Cosmetic and Reconstructive Surgery
J15 · Effective May 28, 2023
14 active Medicare policies list 15877, and 50 commercial payer policies list it. See each policy's status for the code and its official source. Listing a code is not a coverage decision: read each policy’s source for the requirements that apply.
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J15 · Effective May 28, 2023
J9 · Effective Jul 11, 2021
JH · Effective Oct 1, 2015
JL · Effective Oct 1, 2015
J5 · Effective Nov 14, 2021
J8 · Effective Nov 14, 2021
JE · Effective Oct 1, 2015
JF · Effective Oct 1, 2015
JL · Effective Nov 17, 2025
J9 · Effective Nov 17, 2025
50 policies from 12 payers
Summary of the payer’s published policy. Not a coverage determination — confirm with the payer before submitting.
| Policy | Effective | Status of 15877 |
|---|---|---|
| Breast Reconstruction Following Mastectomy or Lumpectomy | Apr 15, 2026 | Not covered |
| Breast Reduction | Nov 15, 2025 | Not covered |
| Cigna Commercial Other Services Code List | Mar 7, 2026 | Prior auth required |
| Cigna Comprehensive Code List | Mar 7, 2026 | Prior auth required |
| Gender Dysphoria Treatment | Sep 15, 2026 | Not covered |
| Gynecomastia Surgery | Aug 15, 2026 |
J5 · Effective Jun 25, 2026
National · Effective Nov 27, 2025
National · Effective Oct 16, 2025
National · Effective Oct 1, 2026
| Not covered |
| Hyperhidrosis: Surgical Treatments | Jan 15, 2026 | Covered |
|---|
| Lymphedema and Lipedema Surgical Treatments | Oct 1, 2026 | Covered with conditions |
|---|
| Panniculectomy and Abdominoplasty | Jun 15, 2026 | Covered with conditions |
|---|
| Redundant Skin Surgery | Sep 15, 2026 | Not covered |
|---|
| Policy | Effective | Status of 15877 |
|---|---|---|
| Abdominoplasty, Suction Lipectomy, and Ventral Hernia Repair | Mar 30, 2023 | Covered |
| Breast Reduction Surgery and Gynecomastia Surgery | Mar 6, 2023 | Covered |
| Cosmetic Surgery and Procedures | Feb 8, 2024 | Covered |
| Gender Affirming Surgery | Mar 5, 2024 | Covered |
| Hyperhidrosis | Jul 18, 2023 | Covered |
| Skin and Soft Tissue Substitutes | Feb 9, 2024 | Covered |
| Policy | Effective | Status of 15877 |
|---|---|---|
| Breast Procedures; including Reconstructive Surgery, Implants and Other Breast Procedures | Jul 1, 2026 | Covered |
| Cosmetic and Reconstructive Services of the Trunk, Groin, and Extremities | Oct 1, 2026 | Covered |
| Mastectomy for Gynecomastia | Apr 15, 2026 | Covered |
| Panniculectomy and Abdominoplasty | Apr 15, 2026 | Covered |
| Reduction Mammaplasty | Jul 1, 2026 | Covered |
| Surgical Treatment of Hyperhidrosis | Jan 6, 2026 | Covered |
| Policy | Effective | Status of 15877 |
|---|---|---|
| Cosmetic and Reconstructive Procedures | Sep 1, 2026 | Covered |
| Gender Affirming Interventions for Gender Dysphoria | Apr 1, 2026 | Covered |
| Reduction Mammaplasty | Nov 1, 2025 | Covered |
| Surgical Treatments for Lymphedema and Lipedema | Jan 1, 2026 | Covered |
| Policy | Effective | Status of 15877 |
|---|---|---|
| Cosmetic and Reconstructive Procedures | Not recorded | Covered |
| Hyperhidrosis Treatments | Not recorded | Covered |
| Liposuction for Lipedema | Not recorded | Covered |
| Policy | Effective | Status of 15877 |
|---|---|---|
| Cosmetic and Reconstructive Procedures | Jan 1, 2026 | Covered |
| Gender Assignment Surgery and Gender Reassignment Surgery with Related Services | Jan 1, 2026 | Covered |
| Liposuction for Lipedema and Lymphedema | Jan 1, 2026 | Covered |
| Policy | Effective | Status of 15877 |
|---|---|---|
| Cosmetic and Reconstructive Procedures | Jan 1, 2026 | Covered |
| Gender Assignment Surgery and Gender Reassignment Surgery with Related Services | Jan 1, 2026 | Covered |
| Liposuction for Lipedema and Lymphedema | Jan 1, 2026 | Covered |
| Policy | Effective | Status of 15877 |
|---|---|---|
| Cosmetic and Reconstructive Procedures | Jan 1, 2026 | Covered |
| Gender Assignment Surgery and Gender Reassignment Surgery with Related Services | Jan 1, 2026 | Covered |
| Liposuction for Lipedema and Lymphedema | Jan 1, 2026 | Covered |
| Policy | Effective | Status of 15877 |
|---|---|---|
| Cosmetic and Reconstructive Procedures | Jan 1, 2026 | Covered |
| Gender Assignment Surgery and Gender Reassignment Surgery with Related Services | Jan 1, 2026 | Covered |
| Liposuction for Lipedema and Lymphedema | Jan 1, 2026 | Covered |
| Policy | Effective | Status of 15877 |
|---|---|---|
| Liposuction for Lipedema | Jan 1, 2026 | Covered |
| Panniculectomy Surgery | Jul 1, 2026 | Covered |
| Surgery for the Prevention and Treatment of Lymphedema | Jan 1, 2026 | Covered |
| Policy | Effective | Status of 15877 |
|---|---|---|
| Liposuction for Lipedema | Jan 1, 2026 | Covered |
| Panniculectomy Surgery | Jul 1, 2026 | Covered |
| Surgery for the Prevention and Treatment of Lymphedema | Jan 1, 2026 | Covered |
| Policy | Effective | Status of 15877 |
|---|---|---|
| Liposuction for Lipedema | Jan 1, 2026 | Covered |
| Panniculectomy Surgery | Jul 1, 2026 | Covered |
| Surgery for the Prevention and Treatment of Lymphedema | Jan 1, 2026 | Covered |