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Billing code 15922: Pressure ulcer excisionMedicare rate & RVUs

Excision of a coccygeal pressure ulcer with flap closure is reported when reconstruction uses a flap rather than direct primary suturing.

CMS RVU26DEffective Oct 1, 2026109 payment localities

Medicare pays $731.15 for 15922 nationally in a facility.

Medicare rate · 15922

Pressure ulcer excision

Swap in your local Medicare rate.

Work RVUs
10.12
Total RVUs
21.89
Global days
090

National rate · 2026

$731.15

Facility setting, before claim adjustments.

See every locality for 15922 → · Billed by an NP, PA or therapist? →

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

On this page 10 sections
  1. Medicare rate
  2. What 15922 covers
  3. By payment locality
  4. Rate map
  5. How it’s calculated
  6. Payment rules
  7. Similar codes
  8. Related codes
  9. Billing questions
  10. Sources

What 15922 covers

This operation removes a pressure ulcer over the coccyx, or tailbone, and closes the resulting defect with a flap. It is typically performed by a surgeon, such as a plastic or reconstructive surgeon, for a patient with a pressure wound requiring operative excision and tissue coverage. The service is generally provided in an operating room, often in a hospital setting.

Report 15922 when the ulcer is coccygeal and closure is by flap; documentation should establish the ulcer site, excision, and flap closure. The code carries a 90-day global period, including 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% reduction. Modifier 50 is inappropriate. Assistant-at-surgery payment may be made; co-surgeon payment requires supporting documentation, and team surgery is 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.

Where 15922 pays more and less

The same RVUs, adjusted for each area’s costs. Open a locality for its calculation, history and nearby areas.

109 of 109 payment localities

15922 office and facility rates by payment locality
Payment localityOfficeFacility
AlabamaUnavailable$662.60
Alaska*Unavailable$893.43
ArizonaUnavailable$711.86
ArkansasUnavailable$654.11
AtlantaUnavailable$750.07
AustinUnavailable$743.82
BakersfieldUnavailable$744.73
Baltimore/Surr. CntysUnavailable$775.55
BeaumontUnavailable$696.96
BrazoriaUnavailable$717.06

15922 rates by state

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

MEWIVTNHMTNDMNMINYMARIWAIDWYSDIAILINOHPANJCTORNVUTCONEMOKYWVVAMDDECAAZNMKSOKARTNNCSCDCTXLAMSALGAFLAKHI

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Local rates. Clear comparisons.

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

View every state and territory as a table
15922 office rate range by state
State / territoryOffice rate rangeLocalities
AKNo published base rate1
ALNo published base rate1
ARNo published base rate1
AZNo published base rate1
CANo published base rate29
CONo published base rate1
CTNo published base rate1
DCNo published base rate1
DENo published base rate1
FLNo published base rate3
GANo published base rate2
GUNo published base rate1
HINo published base rate1
IANo published base rate1
IDNo published base rate1
ILNo published base rate4
INNo published base rate1
KSNo published base rate1
KYNo published base rate1
LANo published base rate2
MANo published base rate2
MDNo published base rate3
MENo published base rate2
MINo published base rate2
MNNo published base rate1
MONo published base rate3
MSNo published base rate1
MTNo published base rate1
NCNo published base rate1
NDNo published base rate1
NENo published base rate1
NHNo published base rate1
NJNo published base rate2
NMNo published base rate1
NVNo published base rate1
NYNo published base rate5
OHNo published base rate1
OKNo published base rate1
ORNo published base rate2
PANo published base rate2
PRNo published base rate1
RINo published base rate1
SCNo published base rate1
SDNo published base rate1
TNNo published base rate1
TXNo published base rate8
UTNo published base rate1
VANo published base rate2
VINo published base rate1
VTNo published base rate1
WANo published base rate2
WINo published base rate1
WVNo published base rate1
WYNo published base rate1

How the 15922 rate is calculated

Each of 15922’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 · 15922

RVUs × geographic indexes × conversion factor

Swap in your local Medicare rate.

Work 10.12Practice expense 9.89Malpractice 1.88

21.8900 adjusted RVUs×$33.4009 conversion factor=$731.15

All indexes start at 1.000 (the national rate). Enter a ZIP or drag a slider.

Payment rules and modifiers for 15922

15922 has a 90-day global period: related visits in that window are included in the surgery payment.

CMS payment indicators · 15922

Pressure ulcer excision

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)2Paid.
Co-surgeons (62)1Permitted with supporting documentation.
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 · 15922

Pressure ulcer excision

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.

  • 24 Unrelated E/M visit by the same physician
  • 79 Unrelated procedure (starts its own global period)
  • 58 Staged, more extensive, or therapy procedure that was planned
  • 78 Unplanned 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

15922 without 51 · national facility

$731.15

Pressure ulcer excision

15922-51 · Second procedure: 50%

$365.58

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

15922 compared with similar codes

Compare codes

15922 vs 15920 vs 15934 vs 15936: national Medicare rates

Swap in your local Medicare rate.

  • 15922
    Pressure ulcer excision · 10.12 wRVU
    —
  • 15920
    Pressure ulcer excision · 8.08 wRVU
    —
  • 15934
    Ulcer excision · 13.34 wRVU
    —
  • 15936
    Pressure ulcer excision · 12.83 wRVU
    —

How to choose

15920Pressure ulcer excision
Both are for coccygeal pressure ulcers. Select 15922 for flap closure and 15920 for primary suture closure.
15934Ulcer excision
This code describes sacral pressure ulcer excision with skin flap closure; 15922 is for the coccygeal site.
15936Pressure ulcer excision
This code is for sacral ulcer excision with preparation of a muscle flap. 15922 describes coccygeal ulcer excision with flap closure.

Codes related to 15922

Related codes aren’t interchangeable: bill the code that matches the service performed.

Codes related to 15922
CodeHow it relatesNational office range
Same family
15920Pressure ulcer excisionCoccygeal ulcer excision with primary suture closure rather than flap closure.No office rate
15931Pressure ulcer excisionSacral pressure ulcer excision with primary suture closure.No office rate
15934Ulcer excisionSacral pressure ulcer excision with skin flap closure.No office rate
15936Pressure ulcer excisionSacral ulcer excision involving preparation of a muscle flap.No office rate
15944Pressure ulcer excisionIschial pressure ulcer excision with skin flap closure.No office rate

15922 billing questions

How does 15922 differ from 15920?

Both describe excision of a coccygeal pressure ulcer. Use 15922 when the defect is closed with a flap; 15920 describes primary suture closure.

Does this code include flap closure?

Yes. The flap closure is part of the service represented by 15922; documentation should identify the flap reconstruction performed.

Which code applies to a sacral pressure ulcer?

Choose a sacral ulcer code, such as 15934 for sacral ulcer excision with skin flap closure. Code 15922 is for the coccygeal site.

Can modifier 50 be used for bilateral work?

No. CMS identifies bilateral adjustment as inappropriate for this code.

How are assistant and co-surgeon services handled?

Assistant-at-surgery payment may be made. Co-surgeon payment requires supporting documentation; team surgery is not permitted.

What happens when another procedure is performed in the same session?

Under the standard multiple procedure reduction, the highest-valued procedure is paid in full and other procedures are paid at 50%.

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 15922PPRRVU2026_Oct_nonQPP.csv, line 1,594 (RVU26D)

Open CMS sourceHow we calculate rates

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