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Skin Substitute, Trunk/Arms/Legs, Add-On 100 sq cm

Louisiana rates for HCPCS C5274

Application of low cost skin substitute graft to trunk, arms, legs, total wound surface area greater than or equal to 100 sq cm; each additional 100 sq cm wound surface area, or part thereof, or each additional 1% of body area of infants and children, or part thereof (list separately in addition to code for primary procedure)

Rates data updated July 2026.

Facilitymedian $427 · 10th–90th $251$1,2590%10%10th90th$427$200.0$500.0$1.0K$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
United
Setting
Facility
Modifier
Global
Typical Low
$251.19
Median
$426.58
Typical High
$1,258.93