CPT code 15837: Skin excision, forearm or hand2026 Medicare rate & RVUs in North Dakota

Removal of redundant skin and underlying tissue from the forearm or hand, commonly during reconstructive contouring when excess tissue causes functional or hygiene problems.

CMS RVU26DEffective Oct 1, 2026One payment locality14 Medicare services in 2024

In North Dakota, Medicare pays $902.91 for 15837 in the office and $624.01 when it’s performed in a hospital or facility.

$902.91Office (non-facility)
$624.01Hospital or facility
−3.7%vs the national office rate ($937.23)

Check a contract rate as a % of Medicare · 15837 nationwide

Medicare allowed amount for participating (non-QP) physicians, before deductible, coinsurance and claim adjustments. Not a patient’s bill or a hospital charge.

We’ll open 15837 for the payment locality that covers the ZIP.

On this page 11 sections
  1. Rate in North Dakota
  2. What 15837 covers
  3. Compared with other areas
  4. Rate map
  5. How it’s calculated
  6. Payment rules
  7. Related codes
  8. Rate history
  9. Where it applies
  10. Billing questions
  11. Sources

What 15837 covers

This operation removes redundant skin and underlying fatty tissue from the forearm or hand, then closes the surgical wound. Plastic and reconstructive surgeons may perform it after substantial weight loss when hanging tissue limits movement, complicates hygiene, or causes persistent skin irritation. The operative site must be the forearm or hand; removal of a discrete lesion or treatment of a wound is a different service.

Report the code when the operative work addresses excess skin and subcutaneous tissue at one of these sites. The record should identify the exact site, the clinical problem, and the tissue removed. This major surgery code has a 90-day global period that includes the day-before preoperative visit and 90 days of related postoperative care. When multiple procedures are performed in the same session, the highest-valued procedure is paid in full and other procedures are subject to the standard 50% multiple-procedure reduction. Modifier 50 is inappropriate for this code. Assistant-at-surgery payment requires documented medical necessity; co-surgeons and team surgery are not permitted.

This summary was written with AI assistance from CMS physician fee schedule data and checked against the CMS billing rules shown here. Rates on this page come directly from CMS files.

How North Dakota compares for 15837

Across 109 of 109 payment localities, the office rate for 15837 runs from $829.05 in Arkansas to $1,195.89 in San Benito County, CA. North Dakota pays $902.91. The RVUs are the same everywhere; the geographic indexes change the dollars.

15837 in North Dakota vs other payment areas
  1. North Dakota · this page$902.91
  2. Los Angeles, CA · California$1,034.60+$131.69
  3. Washington, DC area · District of Columbia$1,061.74+$158.83
  4. Miami, FL · Florida$1,048.89+$145.98
  5. Chicago, IL · Illinois$1,017.08+$114.17
  6. Manhattan, NY · New York$1,083.09+$180.18
  7. Alaska · Alaska$1,103.72+$200.81

Other areas in North Dakota first, then benchmark localities. Bars start at $0.

Every other payment area

15837 in every other Medicare payment locality
Payment localityOfficeFacility
AlabamaAlabama$841.09$597.06
ArkansasArkansas$829.05$589.48
ArizonaArizona$911.29$641.03
Bakersfield, CACalifornia$975.12$669.45
Chico, CACalifornia$970.28$664.61
El Centro, CACalifornia$970.57$664.90
Fresno, CACalifornia$970.28$664.61
Hanford, CACalifornia$970.28$664.61

15837 rates by state

Office rate range in each state. Select a state to see its payment localities.

Explore a state

Local rates. Clear comparisons.

Hover or focus a tile to see its rate range. Select it to open the state’s fee schedule.

$829.05

$1,103.72

Color shows the midpoint of each state’s locality range.

View every state and territory as a table
15837 office rate range by state
State / territoryOffice rate rangeLocalities
AK$1,103.721
AL$841.091
AR$829.051
AZ$911.291
CA$970.28–$1,195.8929
CO$964.691
CT$999.361
DC$1,061.741
DE$926.131
FL$941.28–$1,048.893
GA$886.93–$958.872
GU$990.781
HI$990.781
IA$854.061
ID$861.301
IL$920.30–$1,017.084
IN$866.031
KS$853.991
KY$869.221
LA$869.43–$911.552
MA$960.60–$1,053.912
MD$942.42–$1,061.743
ME$869.91–$910.792
MI$895.23–$956.972
MN$913.041
MO$857.28–$910.063
MS$843.131
MT$937.111
NC$878.281
ND$902.911
NE$857.511
NH$953.311
NJ$1,007.57–$1,051.712
NM$901.661
NV$928.151
NY$891.64–$1,114.095
OH$888.231
OK$863.521
OR$917.79–$990.512
PA$887.44–$977.292
PR$942.621
RI$955.661
SC$885.361
SD$898.861
TN$858.741
TX$881.96–$964.248
UT$897.231
VA$910.58–$1,061.742
VI$942.621
VT$903.001
WA$957.59–$1,071.252
WI$873.371
WV$887.661
WY$922.211

See 15837 in every payment locality

How the 15837 rate is calculated

Each of 15837’s three RVUs is multiplied by a geographic index (GPCI) for the payment locality, added up, and multiplied by the conversion factor. Drag the indexes or enter a ZIP to see what moves the rate.

How the rate is built · 15837

RVUs × geographic indexes × conversion factor

Office or facility?

Work9.31

9.31 RVUs× 1.000 GPCI

Practice expense17.02

17.02 RVUs× 1.000 GPCI

Malpractice1.73

1.73 RVUs× 1.000 GPCI

Adjusted RVUs

28.0600

Conversion factor

$33.4009

Medicare rate

$937.23

Every GPCI starts at 1.000, the national rate. Enter a ZIP or drag a slider.

The exact North Dakota inputs and CMS source lines

PPRRVU2026_Oct_nonQPP.csv

1,576

Code
15837
Physician work
9.31
Practice expense
17.02
Malpractice
1.73

GPCI2026.csv

84

Locality
North Dakota
Physician work
1.000
Practice expense
1.000
Malpractice
0.406
Office calculation for 15837 in North Dakota
ComponentRVULocality factorAdjusted
Physician work9.31× 1.0009.3100
Practice expense17.02× 1.00017.0200
Malpractice1.73× 0.4060.7024
Total RVUs27.0324
Conversion factor× 33.4009

Office rate, North Dakota$902.91

Office: (9.31 × 1 + 17.02 × 1 + 1.73 × 0.406) × $33.4009 = $902.91

Facility: (9.31 × 1 + 8.67 × 1 + 1.73 × 0.406) × $33.4009 = $624.01

Open 15837 in the RVU calculator

Payment rules and modifiers for 15837

15837 has a 90-day global period: related visits in that window are included in the surgery payment.

CMS payment indicators · 15837

Skin excision, forearm or hand

RuleCMS valueWhat it means
Global period090Major surgery: the day before, the day of, and 90 days after are included.
Multiple procedures2Standard reduction: highest-valued procedure at 100%, others at 50%.
Bilateral (modifier 50)0The 150% bilateral adjustment doesn’t apply.
Assistant at surgery (80/81/82/AS)0Not paid without supporting documentation.
Co-surgeons (62)0Not permitted.
Team surgery (66)0Not permitted.
Professional/technical0Physician service: no professional/technical split.
Split (54/55/56)0.10/0.71/0.19Share of the payment for pre-op, the procedure itself, and post-op care.

Global surgery period · 15837

Skin excision, forearm or hand

90-day global period ends

Dec 30, 2026

Covers Sep 30, 2026 through Dec 30, 2026 (92 days, including the day before surgery).

Visit on Oct 31, 2026

Day 30 of the 90-day post-op period: related follow-up care is included in the surgical payment.

  • 24Unrelated E/M visit by the same physician
  • 79Unrelated procedure (starts its own global period)
  • 58Staged, more extensive, or therapy procedure that was planned
  • 78Unplanned return to the operating room for a related complication
SurgeryVisit
Sep 23, 2026Jan 10, 2027

Pre-op dayGlobal period

What modifiers do to the payment

Modifier 51 · payment effect

With and without the modifier

15837 without 51 · national office

$937.23

Skin excision, forearm or hand

15837-51 · Second procedure: 50%

$468.62

When this isn’t the highest-valued procedure in the session, Medicare pays 50% of its fee schedule amount (the highest is paid at 100%).

When to use modifier 51

How 15837 has changed in North Dakota

15837 · Office / nonfacility

$902.91

Effective 2026-10-01

The base rate is $79.21 higher than on 2025-10-01, moving from $823.70 to $902.91 (9.6%).

It is unchanged from the immediately preceding available release, effective 2026-07-01.

Base rate by release · bars start at $0 · select a bar to compare

One bar per available release, ordered by effective date. Missing rates remain gaps. These comparisons hold the code, setting and locality identifiers constant; they do not isolate which policy or input caused a change.

What changed, release by release
  1. January 1, 2026

    RVU26A

    $823.70changed to$902.91

    • Conversion factor 32.3465 changed to 33.4009
    • Work RVU 9.55 changed to 9.31
    • Practice expense RVU 15.01 changed to 17.02
    • Malpractice RVU 1.75 changed to 1.73
    • Malpractice GPCI 0.517 changed to 0.406

    Held through RVU26B, RVU26C, RVU26D.

  2. January 1, 2025

    RVU25A

    $842.00changed to$823.70

    • Conversion factor 33.2875 changed to 32.3465
    • Practice expense RVU 14.84 changed to 15.01

    Held through RVU25B, RVU25C, RVU25D.

  3. March 9, 2024

    RVU24AR

    $828.26changed to$842.00

    • Conversion factor 32.7442 changed to 33.2875

    Held through RVU24B, RVU24C, RVU24D.

  4. January 1, 2024

    RVU24A

    $851.43changed to$828.26

    • Conversion factor 33.8872 changed to 32.7442
    • Practice expense RVU 14.76 changed to 14.84
    • Malpractice RVU 1.72 changed to 1.75
    • Malpractice GPCI 0.474 changed to 0.517
  5. January 1, 2023

    RVU23A

    $854.97changed to$851.43

    • Conversion factor 34.6062 changed to 33.8872
    • Practice expense RVU 14.41 changed to 14.76
    • Malpractice RVU 1.73 changed to 1.72
    • Malpractice GPCI 0.431 changed to 0.474

    Held through RVU23B, RVU23C, RVU23D.

  6. January 1, 2022

    RVU22A

    $858.66changed to$854.97

    • Conversion factor 34.8931 changed to 34.6062
    • Practice expense RVU 14.33 changed to 14.41
    • Malpractice RVU 1.69 changed to 1.73

    Held through RVU22B, RVU22C, RVU22D.

  7. January 1, 2021

    RVU21A

    $867.41changed to$858.66

    • Conversion factor 36.0896 changed to 34.8931
    • Practice expense RVU 13.67 changed to 14.33
    • Malpractice RVU 1.68 changed to 1.69
    • Malpractice GPCI 0.485 changed to 0.431

    Held through RVU21B, RVU21C, RVU21D.

  8. January 1, 2020

    RVU20A

    $863.31changed to$867.41

    • Conversion factor 36.0391 changed to 36.0896
    • Practice expense RVU 13.53 changed to 13.67
    • Malpractice RVU 1.62 changed to 1.68
    • Malpractice GPCI 0.540 changed to 0.485

    Held through RVU20B, RVU20C, RVU20D.

  9. January 1, 2019

    RVU19A

    $862.89changed to$863.31

    • Conversion factor 35.9996 changed to 36.0391
    • Practice expense RVU 13.55 changed to 13.53
    • Malpractice RVU 1.61 changed to 1.62

    Held through RVU19B, RVU19C, RVU19D.

  10. January 1, 2018

    RVU18AR1

    $848.27changed to$862.89

    • Conversion factor 35.8887 changed to 35.9996
    • Practice expense RVU 13.20 changed to 13.55
    • Malpractice RVU 1.62 changed to 1.61
    • Malpractice GPCI 0.547 changed to 0.540

    Held through RVU18B, RVU18C, RVU18D.

  11. January 1, 2017

    RVU17A

    $792.12changed to$848.27

    • Conversion factor 35.8043 changed to 35.8887
    • Practice expense RVU 11.51 changed to 13.20
    • Malpractice RVU 1.92 changed to 1.62
    • Malpractice GPCI 0.554 changed to 0.547

    Held through RVU17B, RVU17C, RVU17D.

  12. January 1, 2016

    RVU16A

    $871.54changed to$792.12

    • Conversion factor 35.9335 changed to 35.8043
    • Practice expense RVU 13.43 changed to 11.51
    • Malpractice RVU 2.30 changed to 1.92

    Held through RVU16B, RVU16C, RVU16D.

  13. July 1, 2015

    RVU15C

    $867.20changed to$871.54

    • Conversion factor 35.7547 changed to 35.9335

    Held through RVU15D.

  14. January 1, 2015

    RVU15A

    $773.74changed to$867.20

    • Conversion factor 35.8228 changed to 35.7547
    • Practice expense RVU 11.02 changed to 13.43
    • Malpractice RVU 1.92 changed to 2.30
    • Malpractice GPCI 0.536 changed to 0.554

    Held through RVU15B.

  15. January 1, 2014

    RVU14A

    $874.36changed to$773.74

    • Conversion factor 34.0230 changed to 35.8228
    • Practice expense RVU 15.11 changed to 11.02
    • Malpractice RVU 2.01 changed to 1.92
    • Malpractice GPCI 0.517 changed to 0.536

    Held through RVU14B, RVU14C, RVU14D.

  16. January 1, 2013

    RVU13AR

    Earliest loaded release: $874.36

    Held through RVU13B, RVU13C, RVU13D.

Rates in every CMS release
Effective fromOfficeFacilityCMS release
2026-10-01$902.91$624.01RVU26D
2026-07-01$902.91$624.01RVU26C
2026-04-01$902.91$624.01RVU26B
2026-01-01$902.91$624.01RVU26A
2025-10-01$823.70$678.14RVU25D
2025-07-01$823.70$678.14RVU25C
2025-04-01$823.70$678.14RVU25B
2025-01-01$823.70$678.14RVU25A
2024-10-01$842.00$689.88RVU24D
2024-07-01$842.00$689.88RVU24C
2024-04-01$842.00$689.88RVU24B
2024-03-09$842.00$689.88RVU24AR
2024-01-01$828.26$678.62RVU24A
2023-10-01$851.43$696.56RVU23D
2023-07-01$851.43$696.56RVU23C
2023-04-01$851.43$696.56RVU23B
2023-01-01$851.43$696.56RVU23A
2022-10-01$854.97$697.51RVU22D
2022-07-01$854.97$697.51RVU22C
2022-04-01$854.97$697.51RVU22B
2022-01-01$854.97$697.51RVU22A
2021-10-01$858.66$699.90RVU21D
2021-07-01$858.66$699.90RVU21C
2021-04-01$858.66$699.90RVU21B
2021-01-01$858.66$699.90RVU21A
2020-10-01$867.41$716.91RVU20D
2020-07-01$867.41$716.91RVU20C
2020-04-01$867.41$716.91RVU20B
2020-01-01$867.41$716.91RVU20A
2019-10-01$863.31$716.27RVU19D
2019-07-01$863.31$716.27RVU19C
2019-04-01$863.31$716.27RVU19B
2019-01-01$863.31$716.27RVU19A
2018-10-01$862.89$718.17RVU18D
2018-07-01$862.89$718.17RVU18C
2018-04-01$862.89$718.17RVU18B
2018-01-01$862.89$718.17RVU18AR1
2017-10-01$848.27$707.59RVU17D
2017-07-01$848.27$707.59RVU17C
2017-04-01$848.27$707.59RVU17B
2017-01-01$848.27$707.59RVU17A
2016-10-01$792.12$659.29RVU16D
2016-07-01$792.12$659.29RVU16C
2016-04-01$792.12$659.29RVU16B
2016-01-01$792.12$659.29RVU16A
2015-10-01$871.54$728.88RVU15D
2015-07-01$871.54$728.88RVU15C
2015-04-01$867.20$725.26RVU15B
2015-01-01$867.20$725.26RVU15A
2014-10-01$773.74$636.54RVU14D
2014-07-01$773.74$636.54RVU14C
2014-04-01$773.74$636.54RVU14B
2014-01-01$773.74$636.54RVU14A
2013-10-01$874.36$702.21RVU13D
2013-07-01$874.36$702.21RVU13C
2013-04-01$874.36$702.21RVU13B
2013-01-01$874.36$702.21RVU13AR

Price 15837 for an earlier date of service

Where the North Dakota rate applies

North Dakota is a Medicare payment area, not a city. Our Census mapping connects it to 406 cities and communities in North Dakota. Some span more than one payment area; confirm with the service ZIP.

  • Abercrombie
  • Adams
  • Alamo
  • Alexander
  • Alice
  • Almont
  • Alsen
  • Ambrose

Browse all communities in North Dakota

15837 billing questions

How is this code different from 15836?

This code is for excess skin and underlying tissue of the forearm or hand. Code 15836 addresses the upper arm.

Can it be used for removal of a skin lesion?

No. It describes removal of redundant skin and subcutaneous tissue for reconstructive contouring, not excision of a discrete lesion.

Is routine closure separately reported?

The code represents the forearm or hand excess-tissue operation, including the surgical closure that completes it. Do not treat routine closure as a separate service.

Should modifier 50 be used when both sides are treated?

No. CMS identifies bilateral adjustment as inappropriate for this code. Document the treated site or sites in the operative report.

What documentation supports reporting this service?

Record whether the site is the forearm or hand, the symptoms or functional problem from redundant tissue, and the tissue removed during surgery.

Where these rates come from

FeeBase calculates base physician payments from CMS work, practice-expense and malpractice RVUs, adjusted by each locality’s geographic indexes and the conversion factor. Services without a published rate are labeled, never given a made-up amount. Amounts are Medicare allowed amounts before claim adjustments: not a patient’s bill or a commercial rate.

CMS RVU26D · effective Oct 1, 2026 through the day before Jan 1, 2027

Show the CMS file lines behind this rate
RVUs for 15837PPRRVU2026_Oct_nonQPP.csv, line 1,576 (RVU26D)
Geographic factors for North DakotaGPCI2026.csv, line 84 (RVU26D)

Open CMS sourceHow we calculate rates

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