How much does Medicare pay for CPT 15734?

Medicare allowed an average of $1018.35 per service and paid $812.83 of that, the balance being the patient's coinsurance and deductible (2024 data). Providers submitted an average of $8354.31, which is what they billed rather than what they received — Medicare pays its fee schedule regardless of the charge.

What is CPT code 15734?

Creation of muscle graft to trunk. It was billed 10,435 times to 5,318 Medicare beneficiaries by 235 providers in 2024.

Which specialty bills 15734 most?

Plastic and Reconstructive Surgery, with 5,308 services from 93 clinicians. Next are General Surgery, Physician Assistant, Surgical Oncology.

CPT 15734

Creation of muscle graft to trunk

$1018.35Medicare-allowed amount per service, averaged across 10,435 services

Providers submitted

$8354.31

Asking price, not received

Medicare allowed

$1018.35

The fee schedule figure

Medicare paid

$812.83

Balance is patient coinsurance

Providers submitted an average of $8354.31 for this code and Medicare allowed $1018.35 — 8.2× 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 $812.83 (80%); the rest is the patient’s coinsurance and deductible.

Services: 10,435
Beneficiaries: 5,318
Providers billing it: 235
Total allowed: $10,626,482

What Medicare pays for CPT 15734

Across 10,435 services billed by 235 providers to 5,318 beneficiaries, Medicare allowed an average of $1018.35 per service. That is 2.0 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 15734

Specialty	Services	Beneficiaries	Avg allowed	Providers
Plastic and Reconstructive Surgery	5,308	2,413	$1159.53	93
General Surgery	2,964	1,601	$1066.19	83
Physician Assistant	862	522	$167.79	21
Surgical Oncology	284	188	$920.99	8
Neurosurgery	282	185	$912.32	9
Orthopedic Surgery	189	116	$836.85	6
Colorectal Surgery (Proctology)	171	85	$943.74	4
Ambulatory Surgical Center	83	61	$1158.35	3
Cardiac Surgery	77	38	$839.42	3
Nurse Practitioner	67	48	$133.09	2
Hand Surgery	62	17	$817.28	1
General Practice	51	28	$1223.92	1
Oral Surgery (Dentist only)	35	16	$1304.63	1

15734 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
New York	3,459	$1052.32	$601.58	49
California	1,058	$998.41	$654.53	26
New Jersey	688	$955.23	$591.44	18
Ohio	549	$994.08	$780.92	14
Florida	526	$1027.90	$664.96	11
Maryland	461	$1079.28	$739.46	12
Pennsylvania	408	$1100.35	$764.33	11
Texas	395	$1124.36	$732.46	12
Arizona	352	$960.41	$678.90	9
Illinois	321	$860.49	$526.22	8
North Carolina	260	$655.43	$518.59	6
District of Columbia	215	$1283.47	$828.88	5
Tennessee	200	$981.48	$812.15	3
Georgia	175	$1157.43	$904.19	6
South Carolina	168	$1008.24	$763.29	5
Alabama	133	$813.64	$706.00	4
Rhode Island	121	$1055.90	$773.71	2
Missouri	108	$986.23	$626.38	4
Oregon	89	$1051.29	$757.49	3
Washington	76	$1131.84	$717.40	3
Michigan	57	$1149.34	$734.00	2
Kansas	52	$901.02	$661.96	1
Minnesota	48	$1045.12	$708.70	1
Indiana	46	$606.52	$356.93	2
Utah	44	$232.50	$129.15	1
Delaware	39	$1221.06	$993.83	2
Nevada	38	$906.64	$523.90	1
Nebraska	36	$981.38	$633.34	1
Idaho	34	$1305.42	$878.73	1
Massachusetts	33	$1036.71	$741.59	2
Mississippi	32	$840.74	$575.48	1
Maine	32	$1075.88	$878.26	1
Kentucky	28	$787.03	$583.21	1
Connecticut	26	$811.84	$587.32	1
Iowa	25	$988.28	$841.44	1
Oklahoma	25	$1099.94	$799.13	1
Virginia	24	$1256.46	$829.25	1
Louisiana	20	$1073.89	$615.73	1
Colorado	17	$1252.45	$963.97	1
Wisconsin	17	$1101.30	$722.38	1

Related codes

15769Self soft tissue graft$431.80
15733Creation of flap graft to head and/or neck$961.01
15730Creation of flap graft to midface$1178.73

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.