{
    "code": "15260",
    "coding_system": "CPT",
    "canonical_url": "https://localishealth.com/cpt/15260/2019/A",
    "release_specific_url": "https://localishealth.com/cpt/15260/2019/D",
    "description": "A skin graft that takes all layers of skin, epidermis and dermis together, from a donor site and transplants it to a defect on the nose, ear, eyelid, or lip; the donor site is then stitched closed. Full-thickness grafts are chosen for these areas because they contract less and match the surrounding skin better than thinner split-thickness grafts. This code covers a smaller graft area, with a companion code for each further block of area on a larger reconstruction. Grafts to the face more broadly, or to the trunk and limbs, fall under different codes.",
    "answer": {
        "question": "How much did Medicare pay for CPT 15260 in Q4 2019?",
        "text": "Medicare paid $1,040.81 for CPT 15260 in the office (non-facility) setting and $888.36 in a facility under the Q4 2019 Physician Fee Schedule, effective October 2019. These are the national allowed amounts before the ~2% sequestration cut and before locality (GPCI) adjustment. This price has been unchanged since Q1 2019, when it increased 0.1%."
    },
    "release": {
        "schedule": "pfs",
        "year": 2019,
        "quarter": "D",
        "label": "Q4 2019",
        "effective": "October 1 – December 31, 2019",
        "revision": 1
    },
    "status": {
        "code": "A",
        "non_facility_payable": true,
        "facility_payable": true
    },
    "national_rates_usd": {
        "office_non_facility": 1040.81,
        "facility": 888.36,
        "sequestration_applied": false,
        "gpci": 1
    },
    "rvus": {
        "work": 11.64,
        "practice_expense_non_facility": 15.55,
        "practice_expense_facility": 11.32,
        "malpractice": 1.69
    },
    "formula": "(work_rvu × work_gpci + pe_rvu × pe_gpci + mp_rvu × mp_gpci) × conversion_factor",
    "conversion_factor": 36.0391,
    "source": {
        "label": "Physician relative value file (Q4 2019)",
        "cms_url": "https://www.cms.gov/medicare/medicare-fee-for-service-payment/physicianfeesched/downloads/rvu19d.zip",
        "local_source_url": "https://localishealth.com/sources/physician-fee-schedule/2019/D",
        "file": "PPRRVU19_OCT.csv",
        "row": 5784,
        "sha256": "4efa7bdbffa98a56affa6d5b05e25d7ac5c39f26c7b281d0c773e7e530767cae"
    },
    "modified_at": "2026-08-04T03:09:13+00:00"
}