Summary & Overview
CPT 15106: Split-Thickness Autograft for Face/Head/Neck, ≤100 sq cm
CPT 15106 represents a split-thickness autograft for facial and adjacent head/neck regions measuring 100 square centimeters or less. The procedure is commonly performed by surgical specialties such as plastic surgery and dermatologic surgery to treat full-thickness skin loss, burns, traumatic defects, or complex scar revision where partial-thickness grafting is appropriate. Nationally, this code matters because it captures a focused category of reconstructive skin grafting on high-visibility areas of the head and neck where functional and cosmetic outcomes are critical.
Key payers covered in this brief include Blue Cross Blue Shield. Readers will find a concise overview of the clinical context in which CPT 15106 is used, relevant procedural comparisons to related grafting codes, and common billing considerations such as typical site of service. The publication also outlines common clinical indications and how this code fits within reconstructive surgery service lines.
This executive summary prepares readers to review benchmarks, payer coverage nuances, and coding relationships for head and neck split-thickness autografts. Where input data were incomplete, the notice "Data not available in the input." appears for missing service-line metadata to clarify limitations.
CPT Code Overview
CPT 15106 describes a split-thickness autograft procedure for the face, scalp, eyelids, mouth, neck, or ears covering 100 square centimeters or less. This is a surgical procedure typically used to repair or reconstruct skin defects by transplanting a partial-thickness layer of the patient’s own skin to a recipient site. The typical site of service for this CPT code is Outpatient Hospital (POS 22).
Clinical & Coding Specifications
Clinical Context
A patient (adult or pediatric) presents to an outpatient hospital setting for definitive wound coverage after a full-thickness skin loss on the face, scalp, eyelids, mouth, neck, or ears. Typical indications include third-degree burns, extensive open wounds, or scar-related contractures in these anatomic areas requiring split-thickness autograft harvest and placement. Preoperative steps include assessment of wound bed viability, debridement or excision of necrotic tissue or scar, selection of donor site, and informed consent. Intraoperative workflow includes preparation of the recipient site, harvest of a split-thickness skin graft sized up to 100 sq cm from a distant donor site, meshing or securing the graft, and dressing application. Postoperative care includes graft checks for adherence and perfusion, dressing changes, pain control, and instructions for activity restriction and wound monitoring. Typical providers involved include plastic surgeons, dermatologic surgeons, or general surgeons with burn care expertise, supported by perioperative nursing and outpatient wound care teams.
Coding Specifications
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Modifier
51— Multiple ProceduresUse when multiple distinct surgical procedures are performed at the same operative session by the same provider. Apply according to payer rules when
15106is billed in addition to other procedures performed during the same encounter. -
Modifier
59— Distinct Procedural ServiceUse when a service is distinct or independent from other services performed on the same day (separate anatomic sites or separate wounds) and documentation supports that the procedures are not part of the same surgical session.
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Provider Taxonomies and Specialties
| Taxonomy Code | Specialty |
|---|---|
208200000X | Plastic Surgery |
207X00000X | Dermatology |
208600000X | Surgery |
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Notes on use
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Documentation must support modifier application with operative dictation and location/extent details.
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If additional preparatory procedures (e.g., excision of burn eschar) are performed, confirm payer bundling rules before separate billing.
Related Diagnoses
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T20.30XA— Burn of third degree of head, face, and neck, initial encounterClinical relevance: Full-thickness burns in the head/face/neck region often require split-thickness autografting for definitive coverage when the dermis is lost.
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L90.5— Scar conditions and fibrosis of skinClinical relevance: Scar contracture or fibrosis in the face/neck region may necessitate excision and placement of a split-thickness autograft to restore contour and function.
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T21.31XA— Burn of third degree of chest wall, initial encounterClinical relevance: Although this code describes the chest wall, donor-site selection or concurrent injuries may influence surgical planning when facial grafting is needed; primary relevance is when multiple anatomic burns are present.
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S01.90XA— Unspecified open wound of head, initial encounterClinical relevance: Open wounds of the head with significant tissue loss may require split-thickness autografting for closure when primary repair is not feasible.
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T22.30XA— Burn of third degree of upper limb, initial encounterClinical relevance: Upper limb full-thickness burns may coexist with facial injuries or serve as donor or recipient sites; relevance is in complex burn cases where multiple graft sites are managed.
Related CPT Codes
| CPT Code | Description | Relation to 15106 |
|---|---|---|
15100 | Split-thickness autograft, trunk, arms, legs; 100 sq cm or less | Alternative anatomic site code for split-thickness autografts when grafting is on trunk or extremities instead of face/neck. |
15120 | Split-thickness autograft, face, scalp, eyelids, mouth, neck, or ears; each additional 100 sq cm | Add-on code when the graft area for the face/neck/related sites exceeds the initial 100 sq cm covered by 15106. Commonly used together when total graft area >100 sq cm. |
15002 | Surgical preparation or creation of recipient site by excision of open wounds, burn eschar, or scar | May be performed intraoperatively to prepare the recipient bed prior to placing the autograft; payer rules determine separate billing versus bundling with graft code. |
15220 | Full-thickness autograft, face, scalp, eyelids, mouth, neck, or ears; 20 sq cm or less | Alternative graft type (full-thickness) for small defects in the same anatomic region; used instead of 15106 when full-thickness grafting is clinically indicated. |
- Codes commonly used together:
15106with15120when additional area is grafted.15002is frequently part of the same operative workflow but may be bundled depending on payer policy.15220is an alternative and not billed with15106for the same graft site.
National Reimbursement Benchmarks
Blue Cross Blue Shield national mean rate for CPT 15106 matches BUCA (average commercial) at $80.02. Medicare data is not available in the input, so a direct Medicare versus BUCA comparison cannot be quantified from the provided values.
Rate dispersion among reported payers is minimal where data exists: for Blue Cross Blue Shield and BUCA the 25th, 50th, and 75th percentiles are all effectively $80.00, indicating no measurable spread (P75–P25 = $0.00). Other major payers have no national values in the input. The table and chart below present the full breakdown of available national benchmarks.
State Benchmarks
State: AK1 / 46
Alaska Benchmarks
For CPT code 15106, reimbursement rates in Alaska from Blue Cross Blue Shield and BUCA are highly consistent, with no spread between the 25th and 75th percentiles; all values are exactly $80.00. This uniformity means providers receive the same rate regardless of percentile, and the mean rate for both payers is $80.82. Compared to national averages, Alaska's mean rates are slightly higher for both payers, but the difference is minimal.
The table and chart below present the full payer breakdown for Alaska, showing the mean rates and percentile values for each payer with available data.
Key Insights for Alaska
- Blue Cross Blue Shield and BUCA both offer the highest and lowest mean rates for CPT 15106 in Alaska, at $80.82.
- There is no rate spread between the 25th and 75th percentiles for either payer, indicating uniform reimbursement.
- Alaska's mean rates are slightly higher than national averages for both payers.
Trek Health ingests and normalizes Transparency in Coverage data and payer policy updates to give provider organizations a clear view of how commercial reimbursement behaves across markets, payers, and services. Our platform transforms raw payer disclosures into structured intelligence that supports contract evaluation, payer negotiations, and service line strategy. By combining market benchmarks with ongoing policy visibility, Trek helps teams identify variability, risk, and opportunity in commercial reimbursement. The result is faster insight, stronger negotiating positions, and more informed financial decisions.