HCPCS C5275
Application of low cost skin substitute graft to face, scalp, eyelids, mouth, neck, ears, orbits, genitalia, hands, feet, and/or multiple digits, total wound surface area up to 100 sq cm; first 25 sq cm or less wound surface area
Retired code31 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 | — | — | — |
| Cascade Valley Hospital | $612 – $643 | $1,033 | $1,291 |
| Deaconess Medical Center | — | — | — |
| EvergreenHealth Medical Center | — | $1,319 | $1,649 |
| Island Hospital | — | — | — |
| Kadlec Regional Medical Center | — | $1,585 | $2,264 |
| 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 | — | $2,225 – $3,346 | $3,423 – $5,148 |
| PeaceHealth St Joseph Medical Center | — | $4,219 | $6,490 |
| Prov Sacred HRT Med Ctr & Childs Hosp. | — | $1,376 | $1,965 |
| Providence Centralia Hospital | — | — | — |
| Providence Holy Family Hospital | — | $1,442 | $2,060 |
| Providence Regional Medical Center Everett | — | — | — |
| Providence St Joseph Hospital | — | $869 | $1,241 |
| Providence St Mary Medical Center | — | $1,611 | $2,301 |
| Providence St Peter Hospital | — | — | — |
| Skagit Valley Hospital | $612 – $643 | $1,033 | $1,291 |
| Swedish Edmonds Hospital | — | — | — |
| Swedish Issaquah | — | $886 – $1,623 | $1,845 – $3,381 |
| Swedish Medical Center | — | $886 – $1,623 | $1,845 – $3,381 |
| Swedish Medical Center / Cherry Hill | — | $886 – $1,623 | $1,845 – $3,381 |
| Tacoma General Allenmore Hospital | — | — | — |
| University of Washington Medical Ctr | — | — | — |
| Virginia Mason Medical Center | $467 – $700 | $916 | $1,796 |
| Yakima Valley Memorial | — | — | — |
Medicare (traditional) reference
CMS publishes no national amount for this code.