{
    "code": "15260",
    "coding_system": "CPT",
    "canonical_url": "https://localishealth.com/cpt/15260/2022/A",
    "release_specific_url": "https://localishealth.com/cpt/15260/2022/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 2022?",
        "text": "Medicare paid $1,015.35 for CPT 15260 in the office (non-facility) setting and $853.04 in a facility under the Q4 2022 Physician Fee Schedule, effective October 2022. These are the national allowed amounts before the ~2% sequestration cut and before locality (GPCI) adjustment. This price has been unchanged since Q1 2022, when it decreased 0.2%."
    },
    "release": {
        "schedule": "pfs",
        "year": 2022,
        "quarter": "D",
        "label": "Q4 2022",
        "effective": "October 1 – December 31, 2022",
        "revision": 1
    },
    "status": {
        "code": "A",
        "non_facility_payable": true,
        "facility_payable": true
    },
    "national_rates_usd": {
        "office_non_facility": 1015.35,
        "facility": 853.04,
        "sequestration_applied": false,
        "gpci": 1
    },
    "rvus": {
        "work": 11.64,
        "practice_expense_non_facility": 16.38,
        "practice_expense_facility": 11.69,
        "malpractice": 1.32
    },
    "formula": "(work_rvu × work_gpci + pe_rvu × pe_gpci + mp_rvu × mp_gpci) × conversion_factor",
    "conversion_factor": 34.6062,
    "source": {
        "label": "Physician relative value file (Q4 2022)",
        "cms_url": "https://www.cms.gov/files/zip/rvu22d.zip",
        "local_source_url": "https://localishealth.com/sources/physician-fee-schedule/2022/D",
        "file": "PPRRVU22_OCT.csv",
        "row": 6302,
        "sha256": "f8774a019545e1fd71536837b20b74674c014b1acef3435d93456857885190ab"
    },
    "modified_at": "2026-08-04T03:12:03+00:00"
}