Summary & Overview
CPT 15135: Dermal Autograft Harvesting and Placement
CPT code 15135 represents the harvesting and placement of a dermal autograft for reconstruction of delicate anatomic regions such as the face, scalp, eyelids, mouth, neck, ears, orbits, genitalia, hands, feet, and multiple digits. This code specifies coverage for the first 100 cm² or less in adults, or 1 percent of body surface area in infants and children, and is used in surgical reconstruction following trauma, oncologic resection, or congenital and reconstructive procedures. Nationally, accurate use of this code affects surgical documentation, billing accuracy, and appropriate payment for complex tissue reconstruction.
Key payers in this analysis include Aetna, Blue Cross Blue Shield, Cigna Health, UnitedHealthcare, and Medicare. Readers will find an overview of clinical context for dermal autografting, common sites of service, payer coverage considerations, and the billing scope defined by the code’s area-based limit. The publication provides benchmarks and policy-relevant details to help clinical billing teams and policy analysts understand how CPT code 15135 is applied across common reconstructive settings. Data not available in the input includes specific payer policies, fee schedules, ICD-10 pairings, and related CPT or HCPCS linkage.
Billing Code Overview
CPT code 15135 describes the harvesting and placement of a dermal autograft for reconstruction of the face, scalp, eyelids, mouth, neck, ears, orbits, genitalia, hands, feet, and/or multiple digits. The code covers the initial 100 cm² or less of donor tissue for an adult, or 1 percent of body surface area for an infant or child.
Service Type: Dermal autograft harvesting and placement
Typical Site of Service: Operating room or procedure suite, with donor and recipient sites located on the specified anatomic regions (face, scalp, eyelids, mouth, neck, ears, orbits, genitalia, hands, feet, and/or multiple digits).
Clinical & Coding Specifications
Clinical Context
A typical patient is an adult who sustained a full-thickness facial skin defect after Mohs micrographic surgery for a large basal cell carcinoma of the cheek. The patient presents to the operating suite for reconstruction under monitored anesthesia care. The surgical workflow includes preoperative marking and consent, harvesting of a dermal autograft from a concealed donor site (for example, supraclavicular or postauricular area), preparation of the recipient bed on the cheek, placement and securement of the dermal autograft sized to 100 cm2 or less, and appropriate dressing and postoperative instructions. Intraoperative documentation includes graft size, donor and recipient sites, type of anesthesia, hemostasis, and any complications. Postoperative follow-up visits document graft viability, signs of infection, and wound healing. Typical sites of service are outpatient surgical centers, hospital outpatient departments, or ambulatory surgery centers for head and neck reconstruction procedures involving the face, scalp, eyelids, mouth, neck, ears, orbits, genitalia, hands, feet, and digits.
Coding Specifications
| Modifier | Description | When to Use |
|---|---|---|
26 | Professional component | Use when reporting only the surgeon's professional component separate from technical facility services (rare for this procedure). |
50 | Bilateral procedure | Use when identical dermal autograft procedures are performed on bilateral anatomic sites and payer requires bilateral modifier. |
51 | Multiple procedures | Use when this dermal autograft is reported with other distinct surgical procedures during the same operative session, per payer rules. |
52 | Reduced services | Use when the procedure is partially reduced or not completed as described in the full code. |
53 | Discontinued procedure | Use when the procedure is started but discontinued due to extenuating circumstances. |
62 | Two surgeons | Use when two surgeons with different specialties work together as primary surgeons performing distinct portions of the procedure. |
66 | Surgical team | Use when a surgical team approach is documented for complex reconstruction requiring multiple surgeons. |
78 | Unplanned return to OR | Use when the patient returns to the operating room for a procedure related to the initial dermal autograft during the global period. |
79 | Unrelated procedure during global period (Note: not in provided list) | Data not included; do not use. |
80 | Assistant surgeon | Use when a surgical assistant participates and payer requires reporting the assistant. |
81 | Minimum assistant surgeon | Use when a minimal assistant surgeon role is documented and accepted by payer. |
82 | Assistant surgeon (when qualified resident not available) | Use when a qualified resident is not available and a non-physician assistant participates. |
22 | Increased procedural services | Use when work, time, or technical difficulty substantially exceeds typical expectations and documentation supports the increased service. |
23 | Unusual anesthesia | Use when the procedure is performed under general anesthesia because local/regional anesthesia was contraindicated and documentation supports use. |
63 | Procedure performed on infants less than 4 kg | Use when applicable to infant patients and weight-related reporting is required. |
| Taxonomy Code | Specialty | Notes |
|---|---|---|
207L00000X | Plastic Surgery | Primary specialty performing complex dermal graft harvest and facial reconstruction. |
207N00000X | Otolaryngology (ENT) | Performs facial and scalp reconstructions, especially when tumors involve periorbital or perinasal areas. |
208200000X | General Surgery | Performs soft-tissue reconstruction in some settings, particularly for hands, feet, or digit reconstruction. |
2080P0002X | Dermatology | Often performs Mohs surgery and coordinates reconstructive procedures including dermal autograft placement. |
207X00000X | Oral and Maxillofacial Surgery | Involved when mouth, jaw, or perioral defects require reconstruction. |
Related Diagnoses
| ICD-10 Code | Description | Clinical Relevance |
|---|---|---|
C44.311 | Basal cell carcinoma of right cheek | Skin cancer of the face frequently requires excision with subsequent reconstructive dermal autograft placement for defect coverage. |
C44.319 | Basal cell carcinoma of face, unspecified | Face skin cancers often result in soft-tissue defects addressed with dermal autografts. |
S01.411A | Laceration without foreign body of right cheek, initial encounter | Traumatic full-thickness defects may need dermal grafting for reconstruction. |
T81.4XXA | Infection following a procedure, initial encounter | Postoperative infections are a potential complication monitored after graft placement. |
L98.4 | Non-healing surgical wound | Chronic or non-healing wounds may require grafting with dermal autograft to achieve closure. |
S21.01XA | Open wound of chest wall, initial encounter | Soft-tissue defects of hands, feet, digits, or trunk when referenced to similar reconstructive needs; grafting techniques overlap. |
Q82.8 | Other congenital malformations of skin | Some congenital defects of the face or digits may be reconstructed with dermal autografting techniques. |
Related CPT Codes
| CPT Code | Description | Relationship to This Procedure |
|---|---|---|
15271 | Split-thickness autograft, trunk; first 100 sq cm or less, or 1 percent BSA of infants/children | May be performed when a split-thickness graft is chosen instead of a dermal autograft for coverage of a facial or scalp defect; alternative graft technique. |
15732 | Muscle, myocutaneous or fasciocutaneous flap; head and neck | Performed when local or regional flap reconstruction is required in addition to or instead of dermal grafting for larger or deeper defects. |
13131 | Repair, complex, forehead, cheeks, chin, mouth, neck, axillae, genitalia, hands and/or feet; 1.1 cm to 2.5 cm | May be performed concurrently for layered complex wound closure adjacent to graft site or for donor site closure. |
14060 | Adjacent tissue transfer or rearrangement, forehead, cheeks, chin and/or neck; defect 10 sq cm to 30 sq cm | Performed when local tissue rearrangement is used in combination with grafts for optimal cosmetic reconstruction. |
12032 | Repair, intermediate, wounds of face; 2.6 cm to 7.5 cm | Often performed for primary closure of smaller facial wounds before or after grafting procedures when indicated. |