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Free Tissue Transfer With Microsurgical Vessel Repair

Montana rates for HCPCS 15758

Moves a piece of the patient's own tissue, with its own artery and vein, from one part of the body to another to rebuild a defect, and reconnects those tiny vessels to blood vessels at the new site under a microscope. Because the transferred tissue brings its own blood supply, it survives in places where a simple graft would not take. It is used for defects after injury, cancer removal, or radiation damage.

Facilitymedian $3,890 · 10th–90th $3,090$4,1690%20%40%10th90th$3,890$2.0K$5.0K

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
Cigna
Setting
Facility
Modifier
Global
Typical Low
$3,548.13
Median
$3,548.13
Typical High
$3,548.13
MountainHealth Co-op
Setting
Facility
Modifier
Global
Typical Low
$3,801.89
Median
$3,981.07
Typical High
$4,168.69
Providence
Setting
Facility
Modifier
Global
Typical Low
$1,905.46
Median
$2,344.23
Typical High
$4,570.88
United
Setting
Facility
Modifier
Global
Typical Low
$2,511.89
Median
$2,511.89
Typical High
$2,511.89