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Free Tissue Transfer With Microsurgical Vessel Repair

Pennsylvania 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.

Rates data updated July 2026.

Facilitymedian $4,074 · 10th–90th $1,288$8,3180%5%10%10th90th$4,074$1.0K$2.0K$5.0K$10.0K$20.0K$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
$1,412.54
Median
$4,786.30
Typical High
$8,317.64
Capital Blue Cross
Setting
Facility
Modifier
Global
Typical Low
$20,417.38
Median
$21,379.62
Typical High
$57,543.99
Martin's Point
Setting
Facility
Modifier
Global
Typical Low
$1,023.29
Median
$3,981.07
Typical High
$8,317.64
UPMC Health Plan
Setting
Facility
Modifier
Global
Typical Low
$1,445.44
Median
$1,949.84
Typical High
$3,311.31
UPMC Health Plan
Setting
Facility
Modifier
62 · Two surgeons
Typical Low
$2,187.76
Median
$2,187.76
Typical High
$2,187.76
United
Setting
Facility
Modifier
Global
Typical Low
$1,174.90
Median
$2,041.74
Typical High
$5,623.41