Add-on code for implanting a biologic material — such as acellular dermal matrix — into breast or trunk tissue to provide structural reinforcement during a primary reconstructive or repair procedure.

Verified May 8, 2026 · 8 sources ↓

Medicare: $224.12
Total RVUs: 6.71
Global, days
Region: General

Drawn from AAPCEntnetKzanowCMSCmadocs

Documentation requirements

What must appear in the operative or office note to support the claim.

Source · Editorial brief grounded in 8 cited references ↓

Identify the primary procedure performed and confirm +15777 is listed in addition to that primary code
Document the anatomic site as breast or trunk — payer audits deny claims where site is ambiguous or falls outside these locations
Record the biologic implant by product name, type (allograft, xenograft, etc.), surface area, and lot number
Confirm the surgeon supplied the implant — if the facility supplied it, the physician cannot bill for the material
Document the surgical technique: how the ADM was positioned, sutured, and its functional role (e.g., sling support, pectoralis extension)
For bilateral procedures, specify that both sides were treated in the same operative session to support modifier 50

Applicable modifiers

Modifiers commonly billed with this code.

Source · AMA CPT modifier descriptors · CMS NCCI Policy Manual

22 Increased complexity 50 Bilateral procedure 51 Multiple procedures 59 Distinct service LT Left side RT Right side

What this code covers

Source · Editorial summary grounded in 8 cited references ↓

CPT +15777 is an add-on code billed alongside a primary procedure when the surgeon implants a biologic material (e.g., acellular dermal matrix, ADM) to reinforce soft tissue in the breast or trunk. Classic use cases include ADM sling placement during tissue expander reconstruction after mastectomy, and trunk soft-tissue defect repair. Because it is an add-on code, it cannot be billed alone — it always requires a primary procedure code (e.g., 19357 for tissue expander reconstruction).

The code is restricted to breast and trunk sites. For ADM implantation at other anatomic locations, 17999 (unlisted integumentary procedure) applies instead, and reimbursement must be negotiated with the local MAC. Modifier 51 is never appended to add-on codes. For bilateral breast procedures, CPT instructs reporting +15777 with modifier 50; however, Medicare's Medically Unlikely Edits limit payment to 1 unit per day, so for Medicare and payers following Medicare guidelines, bill +15777 with modifier 50 — not 2 units — for bilateral cases. Multiple ADM pieces used on a single breast count as one unit of +15777. The surgeon must supply the implant to bill for it; if the facility supplies it, only the facility can claim the material.

Not separately billable with hernia repair procedures: NCCI policy explicitly bundles 15777 into procedures that include hernia repair unless the CPT codebook specifically instructs otherwise. Always report the supply of the biologic implant separately (appropriate HCPCS supply code) when the surgeon provides it.

RVU & reimbursement

Component RVUs and Medicare national rate. Actual payment varies by GPCI locality.

Source · CMS Physician Fee Schedule, RVU26A · January 2026

Work RVU	3.56
Practice expense RVU	2.48
Malpractice RVU	0.67
Total RVU	6.71
Medicare national rate	$224.12
Global period	days

Payment by site of service

Medicare pays different rates by setting. HOPD typically pays substantially more than ASC for the same procedure.

Source · CMS OPPS Addendum B·ASC HCPCS payment rates·2026

Setting	Medicare rate (national)
Office (PFS non-facility) Procedure performed in physician's office	$224.12

Common denial reasons

The recurring reasons claims for CPT 15777 get rejected.

Source · Editorial brief grounded in CMS NCCI edits, AAOS coding appeals, and cited references ↓

Billed as a standalone code — +15777 requires a primary procedure code and will deny without one
Anatomic site outside breast or trunk — ADM at head, neck, or extremity requires 17999, not 15777
Modifier 51 incorrectly appended — add-on codes are exempt from multiple procedure reductions; modifier 51 triggers systematic downcoding
Bilateral cases billed as 2 units instead of modifier 50 for Medicare — MUE limits payment to 1 unit per day, causing the second unit to deny
Reported alongside a hernia repair procedure — NCCI bundles 15777 into hernia repairs absent a specific CPT exception
Material cost billed without documentation that the surgeon (not the facility) supplied the implant

Frequently asked questions

Source · Generated from the editorial pipeline, verified against 8 cited references ↓

01Can +15777 be billed without a primary procedure code?

No. +15777 is an add-on code and will deny if submitted without a primary procedure code. Common pairings include 19357 (tissue expander reconstruction) and 19303 (simple mastectomy), among others.

02How do you bill +15777 for bilateral breast reconstruction in a Medicare patient?

Bill +15777 with modifier 50 for Medicare. CPT instructs 2 units for bilateral cases, but Medicare's MUE caps payment at 1 unit per day, so modifier 50 is the correct approach for Medicare and payers following Medicare guidelines.

03If the surgeon uses two pieces of ADM on one breast, should you bill +15777 twice?

No. Report +15777 once per breast regardless of how many ADM pieces are used. Multiple pieces on the same side do not support additional units.

04What code applies when ADM is implanted at a site other than breast or trunk?

Use 17999 (unlisted integumentary procedure). There is no specific CPT code for biologic implant reinforcement outside the breast and trunk. Reimbursement requires MAC review and supporting documentation.

05Can +15777 be reported with a hernia repair procedure?

Not routinely. NCCI policy bundles +15777 into hernia repair procedures unless the CPT codebook specifically states the implant code may be reported separately with that repair. Check the primary procedure's CPT instructions before appending.

06Who can bill for the biologic implant supply — the surgeon or the facility?

Only the party that supplies the implant can bill for it. If the facility provides the ADM, the surgeon cannot bill the supply separately. Document who purchased and brought the implant to the operative field.

07Is modifier 51 appropriate on +15777 when multiple procedures are performed the same day?

No. Add-on codes are exempt from modifier 51 by CPT convention. Appending modifier 51 to +15777 causes payers to apply a multiple-procedure reduction that should not apply.

Sources & references

Editorial content was developed using the following public sources. Last verified May 8, 2026.

Mira AI Scribe

Mira's AI scribe captures the implant product name, lot number, surface area, fixation technique, and anatomic position (e.g., ADM sutured to subpectoral pocket rim as inferolateral sling) directly from the operative dictation. That specificity prevents the two most common audit flags for +15777: missing implant supply documentation and failure to establish the breast or trunk site. The scribe also flags when a primary procedure code is absent, blocking the most frequent hard denial before the claim is submitted.

See how Mira captures CPT 15777 documentation