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Free Tissue Transfer With Microsurgical Vessel Repair

Utah 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 $4,571 · 10th–90th $2,455$8,5110%10%10th90th$4,571Professionalmedian $2,884 · 10th–90th $1,778$4,6770%20%10th90th$2,884$1.0K$2.0K$5.0K$10.0K

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
$2,454.71
Median
$4,570.88
Typical High
$8,511.38
Select Health
Setting
Facility
Modifier
Global
Typical Low
$3,981.07
Median
$3,981.07
Typical High
$3,981.07
U of Utah Health Plan
Setting
Professional
Modifier
Global
Typical Low
$1,778.28
Median
$2,884.03
Typical High
$4,677.35
United
Setting
Facility
Modifier
Global
Typical Low
$870.96
Median
$4,466.84
Typical High
$7,079.46