team performs a split‑thickness skin autograft to the face and multiple digits to achieve coverage of exposed dermis and promote healing. The procedure involves harvesting a split‑thickness graft from the thigh, preparing the recipient sites on the face and digits, securing the grafts with sutures and dressings, and applying appropriate immobilization for the hand. Postoperative workflow includes monitoring in the post‑anesthesia care unit, pain control, wound checks, graft viability assessments, dressing changes, and scheduled follow‑up with the burn/plastic surgery clinic for graft take evaluation and scar management.

Related CPT Codes

CPT Code	Description	Relationship to This Procedure
`15121`	Split‑thickness autograft, face, scalp, eyelids, mouth, neck, ears, orbits, genitalia, hands, feet, and/or multiple digits; each additional 100 sq cm, or 1 percent of body area of infant or child.	Used when graft area exceeds the initial 100 sq cm or 1% threshold; reported in addition to `15120`.
`15220`

Related Modifiers

12 rows

Modifier	Description	When to Use
24	Modifier 24 denotes an unrelated evaluation and management (E/M) service performed by the same physician or qualified healthcare professional during a postoperative global period. Per CPT guidance,…	- Use modifier 24 when you report an evaluation and management (E/M) service performed by the same physician or same-specialty group during a procedure’s postoperative global period that is unrelated…
52	Modifier ‑52 (Reduced Services) indicates that a service or procedure was partially reduced or omitted at the provider’s discretion, allowing reporting of the basic procedure number with a qualifier…	- Use modifier -52 when a physician or qualified health professional electively reduces or omits part of a procedure or service (for example, performing fewer required views or omitting a portion of…
53	Modifier 53 (Discontinued Procedure) signals that a surgical or diagnostic service was begun by the physician but terminated because of extenuating circumstances that threatened the patient’s…	- Use modifier -53 when a physician/qualified healthcare professional has started a surgical or diagnostic procedure (e.g., anesthesia administered, incision or scope insertion) and then discontinues…
59	Modifier 59 indicates a distinct procedural service when two procedures that are not normally billed together are clinically and procedurally separate. The CPT definition (as reiterated by CMS)…	- Use modifier -59 to report a distinct procedural service when documentation supports that the procedure reported is not normally billed together with another service on the same day because of a…
62	Modifier 62 indicates that two surgeons function as co‑surgeons, each performing distinct parts of the same primary surgical procedure. It is appended to the primary procedure code (and any…	- Use modifier -62 when two surgeons act as co‑surgeons (both primary surgeons) on a single definitive primary procedure, each performing distinct parts of the same surgical procedure (append -62 to…
66	Modifier 66 (Surgical Team) is used when three or more surgeons act as primary surgeons on a single, highly complex procedure. The AMA defines it for use when a surgical team — often composed of…	- Use modifier 66 when three or more surgeons act as primary surgeons working collaboratively as a surgical team on a single, highly complex or difficult procedure (for example organ…
76	Modifier -76, Repeat Procedure or Service by Same Physician or Other Qualified Health Care Professional, is appended when the same provider performs an identical, medically necessary procedure or…	- Use modifier -76 when the same physician or other qualified health care professional performs an identical procedure or service a second (or subsequent) time on the same date of service and the…
78	CPT modifier -78 indicates an unplanned, related return to the operating or procedure room by the same provider during the global postoperative period. It is appended when treatment for a…	- Use modifier -78 when an unplanned, related complication during the original procedure’s global postoperative period requires the patient to return to a formal operating or procedure room and the…
79	Modifier 79 indicates a surgical procedure performed during the postoperative global period of a prior surgery that is unrelated to the original procedure. Per AMA/CPT and CMS guidance, it is…	- Use modifier 79 when the same physician (or same‑specialty physician in the same group) performs a surgical procedure during the postoperative global period of a prior surgery and the new procedure…
50	Modifier –50 (Bilateral Procedure) is appended to a CPT code when an identical procedure is performed on paired anatomical structures during the same operative session. The AMA states to add…	- Use modifier -50 when the same CPT surgical, diagnostic, or radiology procedure is performed on paired anatomical structures (both sides of the body) during the same operative/session by the same…

Showing 1–10 of 12

Related Provider Taxonomies

8 rows

Taxonomy Code
208200000X
207X00000X
208600000X
347B00000X
283XC2000X
156FC0800X
207QS0010X
363LN0005X

Related ICD-10-CM Codes

5 rows

ICD-10-CM Code	Description
T23.301A	Burn of third degree of right hand, unspecified site, initial encounter
T21.31XA	Burn of third degree of chest wall, initial encounter
L90.5	Scar conditions and fibrosis of skin
T20.30XA	Burn of third degree of head, face, and neck, unspecified site, initial encounter
T22.30XA	Burn of third degree of shoulder and upper limb, except wrist and hand, unspecified site, initial encounter

Related Payer Policy Updates

Specialty: Dermatology1 / 3

10 rows

Policy	Payer	Effective Date
Mohs Micrographic Surgery	premerabluecrossofwashington	2027-02-05
Mohs Micrographic Surgery	premerabluecrossofwashington	2027-02-05
Mohs Micrographic Surgery	premerabluecrossofwashington	2027-02-05
Filsuvez	Cigna	2026-11-01
Destruction of Pre-Malignant Skin Lesions	Anthem	2026-10-01
Onychomycosis diagnostic testing and coverage	Oscar Health	2026-10-01
Treatment of Capillary Malformations (Port Wine Stains)	universityofutahhealthplans	2026-09-28
Anzupgo	Cigna	2026-09-15
Hyperhidrosis	priority_health_medicare	2026-09-01
Zevaskyn Coverage for Recessive Dystrophic Epidermolysis Bullosa	Cigna	2026-09-01

CPT 15040: Harvest of Skin for Tissue Cultured Skin Autograft (≤100 cm2)

CPT-15050-PINCH-GRAFT-SKIN-GRAFTING-SMALL-DEFECT

CPT 15050: Pinch Graft, Skin, Up to 2 cm

CPT-15100-SPLIT-THICKNESS-AUTOGRAFT-TRUNK-ARMS-LEGS

CPT 15100: Split-Thickness Autograft from Trunk/Arms/Legs

CPT-15101-SPLIT-THICKNESS-AUTOGRAFT-ADDITIONAL-100CM2

CPT 15101: Split-Thickness Autograft, Additional 100 cm²

CPT-15110-EPIDERMAL-AUTOGRAFT-TRUNK-ARMS-LEGS

CPT 15110: Epidermal Autograft, Trunk/Arms/Legs

CPT-15111-EPIDERMAL-AUTOGRAFT-TRUNK-ARMS-LEGS-ADDITIONAL

CPT 15111: Epidermal Autograft, Trunk/Arms/Legs (per 100 cm2)

CPT-15115-EPIDERMAL-AUTOGRAFT-FACE-AND-SENSITIVE-AREAS

CPT 15115: Epidermal Autograft for Face/Scalp/Hands/Feet

CPT-15116-EPIDERMAL-AUTOGRAFT-FACE-SCALP-HANDS-FEET

CPT 15116: Epidermal Autograft for Face, Hands, Feet, Multiple Digits

CPT-15121-SPLIT-THICKNESS-AUTOGRAFT-ADDITIONAL-100-SQ-CM

CPT 15121: Split-Thickness Autograft for Face, Scalp, Eyelids, Mouth, Neck, Ears

CPT-15130-DERMAL-AUTOGRAFT-HARVEST-PLACEMENT-TRUNK-ARMS-LEGS

CPT 15130: Dermal Autograft Harvest and Placement

Showing 1–10 of 27

Frequently Asked Questions

References

1.CPT® Codes and Descriptions. AAPC. Retrieved Aug 11, 2026.Maintains the CPT code set's official descriptions and guidelines, licensed from the American Medical Association, used as the definitional source for CPT codes on this page.
2.HCPCS Quarterly Update. Centers for Medicare & Medicaid Services (CMS). Retrieved Aug 11, 2026.CMS's quarterly release of HCPCS Level II codes and short/long descriptors, the source for HCPCS code definitions and update history.
3.ICD-10-CM Full Code List. Centers for Medicare & Medicaid Services (CMS). Retrieved Aug 11, 2026.CMS's complete ICD-10-CM diagnosis code list, used to cross-reference diagnosis codes associated with this procedure or service.

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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.

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State Reimbursement Rates

State: Alaska1 / 51

Rate by payer

Clinical & Coding Specifications

Clinical Context

Related CPT Codes

CPT Code	Description	Relationship to This Procedure
`15121`	Split‑thickness autograft, face, scalp, eyelids, mouth, neck, ears, orbits, genitalia, hands, feet, and/or multiple digits; each additional 100 sq cm, or 1 percent of body area of infant or child.	Used when graft area exceeds the initial 100 sq cm or 1% threshold; reported in addition to `15120`.
`15220`

Related Modifiers

12 rows

Modifier	Description	When to Use
24	Modifier 24 denotes an unrelated evaluation and management (E/M) service performed by the same physician or qualified healthcare professional during a postoperative global period. Per CPT guidance,…	- Use modifier 24 when you report an evaluation and management (E/M) service performed by the same physician or same-specialty group during a procedure’s postoperative global period that is unrelated…
52	Modifier ‑52 (Reduced Services) indicates that a service or procedure was partially reduced or omitted at the provider’s discretion, allowing reporting of the basic procedure number with a qualifier…	- Use modifier -52 when a physician or qualified health professional electively reduces or omits part of a procedure or service (for example, performing fewer required views or omitting a portion of…
53	Modifier 53 (Discontinued Procedure) signals that a surgical or diagnostic service was begun by the physician but terminated because of extenuating circumstances that threatened the patient’s…	- Use modifier -53 when a physician/qualified healthcare professional has started a surgical or diagnostic procedure (e.g., anesthesia administered, incision or scope insertion) and then discontinues…
59	Modifier 59 indicates a distinct procedural service when two procedures that are not normally billed together are clinically and procedurally separate. The CPT definition (as reiterated by CMS)…	- Use modifier -59 to report a distinct procedural service when documentation supports that the procedure reported is not normally billed together with another service on the same day because of a…
62	Modifier 62 indicates that two surgeons function as co‑surgeons, each performing distinct parts of the same primary surgical procedure. It is appended to the primary procedure code (and any…	- Use modifier -62 when two surgeons act as co‑surgeons (both primary surgeons) on a single definitive primary procedure, each performing distinct parts of the same surgical procedure (append -62 to…
66	Modifier 66 (Surgical Team) is used when three or more surgeons act as primary surgeons on a single, highly complex procedure. The AMA defines it for use when a surgical team — often composed of…	- Use modifier 66 when three or more surgeons act as primary surgeons working collaboratively as a surgical team on a single, highly complex or difficult procedure (for example organ…
76	Modifier -76, Repeat Procedure or Service by Same Physician or Other Qualified Health Care Professional, is appended when the same provider performs an identical, medically necessary procedure or…	- Use modifier -76 when the same physician or other qualified health care professional performs an identical procedure or service a second (or subsequent) time on the same date of service and the…
78	CPT modifier -78 indicates an unplanned, related return to the operating or procedure room by the same provider during the global postoperative period. It is appended when treatment for a…	- Use modifier -78 when an unplanned, related complication during the original procedure’s global postoperative period requires the patient to return to a formal operating or procedure room and the…
79	Modifier 79 indicates a surgical procedure performed during the postoperative global period of a prior surgery that is unrelated to the original procedure. Per AMA/CPT and CMS guidance, it is…	- Use modifier 79 when the same physician (or same‑specialty physician in the same group) performs a surgical procedure during the postoperative global period of a prior surgery and the new procedure…
50	Modifier –50 (Bilateral Procedure) is appended to a CPT code when an identical procedure is performed on paired anatomical structures during the same operative session. The AMA states to add…	- Use modifier -50 when the same CPT surgical, diagnostic, or radiology procedure is performed on paired anatomical structures (both sides of the body) during the same operative/session by the same…

Showing 1–10 of 12

Related Provider Taxonomies

8 rows

Taxonomy Code
208200000X
207X00000X
208600000X
347B00000X
283XC2000X
156FC0800X
207QS0010X
363LN0005X

Related ICD-10-CM Codes

5 rows

ICD-10-CM Code	Description
T23.301A	Burn of third degree of right hand, unspecified site, initial encounter
T21.31XA	Burn of third degree of chest wall, initial encounter
L90.5	Scar conditions and fibrosis of skin
T20.30XA	Burn of third degree of head, face, and neck, unspecified site, initial encounter
T22.30XA	Burn of third degree of shoulder and upper limb, except wrist and hand, unspecified site, initial encounter

Related Payer Policy Updates

Specialty: Dermatology1 / 3

10 rows

Policy	Payer	Effective Date
Mohs Micrographic Surgery	premerabluecrossofwashington	2027-02-05
Mohs Micrographic Surgery	premerabluecrossofwashington	2027-02-05
Mohs Micrographic Surgery	premerabluecrossofwashington	2027-02-05
Filsuvez	Cigna	2026-11-01
Destruction of Pre-Malignant Skin Lesions	Anthem	2026-10-01
Onychomycosis diagnostic testing and coverage	Oscar Health	2026-10-01
Treatment of Capillary Malformations (Port Wine Stains)	universityofutahhealthplans	2026-09-28
Anzupgo	Cigna	2026-09-15
Hyperhidrosis	priority_health_medicare	2026-09-01
Zevaskyn Coverage for Recessive Dystrophic Epidermolysis Bullosa	Cigna	2026-09-01

CPT 15040: Harvest of Skin for Tissue Cultured Skin Autograft (≤100 cm2)

CPT-15050-PINCH-GRAFT-SKIN-GRAFTING-SMALL-DEFECT

CPT 15050: Pinch Graft, Skin, Up to 2 cm

CPT-15100-SPLIT-THICKNESS-AUTOGRAFT-TRUNK-ARMS-LEGS

CPT 15100: Split-Thickness Autograft from Trunk/Arms/Legs

CPT-15101-SPLIT-THICKNESS-AUTOGRAFT-ADDITIONAL-100CM2

CPT 15101: Split-Thickness Autograft, Additional 100 cm²

CPT-15110-EPIDERMAL-AUTOGRAFT-TRUNK-ARMS-LEGS

CPT 15110: Epidermal Autograft, Trunk/Arms/Legs

CPT-15111-EPIDERMAL-AUTOGRAFT-TRUNK-ARMS-LEGS-ADDITIONAL

CPT 15111: Epidermal Autograft, Trunk/Arms/Legs (per 100 cm2)

CPT-15115-EPIDERMAL-AUTOGRAFT-FACE-AND-SENSITIVE-AREAS

CPT 15115: Epidermal Autograft for Face/Scalp/Hands/Feet

CPT-15116-EPIDERMAL-AUTOGRAFT-FACE-SCALP-HANDS-FEET

CPT 15116: Epidermal Autograft for Face, Hands, Feet, Multiple Digits

CPT-15121-SPLIT-THICKNESS-AUTOGRAFT-ADDITIONAL-100-SQ-CM

CPT 15121: Split-Thickness Autograft for Face, Scalp, Eyelids, Mouth, Neck, Ears

CPT-15130-DERMAL-AUTOGRAFT-HARVEST-PLACEMENT-TRUNK-ARMS-LEGS

CPT 15130: Dermal Autograft Harvest and Placement

Showing 1–10 of 27

Frequently Asked Questions

References

1.CPT® Codes and Descriptions. AAPC. Retrieved Aug 11, 2026.Maintains the CPT code set's official descriptions and guidelines, licensed from the American Medical Association, used as the definitional source for CPT codes on this page.
2.HCPCS Quarterly Update. Centers for Medicare & Medicaid Services (CMS). Retrieved Aug 11, 2026.CMS's quarterly release of HCPCS Level II codes and short/long descriptors, the source for HCPCS code definitions and update history.
3.ICD-10-CM Full Code List. Centers for Medicare & Medicaid Services (CMS). Retrieved Aug 11, 2026.CMS's complete ICD-10-CM diagnosis code list, used to cross-reference diagnosis codes associated with this procedure or service.

Published by

Trek Health powers OpenPayer with a leading commercial payer intelligence platform, seamlessly converting fragmented payer data into actionable insights for provider organizations.

CPT 15120: Split‑Thickness Autograft, Face/Scalp (first 100 sq cm)

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National Reimbursement Benchmarks

CPT 15120: Split‑Thickness Autograft, Face/Scalp (first 100 sq cm)

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National Reimbursement Benchmarks

State Reimbursement Rates

Clinical & Coding Specifications

Clinical Context

Related CPT Codes

Related Modifiers

Related Provider Taxonomies

Related ICD-10-CM Codes

Related Payer Policy Updates

Related Codes

References

State Reimbursement Rates

Clinical & Coding Specifications

Clinical Context

Related CPT Codes

Related Modifiers

Related Provider Taxonomies

Related ICD-10-CM Codes

Related Payer Policy Updates

Related Codes

References

CPT 15120: Split‑Thickness Autograft, Face/Scalp (first 100 sq cm)

Sign up for cpt 15120 policy alerts

National Reimbursement Benchmarks

CPT 15120: Split‑Thickness Autograft, Face/Scalp (first 100 sq cm)

Sign up for cpt 15120 policy alerts

National Reimbursement Benchmarks

State Reimbursement Rates

Clinical & Coding Specifications

Clinical Context

Related CPT Codes

Related Modifiers

Related Provider Taxonomies

Related ICD-10-CM Codes

Related Payer Policy Updates

Related Codes

What clinical situations and anatomic sites does CPT 15120 describe?

Which provider specialties typically bill CPT 15120?

Which CPT modifiers are noted as relevant for CPT 15120 and when are they conceptually used?

What does the payer benchmark data reveal about reimbursement for CPT 15120?

Are there related CPT codes to report additional graft area or alternative graft techniques?

References

State Reimbursement Rates

Clinical & Coding Specifications

Clinical Context

Related CPT Codes

Related Modifiers

Related Provider Taxonomies

Related ICD-10-CM Codes

Related Payer Policy Updates

Related Codes

What clinical situations and anatomic sites does CPT 15120 describe?

Which provider specialties typically bill CPT 15120?

Which CPT modifiers are noted as relevant for CPT 15120 and when are they conceptually used?

What does the payer benchmark data reveal about reimbursement for CPT 15120?

Are there related CPT codes to report additional graft area or alternative graft techniques?

References