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C5278 HCPCS Level II Code: Low cost skin substitute app

Medicare Coverage & Payment

  • CMS short descriptor: Low cost skin substitute app
  • Medicare coverage: Special coverage instructions apply (CMS coverage code D)
  • Pricing indicator: 53
  • BETOS: P5A — Ambulatory procedures - skin
  • Last CMS action effective: January 1, 2026
  • Terminated: December 31, 2025

Source: CMS HCPCS Level II release. Coverage codes indicate how Medicare treats the code, not whether a specific claim will be paid; payer policy and documentation still govern.

Code Set: Removed from the code set — not valid on or after January 1, 2026.

Contextual Map

Every relationship of C5278 in one view: hierarchy, official tabular instructions in both directions, clinical classification, risk adjustment, MS-DRG participation, index terms and change history — each edge carrying the CMS source it derives from.

Nearest codes

Change history (2)

  • January 1, 2026 — Removed from the code set [Change history]— CMS release files (code change ledger)
  • and 1 more

Sources for this page

Codes, titles, notes, index terms and mappings on this page are transcribed from the datasets below. Relationships MedCoder computed and text MedCoder wrote are labelled where they appear.

Code, descriptors, coverage and pricing attributes Official source data
CMS HCPCS Alpha-Numeric (ANWEB) release — July 2026 quarterly update Release, file and checksum · Publisher’s page
Change history and date-of-service validity Official source data
CMS HCPCS quarterly update files, ingested into the change ledger Release, file and checksum · Publisher’s page
Comparisons, relationships and the contextual map MedCoder structured relationship
Computed by MedCoder from the tabular notes and tables above; every derived relationship is marked as derived where it appears
Summary and FAQ answers MedCoder explanation
Written by MedCoder to explain the sources above: drafted with AI assistance, checked by a person against the release files, and labelled as MedCoder text where it appears. Not official text.

Labels on this page: Official source data · MedCoder structured relationship · MedCoder explanation. How to read the labels · All data sources and release dates

Change history

  • January 1, 2026
    Removed from the code set
    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; each additional 100 sq cm wound surface area, or part thereof, or each additional 1% of body area of infants and children, or part thereof (list separately in addition to code for primary procedure)
  • January 1, 2014
    Added to the code set
    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; each additional 100 sq cm wound surface area, or part thereof, or each additional 1% of body area of infants and children, or part thereof (list separately in addition to code for primary procedure)

Nearest Codes in This Family

Official HCPCS Level II classifications closest to C5278 in its code family, with their registry titles.