Summary & Overview
CPT 15260: Full-Thickness Skin Graft of Nose/Ears/Eyelids/Lips ≤20 cm2
CPT code 15260 denotes a free full–thickness skin graft of the nose, ears, eyelids, and/or lips that is 20 cm2 or less. This code captures a specialized reconstructive surgical service used to repair full-thickness defects on delicate facial structures where tissue replacement requires all skin layers. Nationally, accurate coding for these procedures supports appropriate payment, quality tracking, and clinical documentation for facial reconstruction and post-traumatic or post-oncologic repair.
Key payers in this coverage landscape include Aetna, Blue Cross Blue Shield, Cigna Health, UnitedHealthcare, and Medicare. Readers will find a concise overview of clinical context for the procedure, typical sites of service, and the common payer landscape addressed in national policy guidance. The publication summarizes benchmarks and policy-relevant considerations for billing and coverage, highlights typical clinical scenarios in which the code is used, and identifies where additional documentation or coding specificity may be required. Data not available in the input for associated taxonomies, ICD-10 diagnoses, related codes, and service line are noted as missing and not inferred. The aim is to provide a clear, national-level briefing on CPT code 15260 for clinicians, billing professionals, and policy analysts.
Billing Code Overview
CPT code 15260 describes a free full–thickness skin graft procedure of the nose, ears, eyelids, and/or lips where the graft size is 20 cm2 or less. This service is a surgical grafting technique that involves transplanting all layers of the skin from a donor site to cover a full-thickness defect on the specified facial areas.
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Service type: Surgical full–thickness skin graft
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Typical site of service: Ambulatory surgical center or hospital outpatient surgical setting; may also be performed in an office-based surgical procedure room when appropriate
Clinical & Coding Specifications
Clinical Context
A 68-year-old male presents to a dermatologic surgery clinic following Mohs micrographic excision of a basal cell carcinoma on the right ala of the nose. The defect measures 1.5 x 2.0 cm (3.0 cm2) with full-thickness loss of skin and exposure of subcutaneous tissue. The surgeon elects to perform a free full-thickness skin graft to the nasal ala using a donor graft harvested from the postauricular scalp. The procedure is performed in an ambulatory surgery center under local anesthesia with monitored sedation. The graft is inset, secured with fine sutures, and dressed with a bolster for 5 days. The patient is discharged with wound care instructions and a planned follow-up visit in 5 days for bolster removal and graft assessment.
Coding Specifications
| Modifier | Description | When to Use |
|---|---|---|
22 | Increased procedural services | Use when work, time, and effort substantially exceed usual for 15260 (document justification). |
26 | Professional component | Use if reporting only the physician professional component in a split/technical arrangement. |
50 | Bilateral procedure | Use if identical grafting is performed on bilateral anatomic sites and payer allows bilateral modifier application. |
51 | Multiple procedures | Use when 15260 is billed with other CPT codes on the same date; indicates multiple procedures were performed. |
52 | Reduced services | Use if the graft was partially reduced or not completed as originally planned. |
53 | Discontinued procedure | Use if the procedure was started but terminated due to extenuating circumstances. |
59 | Distinct procedural service | Use to indicate a separate and independent procedure when billing 15260 along with other services on the same day (use per payer guidance). |
76* | Repeat procedure by same physician | Not in provided list — Data not available in the input. |
78 | Return to the operating room for a related procedure during the postoperative period | Use when the patient returns to the OR for a complication related to the graft. |
79 | Unrelated procedure or service by the same physician during the postoperative period | Use if an unrelated surgical procedure is performed during the global period. |
LT | Left side | Use to identify laterality when applicable for documentation and payer rules. |
RT | Right side | Use to identify laterality when applicable for documentation and payer rules. |
AS | Physician assistant service | Use when a physician assistant performs or assists in the service per payer policy. |
| Taxonomy Code | Specialty | Notes |
|---|---|---|
| 207P00000X | Plastic Surgery | Common specialty performing full-thickness skin grafts on facial subunits. |
| 2080P0200X | Otolaryngology (ENT) | Performs nasal and periorbital reconstruction including grafting. |
| 207L00000X | Dermatology | Mohs surgeons and procedural dermatologists commonly perform 15260 for oncologic defects. |
| 363A00000X | General Surgery | May perform facial soft tissue reconstruction in select settings. |
| 2086S0105X | Facial Plastic Surgery | Subspecialty focused on complex facial reconstructive grafting. |
Related Diagnoses
| ICD-10 Code | Description | Clinical Relevance |
|---|---|---|
C44.312 | Basal cell carcinoma of right side of nose | Common oncologic indication leading to excision and reconstruction with a full-thickness graft on the nose. |
C44.311 | Basal cell carcinoma of left side of nose | As above for left-sided nasal lesions requiring grafting. |
C44.91 | Squamous cell carcinoma of skin, unspecified | Squamous cell carcinomas on facial sites may require full-thickness graft reconstruction after excision. |
S01.81XA | Laceration without foreign body of nose, initial encounter | Traumatic full-thickness defects of the nose may be reconstructed with 15260. |
L98.9 | Disorder of skin and subcutaneous tissue, unspecified | Used when a specific skin disorder requiring grafting is not otherwise specified; less commonly appropriate but sometimes used in complex documentation. |
Related CPT Codes
| CPT Code | Description | Relationship to This Procedure |
|---|---|---|
13131 | Repair, complex, forehead, cheeks, chin, mouth, neck, axillae, genitalia, hands and/or feet; 2.6 cm to 7.5 cm | May be performed when local flap or complex layered closure is chosen instead of a full-thickness graft for similar-sized facial defects. |
15261 | Full-thickness graft, nose, ears, eyelids, and/or lips; each additional 20 sq cm, or part thereof (List separately in addition to code for primary procedure) | Billed in addition to 15260 when the graft exceeds 20 cm2 and requires an additional unit. |
13132 | Repair, complex, forehead, cheeks, chin, mouth, neck, axillae, genitalia, hands and/or feet; each additional 5 cm beyond the primary repair | May be used when closure requires additional layered complex repairs following lesion excision. |
11642 | Excision, malignant lesion including margins, face, ears, eyelids, nose, lips; excised diameter 2.1 cm to 3.0 cm | Often performed immediately before grafting when the indication is oncologic resection; defect created by this excision may be reconstructed with 15260. |
12051 | Repair, intermediate, wounds of face, ears, eyelids, nose, lips; 2.6 cm to 7.5 cm | May be used for layered closure of donor site or adjacent wounds when primary closure is performed alongside grafting. |
99024 | Postoperative follow-up visit, global period | Used for routine postoperative follow-up related to surgical procedures including graft checks (billing depends on payer rules). |