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C5276 - Low cost skin substitute app

Navigation: HCPCS Codes > Codes with Prefix: C5
Field Value
HCPCS Code: C5276
Long Description: 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
Pricing Indicator 1: 53 (Statute)
Multiple Pricing Code: A (Not applicable as HCPCS priced under one methodology)
Statute Number: 1833(t)
Coverage Code: D (Special coverage instructions apply)
ASC Payment Group Code:
Processing Note Number:
Berenson-Eggers Type of Service (BETOS) Code: P5A (Ambulatory procedures - skin)
Type of Service Code 1: 2 (Surgery)
Type of Service Code 2: F (Ambulatory surgical center (facility usage for surgical services))
Anesthesia Base Unit Quality: 0
Code Added: 01-01-2014
Action Effective Date: 01-01-2014
Action Code: A (Add procedure or modifier code)