How much does Medicare pay for CPT 15274?

Medicare allowed an average of $48.85 per service and paid $38.96 of that, the balance being the patient's coinsurance and deductible (2024 data). Providers submitted an average of $257.98, which is what they billed rather than what they received — Medicare pays its fee schedule regardless of the charge.

Does 15274 pay differently in an office than a hospital?

Yes. The allowed amount averaged $70.26 in an office setting and $43.15 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 15274 most?

General Surgery, with 6,170 services from 20 clinicians. Next are Plastic and Reconstructive Surgery, Nurse Practitioner, Critical Care (Intensivists).

CPT 15274

Skin substitute graft to wound 100.0 sq cm or more of trunk, arms, or legs, each additional 100.0 sq cm or 1% body area for infants and children, or less

$48.85Medicare-allowed amount per service, averaged across 10,638 services

Providers submitted

$257.98

Asking price, not received

Medicare allowed

$48.85

The fee schedule figure

Medicare paid

$38.96

Balance is patient coinsurance

Providers submitted an average of $257.98 for this code and Medicare allowed $48.85 — 5.3× 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 $38.96 (80%); the rest is the patient’s coinsurance and deductible.

Office pays differently to hospital

Office / non-facility: $70.26
Hospital / facility: $43.15

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. 2,239 services were billed in an office setting and 8,399 in a facility.

Services: 10,638
Beneficiaries: 965
Providers billing it: 48
Total allowed: $519,666

What Medicare pays for CPT 15274

Across 10,638 services billed by 48 providers to 965 beneficiaries, Medicare allowed an average of $48.85 per service. That is 11.0 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 15274

Specialty	Services	Beneficiaries	Avg allowed	Providers
General Surgery	6,170	380	$45.66	20
Plastic and Reconstructive Surgery	1,464	145	$43.87	10
Nurse Practitioner	1,094	196	$65.38	11
Critical Care (Intensivists)	1,059	45	$45.72	1
Family Practice	315	19	$73.29	1
Physician Assistant	226	36	$66.03	3
Orthopedic Surgery	197	128	$41.91	1
Pediatric Medicine	113	16	$67.01	1

15274 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
Georgia	2,911	$43.75	$34.37	6
Florida	1,387	$46.49	$34.44	3
California	1,323	$60.06	$45.67	5
Arizona	790	$65.82	$53.52	9
Tennessee	736	$39.82	$34.37	4
Oklahoma	650	$62.05	$53.36	4
Nevada	571	$42.22	$34.32	2
Mississippi	569	$40.22	$34.43	1
North Carolina	475	$40.05	$34.04	2
Nebraska	349	$38.66	$34.41	1
Kansas	221	$64.29	$58.52	2
Texas	197	$41.91	$34.41	1
Virginia	194	$41.71	$34.42	2
Colorado	191	$68.56	$53.53	3
New York	30	$51.96	$34.30	1
New Jersey	26	$47.06	$34.45	1
Maryland	18	$46.50	$34.45	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
15272Application of skin substitute graft to wound of trunk$22.96
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.