HCPCS C5273
Application of low cost skin substitute graft to trunk, arms, legs, total wound surface area greater than or equal to 100 sq cm; first 100 sq cm wound surface area, or 1% of body area of infants and children
Retired code28 hospitals with prices
This code is retired. Some hospitals still list it.
What Washington hospitals publish for this code
Medicare Advantage: Rate for a private Medicare Advantage plan. Applies only to members of that plan.
| Hospital | Medicare Advantage rates (lowest – highest) | Cash price | List price (before discounts) |
|---|---|---|---|
| Capital Medical Center | — | — | — |
| Deaconess Medical Center | — | — | — |
| EvergreenHealth Medical Center | — | $8,865 | $11,081 |
| Island Hospital | — | — | — |
| Kadlec Regional Medical Center | — | $4,762 | $6,803 |
| Legacy Salmon Creek Medical Center | — | — | — |
| Mary Bridge Children's Hospital | — | — | — |
| MultiCare Auburn Medical Center | — | — | — |
| MultiCare Covington Medical Center | — | — | — |
| MultiCare Good Samaritan Hospital | — | — | — |
| MultiCare Valley Hospital | — | — | — |
| Overlake Hospital Medical Center & Clinics | — | — | — |
| PeaceHealth Southwest Medical Cente | — | $11,775 | $18,116 |
| Prov Sacred HRT Med Ctr & Childs Hosp. | — | $4,086 | $5,837 |
| Providence Centralia Hospital | — | — | — |
| Providence Holy Family Hospital | — | $4,282 | $6,117 |
| Providence Regional Medical Center Everett | — | — | — |
| Providence St Joseph Hospital | — | $2,582 | $3,689 |
| Providence St Mary Medical Center | — | $4,841 | $6,916 |
| Providence St Peter Hospital | — | — | — |
| Swedish Edmonds Hospital | — | — | — |
| Swedish Issaquah | — | $2,753 – $5,048 | $5,736 – $10,516 |
| Swedish Medical Center | — | $2,753 – $5,048 | $5,736 – $10,516 |
| Swedish Medical Center / Cherry Hill | — | $2,753 – $5,048 | $5,736 – $10,516 |
| Tacoma General Allenmore Hospital | — | — | — |
| University of Washington Medical Ctr | — | — | — |
| Virginia Mason Medical Center | $1,395 – $2,092 | $2,861 | $5,610 |
| Yakima Valley Memorial | — | — | — |
Medicare (traditional) reference
CMS publishes no national amount for this code.