C5273 Low cost skin substitute app

Application of low cost skin substitute graft to trunk, arms, legs, 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

Payer policies and prior authorization for C5273

Payer coverage policies that name C5273

C5273 appears in 3 coverage policies from Aetna, Cigna, Health Care Service Corporation (BCBS IL, TX, OK, NM, MT).

PayerPolicyRole in policyReviewedDocument
AetnaMohs Micrographic Surgery (0383)listed, no stance (range C5271-C5278)May 28, 2026payer document
CignaTissue-Engineered Skin Substitutes (0068)covered if criteria are metJun 15, 2026payer document
Health Care Service Corporation (BCBS IL, TX, OK, NM, MT)Bioengineered Skin and Soft Tissue Substitutes (SUR704.012)
HCPCS Codes A2002, A2004, A2005, A2006, A2007, A2008, A2009, A2010, A2011,		listed, no stanceJul 1, 2026payer document

Medicaid fee-for-service

Prior authorization required or conditional in IN.

  • KY: $948.27 (asc), effective Jan 1, 2026
  • MA: $696.96 (asc), effective May 1, 2026

From payers' published prior-auth lists, coverage policies and state Medicaid fee schedules, updated Oct 16, 2026. The role is what the policy's own code table or text says about the code. Not a guarantee of coverage or payment; verify with the payer. CPT® is a registered trademark of the American Medical Association.