HCPCS C5272
Application of low cost skin substitute graft to trunk, arms, legs, total wound surface area up to 100 sq cm; each additional 25 sq cm wound surface area, or part thereof (list separately in addition to code for primary procedure)
Retired code20 hospitals with prices
This code is retired. Some hospitals still list it.
What Washington hospitals publish for this code
Medicaid managed care: Rate for an Apple Health managed-care plan. Applies only to members of that plan.
| Hospital | Medicaid managed care rates (lowest – highest) | Cash price | List price (before discounts) |
|---|---|---|---|
| Cascade Valley Hospital | $342 | $274 | $342 |
| EvergreenHealth Medical Center | — | $488 | $610 |
| Island Hospital | — | — | — |
| Kadlec Regional Medical Center | — | $578 | $825 |
| Legacy Salmon Creek Medical Center | — | — | — |
| PeaceHealth Southwest Medical Cente | — | $367 | $565 |
| Prov Sacred HRT Med Ctr & Childs Hosp. | — | $4,182 | $5,974 |
| Providence Centralia Hospital | — | — | — |
| Providence Holy Family Hospital | — | $4,383 | $6,262 |
| Providence Regional Medical Center Everett | — | — | — |
| Providence St Joseph Hospital | — | $215 | $307 |
| Providence St Mary Medical Center | — | $587 | $838 |
| Providence St Peter Hospital | — | — | — |
| Swedish Edmonds Hospital | — | — | — |
| Swedish Issaquah | — | $190 – $200 | $395 – $416 |
| Swedish Medical Center | — | $190 – $200 | $395 – $416 |
| Swedish Medical Center / Cherry Hill | — | $190 – $200 | $395 – $416 |
| Virginia Mason Medical Center | — | $770 | $1,509 |
| WhidbeyHealth Medical Center | — | $1,880 | $1,880 |
| Yakima Valley Memorial | — | — | — |
Medicare (traditional) reference
CMS publishes no national amount for this code.