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Free Tissue Transfer With Microsurgical Vessel Repair

Wisconsin 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 $7,586 · 10th–90th $2,630$12,5890%10%10th90th$7,586Professionalmedian $4,677 · 10th–90th $3,388$6,7610%20%10th90th$4,677$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
$1,862.09
Median
$4,570.88
Typical High
$14,454.40
Anthem BCBS
Setting
Facility
Modifier
Global
Typical Low
$3,981.07
Median
$7,943.28
Typical High
$14,125.38
Cigna
Setting
Facility
Modifier
Global
Typical Low
$5,754.40
Median
$6,760.83
Typical High
$10,715.19
DeanCare
Setting
Facility
Modifier
Global
Typical Low
$2,089.30
Median
$4,365.16
Typical High
$7,244.36
Medica
Setting
Facility
Modifier
Global
Typical Low
$2,089.30
Median
$5,495.41
Typical High
$8,317.64
Medica
Setting
Facility
Modifier
62 · Two surgeons
Typical Low
$6,456.54
Median
$6,456.54
Typical High
$6,456.54
Network Health
Setting
Facility
Modifier
Global
Typical Low
$4,570.88
Median
$5,754.40
Typical High
$7,762.47
Prevea360
Setting
Facility
Modifier
Global
Typical Low
$1,862.09
Median
$3,090.30
Typical High
$6,456.54
Quartz
Setting
Professional
Modifier
Global
Typical Low
$3,388.44
Median
$4,677.35
Typical High
$6,760.83
Quartz
Setting
Facility
Modifier
Global
Typical Low
$5,011.87
Median
$14,125.38
Typical High
$14,125.38
Quartz
Setting
Facility
Modifier
62 · Two surgeons
Typical Low
$3,162.28
Median
$3,162.28
Typical High
$8,912.51
Security Health
Setting
Professional
Modifier
Global
Typical Low
$4,168.69
Median
$4,168.69
Typical High
$4,168.69
United
Setting
Facility
Modifier
Global
Typical Low
$3,162.28
Median
$7,244.36
Typical High
$9,120.11