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Wound Bed Preparation, Face/Hands/Feet

Pennsylvania rates for HCPCS 15004

This procedure prepares a wound on the face, hands, feet, or genital area to receive a skin graft or wound covering by surgically cleaning and removing damaged tissue from the wound bed. It creates a healthy surface that will allow a subsequent graft to attach and heal properly.

Rates data updated July 2026.

Facilitymedian $2,455 · 10th–90th $347$7,2440%10%10th90th$2,455Professionalmedian $355 · 10th–90th $229$7080%20%10th90th$355$0.5$5.0$50.0$500.0$5.0K$50.0K

Distribution of negotiated rates across all payers (price axis is log-scale). Facility and professional rates are different services and are charted separately. Need provider-level prices? Contact us.

Insurance Carrier
Aetna
Setting
Facility
Modifier
Global
Typical Low
$346.74
Median
$2,570.40
Typical High
$7,244.36
Aetna
Setting
Professional
Modifier
Global
Typical Low
$229.09
Median
$346.74
Typical High
$707.95
AmeriHealth
Setting
Facility
Modifier
Global
Typical Low
$229.09
Median
$9,120.11
Typical High
$23,988.33
Capital Blue Cross
Setting
Facility
Modifier
Global
Typical Low
$2,344.23
Median
$2,570.40
Typical High
$57,543.99
Capital Blue Cross
Setting
Professional
Modifier
Global
Typical Low
$389.05
Median
$588.84
Typical High
$724.44
Cigna
Setting
Facility
Modifier
Global
Typical Low
$2,041.74
Median
$2,041.74
Typical High
$2,041.74
Cigna
Setting
Professional
Modifier
Global
Typical Low
$239.88
Median
$371.54
Typical High
$588.84
Emblem Health
Setting
Professional
Modifier
Global
Typical Low
$691.83
Median
$691.83
Typical High
$691.83
Geisinger
Setting
Professional
Modifier
Global
Typical Low
$323.59
Median
$489.78
Typical High
$676.08
Highmark BCBS
Setting
Facility
Modifier
Global
Typical Low
$446.68
Median
$741.31
Typical High
$2,951.21
Independence Blue Cross
Setting
Facility
Modifier
Global
Typical Low
$208.93
Median
$5,754.40
Typical High
$19,054.61
Martin's Point
Setting
Facility
Modifier
Global
Typical Low
$363.08
Median
$2,344.23
Typical High
$7,244.36
Martin's Point
Setting
Professional
Modifier
Global
Typical Low
$229.09
Median
$354.81
Typical High
$954.99
Oscar Health
Setting
Professional
Modifier
Global
Typical Low
$302.00
Median
$302.00
Typical High
$316.23
UPMC Health Plan
Setting
Facility
Modifier
Global
Typical Low
$380.19
Median
$1,905.46
Typical High
$3,388.44
UPMC Health Plan
Setting
Professional
Modifier
Global
Typical Low
$257.04
Median
$275.42
Typical High
$389.05
United
Setting
Facility
Modifier
Global
Typical Low
$354.81
Median
$870.96
Typical High
$3,890.45
United
Setting
Professional
Modifier
Global
Typical Low
$239.88
Median
$371.54
Typical High
$616.60