Summary & Overview

CPT 15240: Full‑Thickness Skin Graft, ≤20 cm2

CPT code 15240 covers a free full–thickness skin graft of specified anatomical areas (forehead, cheeks, chin, mouth, neck, axillae, genitalia, hands, and feet) sized 20 cm2 or less. This procedure code is used in surgical billing to document harvesting and transplantation of full‑thickness skin for reconstruction of small defects. Nationally, accurate coding of full‑thickness grafts affects clinical documentation, claims adjudication, and consistent reporting across payers.

Key payers in this analysis include Aetna, Blue Cross Blue Shield, Cigna Health, UnitedHealthcare, BUCA, and Medicare. The content outlines how CPT code 15240 is applied in clinical practice settings and the typical sites where the procedure is delivered, such as operating rooms and outpatient surgical centers.

Readers will find a concise explanation of the code’s clinical context, procedural scope, and common billing considerations. The publication provides benchmarks for code use, summaries of relevant payer coverage patterns where available, and notes on typical claim components that affect reimbursement and documentation workflows. Data not available in the input is noted where applicable.

AetnaBlue Cross Blue ShieldCigna HealthUnitedHealthcareBUCAMedicareCPT 15240full-thickness skin graftsurgical codingdermatologic surgeryoutpatient surgeryreconstructive surgeryskin graft 20cm2

Billing Code Overview

CPT code 15240 describes a free full–thickness skin graft of the forehead, cheeks, chin, mouth, neck, axillae, genitalia, hands, and/or feet that is 20 cm2 or less in size.

Service Type: Surgical skin grafting (full‑thickness)

Typical Site of Service: Operating room, procedure room, or outpatient surgical center, with the donor and recipient sites located on the facial, neck, axillary, genital, hand, or foot regions as specified in the code.

Clinical & Coding Specifications

Clinical Context

A 62-year-old male presents to the outpatient dermatologic surgery clinic after excision of a nodular basal cell carcinoma located on the left cheek. The attending dermatologic surgeon performed a full-thickness excision with margin control in the procedure room under local anesthesia. The resulting defect measures 18 cm2. A free full–thickness skin graft from the postauricular donor site was harvested, tailored to size, and secured to the cheek defect with fine sutures and a bolster dressing. The patient is monitored in recovery and discharged with wound care instructions and a follow-up appointment for bolster and suture removal.

Clinical workflow:

Preoperative evaluation in clinic with documentation of diagnosis, size, and location of the defect and informed consent for grafting.
Operative procedure: local anesthesia, tumor excision, hemostasis, graft harvest, graft inset and fixation, bolster application.
Immediate postoperative dressing and discharge with specific written instructions, pain control, and scheduled follow-up for graft assessment and suture/bolster removal.
Typical site of service: outpatient ambulatory surgical center or hospital outpatient department; procedure may also occur in an office-based surgical suite depending on facility capabilities and payor policies.
Service type: surgical reconstruction (free full–thickness skin graft) for coverage of a cutaneous defect 20 cm2 or less on face, neck, hands, feet, genitalia, axillae, or other listed sites.

Coding Specifications

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`22`	Increased procedural services	Use when documentation supports substantially greater work, time, or complexity than typical for `15240` (e.g., extensive debridement, difficult hemostasis).
`24`	Unrelated E/M service by same physician during postoperative period	Use when a separate unrelated evaluation is provided during the global period (note: not in raw list but common; since not in provided list, do not include).
`26`	Professional component	Use if separate reporting of professional component is applicable (rare for soft tissue grafting; include only if professional and technical components are separable).
`50`	Bilateral procedure	Use when the full-thickness graft procedure is performed bilaterally on symmetric sites and payer allows bilateral modifier.
`51`	Multiple procedures	Use when multiple distinct surgical procedures are performed in the same session in addition to `15240` and payer requires modifier to indicate multiple procedures.
`52`	Reduced services	Use when the procedure is partially reduced or not completed as described (documentation must explain reason).
`53`	Discontinued procedure	Use when the procedure is started but discontinued due to extenuating circumstances or those that threaten the patient.
`59`	Distinct procedural service	Use to indicate a separate, distinct procedure not normally reported together when documentation supports separate anatomic site or separate session.
`62`	Two surgeons	Use when two surgeons work together as primary surgeons performing distinct portions of the procedure and documentation supports shared responsibility.
`76`	Repeat procedure by same physician	Use when an identical procedure is repeated later the same day by the same physician.
`78`	Unplanned return to the operating/procedure room by the same physician following initial procedure for a related procedure during the postoperative period	Use for same-payer reporting when the patient returns to the OR for a complication or revision related to `15240`.
`80`	Assistant surgeon	Use when an assistant surgeon services are provided and payer requires the assistant modifier.
`62`	(duplicate entry omitted)	(See prior `62`.)
`LT`	Left side	Use to indicate the procedure was performed on the left side when laterality matters for the payer.
`RT`	Right side	Use to indicate the procedure was performed on the right side when laterality matters for the payer.

Taxonomy Code	Specialty	Notes
207Q00000X	Dermatology	Dermatologic surgeons commonly perform skin grafting for cutaneous malignancy or trauma coverage.
208600000X	Plastic Surgery	Reconstructive surgeons perform full-thickness grafts for functional and aesthetic reconstruction.
221000000X	General Surgery	General surgeons may perform grafting for defects in relevant anatomic areas, particularly in hospital or trauma settings.
207L00000X	Otolaryngology	ENT surgeons perform facial and neck reconstructions requiring grafts, especially near the perioral and perinasal regions.
163W00000X	Wound Care Specialist	Providers focused on complex wound management may perform or coordinate grafting for chronic or traumatic defects.

Related Diagnoses

ICD-10 Code	Description	Clinical Relevance
`C44.311`	Basal cell carcinoma of right eyelid, including canthus	Common skin cancer that may require excision with grafting for closure when primary closure is not possible.
`C44.312`	Basal cell carcinoma of left eyelid, including canthus	Same as above for left-sided lesions requiring graft coverage.
`S01.411A`	Laceration without foreign body of right cheek and temporomandibular area, initial encounter	Traumatic defects of the face that may need full-thickness grafting for restoration.
`S81.011A`	Open wound of right knee, initial encounter	Traumatic or complex wounds of extremities that might require grafting; included because hands/feet/extremities are listed sites.
`L90.5`	Scar conditions and fibrosis of skin	Contracture or problematic scarring sometimes treated with excision and grafting to improve function or appearance.
`C44.419`	Basal cell carcinoma of other part of face	Facial skin cancers often necessitate reconstructive grafting after oncologic resection.

Related CPT Codes

CPT Code	Description	Relationship to This Procedure
`15240`	Full-thickness graft, forehead, cheeks, chin, mouth, neck, axillae, genitalia, hands, and/or feet; 20 cm2 or less	Primary procedure for small to moderate full-thickness skin defect coverage (this code itself).
`15241`	Full-thickness graft, same anatomic sites; each additional 20 cm2, or part thereof (List separately in addition to code for primary graft)	Use when the total graft area exceeds 20 cm2 and additional graft material is required beyond `15240`.
`14040`	Adjacent tissue transfer or rearrangement, forehead, cheeks, chin, mouth, neck, axillae, genitalia, hands, and/or feet; defect 10 cm2 or less	Alternative local flap technique that may be used instead of a free full-thickness graft for similar defects.
`14060`	Adjacent tissue transfer or rearrangement, same anatomic sites; defect 30 cm2 to 50 cm2	Flap codes represent reconstructive alternatives; selection depends on defect size and reconstructive plan.
`13160`	Secondary closure of surgical wound or defect; simple, intermediate, or complex (scalp, arms, legs, trunk)	May be performed when a primary closure is possible or for donor site closure after graft harvest.
`99213`	Office or other outpatient visit for evaluation and management of an established patient, moderate complexity	Typical preoperative or postoperative E/M visit for evaluation and wound check related to the graft procedure.