C5276
Application of low cost skin substitute graft to face, scalp, eyelids, mouth, neck, ears, orbits, genitalia, hands, feet, and/or multiple digits, total wound surface area up to 100 sq cm; each additional 25 sq cm wound surface area, or part thereof (list separately in addition to code for primary procedure)
Short Description
-
Low cost skin substitute app
HCPCS Coverage Code
-
D = Special coverage instructions apply
HCPCS Action Code
-
N = No maintenance for this code
HCPCS Action Effective Date
-
January 01, 2014
HCPCS Code Added Date
-
January 01, 2014
HCPCS Pricing Indicator Code
-
53 = Statute
HCPCS Multiple Pricing Indicator Code
-
A = Not applicable as HCPCS priced under one methodology
HCPCS Statute Number
-
1833(t)
HCPCS Type Of Service Code
-
2 = SurgeryF = Ambulatory surgical center (facility usage for surgical services)
HCPCS Anesthesia Base Unit Quantity
-
0