How much does Medicare pay for CPT 15272?

Medicare allowed an average of $22.96 per service and paid $18.15 of that, the balance being the patient's coinsurance and deductible (2024 data). Providers submitted an average of $79.34, which is what they billed rather than what they received — Medicare pays its fee schedule regardless of the charge.

What is CPT code 15272?

Application of skin substitute graft to wound of trunk, arms, or legs, each additional 25.0 sq cm of wound 100.0 sq cm or less. It was billed 17,667 times to 2,658 Medicare beneficiaries by 140 providers in 2024.

Does 15272 pay differently in an office than a hospital?

Yes. The allowed amount averaged $23.18 in an office setting and $16.52 in a facility. The office rate is generally higher because the practice supplies the room, staff and equipment out of that single payment; in a hospital those are billed separately by the facility.

Which specialty bills 15272 most?

Nurse Practitioner, with 5,687 services from 54 clinicians. Next are Physician Assistant, Internal Medicine, General Surgery.

CPT 15272

Application of skin substitute graft to wound of trunk, arms, or legs, each additional 25.0 sq cm of wound 100.0 sq cm or less

$22.96Medicare-allowed amount per service, averaged across 17,667 services

Providers submitted

$79.34

Asking price, not received

Medicare allowed

$22.96

The fee schedule figure

Medicare paid

$18.15

Balance is patient coinsurance

Providers submitted an average of $79.34 for this code and Medicare allowed $22.96 — 3.5× less. That gap is normal and means nothing on its own: Medicare pays its fee schedule regardless of what is billed, so the submitted figure describes a hospital chargemaster, not a price anyone paid. Of the allowed amount Medicare paid $18.15 (79%); the rest is the patient’s coinsurance and deductible.

Office pays differently to hospital

Office / non-facility: $23.18
Hospital / facility: $16.52

The office rate is higher because the practice supplies the room, staff and equipment out of that payment. In a hospital the facility bills those separately, so the clinician's share is smaller — the total cost to Medicare is usually higher, not lower. 17,076 services were billed in an office setting and 591 in a facility.

Services: 17,667
Beneficiaries: 2,658
Providers billing it: 140
Total allowed: $405,634

What Medicare pays for CPT 15272

Across 17,667 services billed by 140 providers to 2,658 beneficiaries, Medicare allowed an average of $22.96 per service. That is 6.6 services per beneficiary, so this is a code patients typically receive more than once. The allowed amount is the figure that matters: it is what Medicare and the patient together owe, set by the fee schedule and adjusted for local practice costs. What a provider chose to submit has no bearing on it.

Who bills 15272

Specialty	Services	Beneficiaries	Avg allowed	Providers
Nurse Practitioner	5,687	908	$21.33	54
Physician Assistant	2,604	368	$21.70	25
Internal Medicine	2,253	285	$25.13	6
General Surgery	1,633	315	$23.05	16
Plastic and Reconstructive Surgery	1,234	164	$24.17	9
Family Practice	989	160	$23.87	7
General Practice	885	101	$24.93	5
Podiatry	776	66	$24.39	3
Dermatology	648	110	$25.80	5
Emergency Medicine	325	49	$24.23	3
Pediatric Medicine	226	34	$20.70	1
Vascular Surgery	125	27	$24.87	2
Physical Therapist in Private Practice	116	23	$25.54	1
Hematology-Oncology	79	14	$25.39	1
Critical Care (Intensivists)	46	22	$17.12	1

15272 reimbursement by state

Two different numbers. Allowed is what Medicare actually allowed in that state, which includes the local practice-cost adjustment. Standardized strips that geographic adjustment out of the payment, so it is the column to use when comparing states — a difference there reflects how the code was billed, not what it costs to run a practice locally.

State	Services	Allowed	Standardized pmt	Providers
California	8,440	$24.14	$17.78	55
Texas	1,762	$21.54	$17.40	14
Florida	1,173	$22.62	$17.31	15
Oklahoma	932	$20.84	$17.71	5
Arizona	744	$21.56	$17.04	6
Georgia	631	$20.29	$15.97	7
Oregon	625	$23.35	$19.23	1
Colorado	574	$20.84	$16.32	3
Illinois	507	$25.14	$18.74	4
New York	449	$23.54	$16.07	5
Nevada	447	$20.97	$16.93	6
Kansas	383	$19.99	$18.07	4
New Jersey	239	$25.32	$18.56	4
Washington	174	$20.76	$16.39	1
Utah	148	$20.04	$16.38	2
Arkansas	88	$18.60	$16.41	1
District of Columbia	75	$27.39	$19.31	1
Mississippi	73	$18.76	$16.38	1
Virginia	62	$15.92	$13.04	2
Delaware	54	$20.40	$16.31	1
Connecticut	44	$25.87	$19.30	1
Pennsylvania	43	$30.57	$19.30	1

Related codes

15271Application of skin substitute graft to wound of trunk$128.42
15275Application of skin substitute graft to wound of face$129.23
15260Full thickness skin graft to nose$928.72
15274Skin substitute graft to wound 100.0 sq cm or more of trunk$48.85
15240Full thickness skin graft to forehead$841.38
15273Skin substitute graft to wound 100.0 sq cm or more of trunk$211.10
15220Full thickness skin graft to scalp$669.90
15276Application of skin substitute graft to wound of face$29.63

Billing this code is not the same as earning it

An allowed amount is revenue to a practice, not income to a clinician. It funds staff, premises, equipment and supplies before anyone is paid. What clinicians actually earn is published separately by the Department of Labor, and what industry pays them is published separately again by CMS — this site carries both.

What doctors are paid →·Look up a clinician →·All procedure codes →

Where this comes from. CMS Medicare Physician & Other Practitioners, by Provider and Service, 2024. It covers fee-for-service Original Medicare Part B only — not Medicare Advantage, not Medicaid, and not commercial insurance, which typically pays more for the same code.

How it is averaged. CMS publishes one average per provider per code. Every figure here is re-weighted by the number of services, so a clinician who billed the code 4,000 times counts 4,000 times more than one who billed it twice. CMS also suppresses any provider-code pair with fewer than 11 beneficiaries, so low-volume practice is missing from these totals by design.