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Free Tissue Transfer With Microsurgical Vessel Repair

Washington 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 $4,898 · 10th–90th $2,042$14,4540%5%10%10th90th$4,898$1.0K$2.0K$5.0K$10.0K$20.0K

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
$2,884.03
Median
$6,456.54
Typical High
$18,620.87
Cigna
Setting
Facility
Modifier
Global
Typical Low
$1,122.02
Median
$1,122.02
Typical High
$1,122.02
Kaiser Permanente
Setting
Facility
Modifier
Global
Typical Low
$2,951.21
Median
$4,570.88
Typical High
$5,754.40
Pacific Source
Setting
Facility
Modifier
Global
Typical Low
$3,235.94
Median
$4,365.16
Typical High
$4,570.88
Premera BCBS
Setting
Facility
Modifier
Global
Typical Low
$1,995.26
Median
$3,019.95
Typical High
$3,090.30
United
Setting
Facility
Modifier
Global
Typical Low
$1,288.25
Median
$1,445.44
Typical High
$2,691.53