Beginning in 2027, RECELL procedures will have four billing codes instead of eight, along with nationally established values for calculating Medicare physician payment.

The Centers for Medicare & Medicaid Services (CMS) has finalized national physician valuations for skin cell suspension autograft procedures performed using RECELL under the Calendar Year 2027 Medicare Physician Fee Schedule, according to RECELL manufacturer AVITA Medical.

Effective Jan 1, 2027, nationally published relative value units (RVUs), which Medicare uses to calculate physician payment, will replace valuations set by regional Medicare Administrative Contractors. The change coincides with a new family of four Current Procedural Terminology (CPT) billing codes that will replace the current eight-code structure.

AVITA Medical expects the changes to simplify procedure reporting and give physicians a clearer, more consistent basis for understanding Medicare payment when treating patients with burns and other serious skin injuries.

RECELL uses a small sample of a patient’s own healthy skin to prepare a suspension of skin cells that clinicians can spray directly onto a wound. Depending on the wound and approved indication, clinicians use it alone or with a skin graft to support healing while reducing the amount of donor skin required compared with conventional skin grafting. In the US, the device is approved by the FDA for the treatment of thermal burn and trauma wounds.

“Clinicians should be able to focus on helping patients heal, with clear expectations around physician payment,” says Cary Vance, president and CEO of AVITA Medical, in a release. “These changes bring simpler billing and greater payment predictability to physicians using RECELL. For AVITA, they strengthen the foundation for broader adoption as we continue to make RECELL a standard of care for patients with burn and wound injuries.”

What Changes in Coding

The new Category I CPT code family combines reporting for skin harvesting, cell preparation, and application into a single, bundled procedure structure. According to the company, the key changes are:

  • Fewer codes: Four codes replace the existing eight.
  • Consistent treatment-area increments: Codes distinguish the body area treated and report treatment in increments of 100 square centimeters, with percentage-of-body-area reporting for infants and children.
  • Simpler reporting across RECELL systems: The new structure removes separate coding distinctions for manual and automated cell preparation.
  • National physician valuations: CMS-published RVUs replace regionally determined valuations, providing a common national basis for calculating Medicare physician payment.

Physician Work Values

CMS adopted the physician work RVUs recommended by the American Medical Association/Specialty Society RVS Update Committee without modification. The values are:

  • Trunk, arms, and/or legs: 10.97 for the initial 100 square centimeters or less, and 0.59 for each additional 100 square centimeters or part thereof.
  • Specified areas, including the face, scalp, neck, hands, feet, fingers, and toes: 11.28 for the initial 100 square centimeters or less, and 0.98 for each additional 100 square centimeters or part thereof.

For infants and children, the codes also provide for reporting based on 1% of body area and additional 1% increments, as applicable.

Work RVUs reflect the time, skill, and intensity involved in providing a service, but they are only one component of Medicare payment. Payment also accounts for practice expense and malpractice expense RVUs, geographic adjustments, and the annual dollar conversion factor.

Payment Across Care Settings

In the inpatient setting, Medicare pays hospitals for cases involving RECELL through the Medicare Severity Diagnosis-Related Group system, a single, case-based payment determined by the patient’s condition and procedures performed. The RECELL System is not reimbursed separately but is included among the resources used to treat the patient, and physicians receive separate payment for their professional services.

In a separate 2027 hospital outpatient and ambulatory surgery center payment rule, CMS finalized facility payment assignments and rates for the new code family in both settings. The physician valuations are separate from those facility payments, and Medicare coverage policies continue to apply.

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