HCPCS C5276
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; each additional 25 sq cm wound surface area, or part thereof (list separately in addition to code for primary procedure)
Retired code19 hospitals with prices
This code is retired. Some hospitals still list it.
What Washington hospitals publish for this code
Unknown: The source file doesn't say which population this rate applies to.
| Hospital | Unknown rates (lowest – highest) | Cash price | List price (before discounts) |
|---|---|---|---|
| EvergreenHealth Medical Center | $438 | $390 | $487 |
| Island Hospital | — | — | — |
| Kadlec Regional Medical Center | — | $942 | $1,345 |
| Legacy Salmon Creek Medical Center | — | — | — |
| PeaceHealth Southwest Medical Cente | — | $545 – $2,547 | $838 – $3,918 |
| PeaceHealth St Joseph Medical Center | — | $4,219 | $6,490 |
| Prov Sacred HRT Med Ctr & Childs Hosp. | — | $2,885 | $4,122 |
| Providence Centralia Hospital | — | — | — |
| Providence Holy Family Hospital | — | $3,024 | $4,320 |
| Providence Regional Medical Center Everett | — | — | — |
| Providence St Joseph Hospital | — | $744 | $1,063 |
| Providence St Mary Medical Center | — | $957 | $1,367 |
| Providence St Peter Hospital | — | — | — |
| Swedish Edmonds Hospital | — | — | — |
| Swedish Issaquah | — | $226 – $239 | $471 – $497 |
| Swedish Medical Center | — | $226 – $239 | $471 – $497 |
| Swedish Medical Center / Cherry Hill | — | $226 – $239 | $471 – $497 |
| Virginia Mason Medical Center | — | $731 | $1,434 |
| Yakima Valley Memorial | — | — | — |
Medicare (traditional) reference
CMS publishes no national amount for this code.