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
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 | — | $5,054 | $6,317 |
| Island Hospital | — | — | — |
| Kadlec Regional Medical Center | — | $1,632 | $2,331 |
| 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 | — | — | — |
| 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 | — | $1,658 | $2,369 |
| Providence St Peter Hospital | — | — | — |
| 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 | $887 | $1,740 |
| Yakima Valley Memorial | — | — | — |
Medicare (traditional) reference
CMS publishes no national amount for this code.