15121
CPT/HCPCSPartial thickness self skin graft of face, scalp, eyelids, mouth, neck, ears, around eyes, genitals, hands, feet, fingers, or toes, each additional 100.0 sq cm or 1% body area for infants and children, or less
Physician Fee Schedule
Facility
Medicare Payment
$105.68
Submitted Charge$946.36
Medicare Allowed$132.39
Providers476
Beneficiaries719
Total Services1,521