Summary & Overview

HCPCS A2007: Restrata, per square centimeter (topical wound material)

HCPCS Level II code A2007 designates Restrata billed per square centimeter as an add-on supply when used in conjunction with a primary procedure. Nationally, this code matters because it standardizes reporting and billing for area-based topical materials and tissue substitutes used in wound care and surgical applications, affecting facility and professional reimbursements when applied across diverse care settings.

Key payers covered in this analysis include Aetna, Blue Cross Blue Shield, Cigna Health, UnitedHealthcare, and Medicare. Readers will find a concise overview of reimbursement and billing context for an add-on, area-based supply code, including typical sites of service, common billing modifiers, and where available, payer coverage patterns. The publication also outlines practical clinical context for use — primarily wound care and topical application during surgical or outpatient procedures — and summarizes benchmarks and policy considerations relevant to payers and billing operations.

The report does not include state-specific rules; it focuses on national patterns, payer approaches, and operational considerations for coding A2007. Data not available in the input is noted where applicable.

AetnaBlue Cross Blue ShieldCigna HealthUnitedHealthcareMedicareA2007HCPCS Level IIRestratawound-caretopical-supplyadd-on-codeambulatory-surgeryoutpatient-billing

Billing Code Overview

HCPCS Level II code A2007 describes Restrata, billed per square centimeter as an add-on supply item that is listed separately in addition to a primary procedure. This code represents a topical or wound-related material measured and reimbursed by surface area rather than by unit, indicating a service type of wound care supply/application or topical graft/substitute material.

Typical site of service for items billed with A2007 is ambulatory surgical centers, hospital outpatient departments, and physician offices where procedures involving application of topical materials or wound dressings are performed and billed in conjunction with a primary procedure.

Data not available in the input.

Clinical & Coding Specifications

Clinical Context

A typical patient is an adult with a chronic or large-sized skin or soft-tissue wound (e.g., pressure ulcer, diabetic foot ulcer, surgical dehiscence, full-thickness burn) requiring application of a skin substitute product billed by surface area. The procedure using A2007 (Restrata, per square centimeter) is performed in an outpatient wound care clinic, hospital outpatient department, or ambulatory surgical center. The clinical workflow commonly includes: initial wound assessment and debridement, measurement of wound surface area, selection and preparation of the Restrata dermal substitute, application and fixation of the product to the wound bed, dressing placement, and patient education on wound care and follow-up. Documentation includes wound measurements (cm2), indication for graft/substitute, prior conservative treatments, procedure note describing application technique, quantity (square centimeters) of A2007 used, and post-procedure plan including frequency of dressing changes and follow-up visits.

Coding Specifications

Modifier	Description	When to Use
`22`	Increased procedural services	Use when work, time, or complexity substantially exceeds typical for application of the skin substitute and documentation supports increased work.
`52`	Reduced services	Use when the procedure is partially reduced or not completed as originally planned (e.g., product partially applied due to intraoperative findings).
`53`	Discontinued procedure	Use when the application is started but then discontinued for patient safety reasons before completing the intended application.
`54`	Surgical care only	Use when the provider bills only for the intraoperative application and another provider bills pre/postoperative care.
`55`	Postoperative management only	Use when the provider bills for postoperative management of the wound after application performed by another surgeon.
`56`	Preoperative management only	Use when the provider bills for preoperative evaluation and planning only.
`62`	Two surgeons	Use when two surgeons of different specialties perform distinct portions of the application and documentation supports co-surgery.
`78`	Unplanned return to the OR following initial procedure	Use if an unplanned re-operation for the wound occurs related to the initial application.
`AS`	Physician assistant, nurse practitioner, or clinical nurse specialist services for assistant at surgery	Use when an advanced practice provider assists during the application as defined by payor rules.
`QX`	CRNA service with qualified anesthesia person (modifier for anesthesia-qualified clinician)	Use when a certified registered nurse anesthetist provides anesthesia services during operative application under the appropriate supervising arrangement.

Taxonomy Code	Specialty	Notes
`2084P0800X`	General Surgery	Surgeons performing wound debridement and skin substitute application.
`207K00000X`	Plastic Surgery	Plastic surgeons performing complex wound coverage and dermal substitute placement.
`364S00000X`	Podiatry	Podiatrists managing diabetic foot ulcers and applying skin substitutes to lower-extremity wounds.
`207L00000X`	Dermatology	Dermatologists treating complex skin defects and applying biologic dressings.
`363LP0800X`	Wound Care Management	Wound care specialists and nurses coordinating application and follow-up.

Related Diagnoses

ICD-10 Code	Description	Clinical Relevance
`L89.153`	Pressure ulcer of sacral region, stage 3	Deep pressure injuries often require dermal substitutes like Restrata for reconstruction of tissue loss.
`L97.524`	Non-pressure chronic ulcer of left lower leg with fat layer exposed	Chronic lower-extremity ulcers that involve deeper tissues may be treated with dermal substitute to promote healing.
`E11.621`	Type 2 diabetes mellitus with foot ulcer	Diabetic foot ulcers commonly require debridement and advanced wound products billed per cm2.
`S81.811A`	Laceration without foreign body of right lower leg, initial encounter	Traumatic soft-tissue defects may be reconstructed with dermal substitutes to restore tissue integrity.
`T31.2`	Burns of 10-19% of body surface with third degree burns	Full-thickness burns with significant surface area may be managed with dermal substitutes as part of staged reconstruction.

Related CPT Codes

CPT Code	Description	Relationship to This Procedure
`11042`	Debridement, subcutaneous tissue (includes removal of devitalized tissue prior to application of skin substitute)	Often performed immediately prior to application of `A2007` to prepare a vascularized wound bed.
`11730`	Avulsion of nail plate, partial or complete, any number of fingers or toes	May be performed in conjunction with wound care in digital infections prior to skin substitute placement.
`15002`	Adjacent tissue transfer or rearrangement, trunk, arms, legs; first 30 sq cm or less, each additional 30 sq cm (includes soft tissue advancement procedures)	Used when local tissue rearrangement is performed alongside or instead of dermal substitute placement for wound closure.
`15271`	Full-thickness skin graft, trunk, arms, legs; first 100 sq cm or less, or scalp, neck, hands, genitalia; first 20 sq cm or less	Performed when autograft is used in combination with or following use of dermal substitute for definitive closure.
`97597`	Removal of devitalized tissue from wound(s), selective debridement, without anesthesia (first 20 sq cm or less)	Commonly billed in serial outpatient wound care visits prior to or after application of `A2007` for wound bed maintenance.