CPT 15200
Global 090 ActiveFth/gft fr trnk 20 sq cm/<
CPT 15200 Billing & Documentation Guide
CPT code 15200 (Fth/gft fr trnk 20 sq cm/<) is classified under Anesthesia with a global period indicator of 090. The 2026 Medicare Physician Fee Schedule assigns a work RVU of 8.92, a non-facility practice expense RVU of 15.8, and a malpractice RVU of 1.5, a total non-facility RVU of 26.22 and facility RVU of 18.12. With the current conversion factor of $33.4009, the national average non-facility reimbursement is approximately $897.67, though rates vary from $777.06 to $1118.56 based on MAC locality and Geographic Practice Cost Indices (GPCIs).
When billing 15200, ensure documentation supports medical necessity and the specific components required for the code's level of service. For E/M codes, document MDM (medical decision-making) elements: problems addressed, data reviewed, and risk. For procedural codes, document the indication, technique, and any complications. Always verify NCCI edits before bundling 15200 with related codes; this code has 10 PTP bundling relationships on file (see table below).
Payment Status & Global Period
Active code (paid under MPFS)
90-day global period (major surgery: 1 day pre-op + procedure + 90 days post-op)
MUE Limit (Medically Unlikely Edits)
Submitting more than 1 units of 15200 for the same patient on the same date triggers automatic line denial unless an appropriate modifier and supporting documentation justify the higher quantity.
RVU Breakdown, CPT 15200
| Component | Non-Facility | Facility |
|---|---|---|
| Work RVU | 8.92 | 8.92 |
| Practice Expense RVU | 15.8 | 7.7 |
| Malpractice RVU | 1.5 | 1.5 |
| Total RVU | 26.22 | 18.12 |
| Conversion Factor | $33.4009 | |
2026 Medicare Reimbursement by State, CPT 15200
State-level averages across all MAC localities. Non-facility rates typically apply to office-based services; facility rates apply to hospital outpatient / inpatient.
| State | Non-Facility | Facility | Range (Non-Fac) | Localities |
|---|---|---|---|---|
| California | $960.24 | $640.1 | $908.25 - $1118.56 | 29 |
| Florida | $924.96 | $653.51 | $877.75 - $974.01 | 3 |
| Georgia | $861.79 | $603.69 | $828.4 - $895.18 | 2 |
| Illinois | $904.65 | $643.23 | $858.07 - $945.38 | 4 |
| Michigan | $864 | $609.95 | $836.32 - $891.67 | 2 |
| North Carolina | $822.33 | $569.91 | $822.33 - $822.33 | 1 |
| New York | $968.91 | $667.1 | $834.5 - $1037.52 | 5 |
| Ohio | $830.26 | $583.25 | $830.26 - $830.26 | 1 |
| Pennsylvania | $871.09 | $606.09 | $829.74 - $912.44 | 2 |
| Texas | $865.67 | $599.31 | $824.72 - $901.26 | 8 |
Source: CMS PFSRVU 2026 · Updated 2026-04-01. Full locality-level detail available for all 53 states, contact us for custom reports.
NCCI Bundling Edits, CPT 15200
Procedure-to-procedure (PTP) edits. If you bill any of these codes with 15200 on the same date of service, review the modifier indicator and payer policy before submission.
| Partner Code | Relationship | Modifier Allowed | Rationale |
|---|---|---|---|
| 01951 | Column 1 (primary), can be billed with modifier | No | Anesthesia service included in surgical procedure |
| 01952 | Column 1 (primary), can be billed with modifier | No | Anesthesia service included in surgical procedure |
| 01995 | Column 1 (primary), can be billed with modifier | No | Anesthesia service included in surgical procedure |
| 0213T | Column 1 (primary), can be billed with modifier | No | Misuse of Column Two code with Column One code |
| 0216T | Column 1 (primary), can be billed with modifier | No | Misuse of Column Two code with Column One code |
| 0228T | Column 1 (primary), can be billed with modifier | No | Standards of medical/surgical practice |
| 0230T | Column 1 (primary), can be billed with modifier | No | Standards of medical/surgical practice |
| 0490T | Column 1 (primary), can be billed with modifier | Yes | Misuse of Column Two code with Column One code |
| 0596T | Column 1 (primary), can be billed with modifier | Yes | Standards of medical/surgical practice |
| 0597T | Column 1 (primary), can be billed with modifier | Yes | Standards of medical/surgical practice |
Frequently Asked Questions, CPT 15200
What does CPT code 15200 mean? +
CPT code 15200 represents: Fth/gft fr trnk 20 sq cm/<. It's in the Anesthesia category with a global period of 090.
What is the Medicare reimbursement for CPT 15200? +
The 2026 Medicare national average non-facility payment for CPT 15200 is $897.67. Rates range from $777.06 to $1118.56 across 53 states depending on MAC locality and GPCIs.
What modifiers can I use with CPT 15200? +
Surgery codes commonly use modifier 22 (increased procedural services), 50 (bilateral), 51 (multiple procedures), 52 (reduced services), 58/78/79 (staged, unplanned return, unrelated within global), 62 (co-surgeons), 80/82 (assistant surgeon), and 59 or the X{EPSU} subset for distinct procedural service.
What bundling edits apply to CPT 15200? +
This code has 10 NCCI PTP bundling relationships. See the NCCI Bundling section below for full list.
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Reviewed by the PayerReady Medical Coding Team
Verified against the CMS 2026 code set on June 1, 2026.
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