Nerve palsy fascial graft
Facial nerve graft repair procedures show a potential difference of $2,770 between Medicare's $890.88 benchmark and hospital outpatient rates of $3,660.97, making bill verification essential before treatment.
About the analyst
Priya Iyengar leads the billing code review team at BillRazor Research. She analyzes NCCI bundling edits, DRG coding, and regional rate variation. Expertise: NCCI bundling, DRG analysis, regional pricing.
Code 15840 covers surgical repair using tissue grafts to restore facial nerve function, typically performed when facial paralysis affects muscle movement and facial expressions. Patients commonly include those with Bell's palsy, facial trauma, or nerve damage from tumor removal. This procedure charges approximately 12.5x the Medicare reimbursement rate, with potential billing differences of $4,200 between outpatient and inpatient settings.
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Facility rate
$891
National Medicare benchmark
Non-facility rate
$99
Office setting benchmark
Data sources
4
24 data points
Key insights for CPT 15840
ASC vs hospital outpatient savings
$1,704Having this done at an ambulatory surgery center costs $1,957 vs $3,661 at a hospital outpatient
Facility vs office setting
$792 differenceNon-facility setting is less expensive for this procedure
What this procedure costs across different settings
The same procedure can cost very different amounts depending on where it's performed. These are the Medicare-allowed amounts — what hospitals actually charge can be 3-10x higher.
| Setting | Medicare rate | vs lowest |
|---|---|---|
| Facility (physician office) | $891 | +800% |
| Non-facility (office) | $99 | Lowest |
| Outpatient (APC) | $3,661 | +3598% |
| Ambulatory surgery (ASC) | $1,957 | +1877% |
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About this data
Rates shown are from the 2026 Medicare Physician Fee Schedule, Hospital Outpatient Prospective Payment System (OPPS), Ambulatory Surgery Center Payment System, Clinical Laboratory Fee Schedule, Durable Medical Equipment Fee Schedule, and CMS Inpatient Prospective Payment System (DRG weights). Regional adjustments use CMS Geographic Practice Cost Indices (GPCI). Hospital charges are from CMS Hospital Price Transparency machine-readable files. All data is publicly available under federal law (45 CFR Part 180).
This data is for informational purposes only and does not constitute medical or financial advice. Actual costs depend on insurance coverage, negotiated rates, and individual circumstances.
Data: Medicare Physician Fee Schedule, CMS Inpatient PPS (IPPS), Outpatient PPS (OPPS), ASC Payment System, Clinical Lab Fee Schedule (CLFS), National Average Drug Acquisition Cost (NADAC). FY 2024 data. All publicly available from CMS.
Methodology: Facility rate applies when the procedure is performed in a hospital or ASC. Non-facility rate applies in a physician office. GPCI adjustments reflect regional cost-of-living differences.
This information is for educational purposes only and is not medical, financial, or legal advice. Actual costs depend on your insurance and provider. We recommend verifying costs directly with your provider. Full methodology · Terms of use