Summary & Overview
CPT 15119: Epidermal Autograft, Additional 1% Body Area
CPT 15119 represents an epidermal autograft procedure billed for each additional 1 percent of body area when grafting delicate or functionally important regions such as the face, hands, feet, and genitalia. This add-on surgical code supplements primary autograft codes to capture incremental grafting beyond the initial unit and is relevant across acute burn care, reconstructive, and specialty surgical settings. Nationally, accurate use of this code ensures appropriate capture of resource intensity and clinical complexity when treating partial-thickness and complex wound beds in anatomically sensitive locations. Key payers discussed include Blue Cross Blue Shield. Readers will find a concise overview of clinical context, relevant associated CPT codes, common ICD-10 diagnoses linked to use of the code (including third-degree burns of various anatomic regions), typical sites of service, and commonly applied modifiers. The publication outlines billing considerations, code relationships (primary and add-on graft codes), and documentation areas that commonly affect payer adjudication. Data not available in the input for service line details. This summary is intended to inform coding, billing, and policy staff about when CPT 15119 is used and how it relates to related graft and wound preparation codes without providing clinical or reimbursement advice.
CPT Code Overview
CPT 15119 describes an epidermal autograft applied to anatomically sensitive areas such as the face, scalp, eyelids, mouth, neck, ears, orbits, genitalia, hands, feet, and/or multiple digits. The code is billed in addition to the primary procedure to account for each additional 1 percent of body area treated beyond the first unit.
Service Type: Surgery
Typical Site of Service: Outpatient Hospital (POS 22)
Clinical & Coding Specifications
Clinical Context
A patient presents to the outpatient hospital surgical clinic with full-thickness skin loss and exposed dermis following a burn injury to a digit and adjacent hand. The surgical team (plastic surgery or surgical oncology covering reconstructive needs) evaluates the wound, determines that epidermal autografting is required for coverage of small, discrete areas (additional 1% increments beyond the initial 1% graft), and schedules an outpatient operating room procedure. Preoperative steps include wound bed preparation and debridement under local or general anesthesia, donor site selection and harvesting of epidermal autograft, and placement of the graft on the recipient site. Postoperative workflow includes dressing changes, pain management, wound checks in the outpatient burn or plastic surgery clinic, and documentation of percent body area grafted to support use of additional-percentage billing with 15119.
Coding Specifications
Modifier 51 - Multiple Procedures
- Use when multiple procedures are performed during the same operative session in addition to the primary procedure. It indicates a secondary procedure that may be subject to reduced payment rules.
Modifier 59 - Distinct Procedural Service
- Use when the epidermal autograft represents a procedure that is separate and distinct from other services performed on the same day (e.g., separated by anatomy or separate incision), to indicate a distinct procedural service.
Provider Taxonomies
-
208200000X— Plastic Surgery -
2086S0122X— Surgical Oncology -
208600000X— Surgery
Notes
- Select modifiers based on payer policy and operative documentation supporting multiple procedures or distinct services. Ensure operative report documents the additional percentage of body area grafted when reporting
15119as an add-on to the primary epidermal graft code.
Related Diagnoses
-
T20.30XA— Burn of third degree of head, face, and neck, initial encounter- Third-degree burns in this region frequently require grafting for wound closure and restoration of form and function; epidermal autograft codes may apply when skin coverage is needed.
-
T21.31XA— Burn of third degree of chest wall, initial encounter- Full-thickness chest wall burns may require staged excision and grafting; epidermal autografting can be used for small percentage areas or donor/recipient sites as documented.
-
T22.30XA— Burn of third degree of upper limb, initial encounter- Third-degree burns of the upper limb often necessitate surgical coverage; epidermal autograft may be applied to fingers, hands, or localized areas.
-
T23.301A— Burn of third degree of wrist and hand, initial encounter- Burns of the wrist and hand frequently require grafting to restore function; coding supports use of grafting procedures such as
15110plus additional15119units when applicable.
- Burns of the wrist and hand frequently require grafting to restore function; coding supports use of grafting procedures such as
-
T24.301A— Burn of third degree of lower limb, initial encounter- Third-degree lower limb burns may be managed with grafting for wound closure; documentation of body area percentage treated supports reporting of additional
15119units.
- Third-degree lower limb burns may be managed with grafting for wound closure; documentation of body area percentage treated supports reporting of additional
Related CPT Codes
| CPT Code | Description |
|---|---|
15110 | Epidermal autograft, face, scalp, eyelids, mouth, neck, ears, orbits, genitalia, hands, feet, and/or multiple digits; first 1 percent of body area |
15220 | Full thickness graft, free, including direct closure of donor site, face, scalp, eyelids, mouth, neck, ears, orbits, genitalia, hands, feet, and/or multiple digits; 20 sq cm or less |
15240 | Full thickness graft, free, including direct closure of donor site, face, scalp, eyelids, mouth, neck, ears, orbits, genitalia, hands, feet, and/or multiple digits; each additional 20 sq cm, or part thereof (List separately in addition to code for primary procedure) |
15002 | Surgical preparation or creation of recipient site by excision of open wounds, burn eschar, or scar (including subcutaneous tissues), or incisional release of scar contracture, face, scalp, ears, neck, hands, feet, and/or multiple digits; first 100 sq cm or 1% of body area of infants and children |
Relationships to 15119
-
15110is the primary code for the first 1% body area epidermal autograft;15119is reported for each additional 1% beyond that first unit. -
15220and15240describe full-thickness free grafts and represent alternative grafting techniques; these codes may be used instead of epidermal autograft codes when full-thickness grafting is performed. -
15002documents surgical preparation or creation of the recipient site (excision, eschar removal, or scar release) and may be reported in the same operative episode when documented; payer rules determine bundling or separate payment. -
Codes commonly used together:
15110(primary) with one or more units of15119for additional percentages;15002may be performed prior to grafting and reported when not bundled by the payer.
National Reimbursement Benchmarks
Blue Cross Blue Shield and BUCA share an identical national mean rate of $80.02 for 15119, so average commercial reimbursement for BUCA aligns directly with Blue Cross Blue Shield at the national level. Medicare is not present in the provided input for direct comparison, so national Medicare benchmarking is not available in the input.
Rate dispersion across the provided payers is minimal where data exists: both BCBS and BUCA show no spread between the 25th, 50th, and 75th percentiles (all equal to $80), indicating the tightest possible distribution for those payers. Other major payers (Aetna, Cigna, UHC, Medicare) are not present in the input, so dispersion for those payers is Data not available in the input.
The table and chart below present the full breakdown of the national mean and percentile values from the input.
State Benchmarks
State: AK1 / 46
Alaska Benchmarks
For CPT code 15119, reimbursement rates in Alaska are highly consistent across Blue Cross Blue Shield and BUCA, with no spread between the 25th and 75th percentiles; all values are $80.00. This uniformity suggests a standardized approach to payment for this procedure in the state. The mean rate for both payers is $80.82, which is marginally higher than the national mean rate of $80.02.
The table and chart below present the full payer breakdown for Alaska, highlighting the lack of variation in rates and the slight premium over national averages. No other payers have available data for this state and procedure.
Key Insights for Alaska
- Blue Cross Blue Shield and BUCA both reimburse at $80.82, making them the highest and lowest paying payers in Alaska for CPT 15119.
- There is no rate spread between the 25th and 75th percentiles; all values are $80.00, indicating uniformity in reimbursement.
- Alaska's mean rates are slightly higher than the national average by $0.79.
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.