HCPCS C5277
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 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 code27 hospitals with prices
This code is retired. Some hospitals still list it.
What Washington hospitals publish for this code
Commercial insurance: Rate negotiated with a private insurer or employer plan, including exchange and public-option plans.
| Hospital | Commercial insurance rates (lowest – highest) | Cash price | List price (before discounts) |
|---|---|---|---|
| Capital Medical Center | $1,088 – $3,082 | — | — |
| Deaconess Medical Center | $1,056 – $2,591 | — | — |
| EvergreenHealth Medical Center | $782 – $5,875 | $5,054 | $6,317 |
| Island Hospital | $648 | — | — |
| Kadlec Regional Medical Center | $1,704 – $7,475 | $1,632 | $2,331 |
| Legacy Salmon Creek Medical Center | $1,401 – $7,569 | — | — |
| Mary Bridge Children's Hospital | $1,088 – $4,569 | — | — |
| MultiCare Auburn Medical Center | $1,088 – $3,161 | — | — |
| MultiCare Covington Medical Center | $1,088 – $3,161 | — | — |
| MultiCare Good Samaritan Hospital | $1,088 – $3,161 | — | — |
| MultiCare Valley Hospital | $1,027 – $2,585 | — | — |
| Overlake Hospital Medical Center & Clinics | $1,419 – $4,742 | — | — |
| Prov Sacred HRT Med Ctr & Childs Hosp. | $1,262 – $16,508 | $1,376 | $1,965 |
| Providence Centralia Hospital | $2,187 – $9,575 | — | — |
| Providence Holy Family Hospital | $1,394 – $6,462 | $1,442 | $2,060 |
| Providence Regional Medical Center Everett | $1,320 – $8,846 | — | — |
| Providence St Joseph Hospital | — | $869 | $1,241 |
| Providence St Mary Medical Center | $557 – $13,809 | $1,658 | $2,369 |
| Providence St Peter Hospital | $2,336 – $6,260 | — | — |
| Swedish Edmonds Hospital | $1,571 – $7,277 | — | — |
| Swedish Issaquah | $1,389 – $10,403 | $886 – $1,623 | $1,845 – $3,381 |
| Swedish Medical Center | $1,673 – $7,277 | $886 – $1,623 | $1,845 – $3,381 |
| Swedish Medical Center / Cherry Hill | $1,673 – $7,277 | $886 – $1,623 | $1,845 – $3,381 |
| Tacoma General Allenmore Hospital | $1,088 – $2,884 | — | — |
| University of Washington Medical Ctr | $1,926 – $2,628 | — | — |
| Virginia Mason Medical Center | $1,044 – $8,500 | $887 | $1,740 |
| Yakima Valley Memorial | $910 – $5,793 | — | — |
Medicare (traditional) reference
CMS publishes no national amount for this code.