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Billing code 15935: Pressure ulcer surgeryMedicare rate & RVUs

Reports excision of a sacral pressure ulcer with skin-flap closure and removal of underlying bone as part of the reconstructive procedure.

CMS RVU26DEffective Oct 1, 2026109 payment localities35 Medicare services in 2024

Medicare pays $1,045.11 for 15935 nationally in a facility.

Medicare rate · 15935

Pressure ulcer surgery

Swap in your local Medicare rate.

Work RVUs
15.39
Total RVUs
31.29
Global days
090

National rate · 2026

$1,045.11

Facility setting, before claim adjustments.

See every locality for 15935 → · 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 15935 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 15935 covers

This operation treats a pressure ulcer over the sacrum by removing the ulcerated tissue, excising underlying bone, and closing the defect with a skin flap. Plastic and reconstructive surgeons commonly perform it in an operating room or surgical facility for wounds requiring operative reconstruction. The documented work must support the sacral site, flap closure, and bone removal; a skin flap without ostectomy or primary suture closure represents a different service in this code family.

Select the code based on the operative technique and anatomy, not simply the ulcer’s size or severity. The operative report should identify the ulcer site, excision, flap used for closure, and ostectomy. This major surgery has a 90-day global period, including the day-before preoperative visit and 90 days of related postoperative care. When other 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. Assistant-at-surgery services may be paid; 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 15935 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

15935 office and facility rates by payment locality
Payment localityOfficeFacility
AlabamaUnavailable$949.21
Alaska*Unavailable$1,287.55
ArizonaUnavailable$1,017.86
ArkansasUnavailable$937.37
AtlantaUnavailable$1,072.83
AustinUnavailable$1,060.51
BakersfieldUnavailable$1,059.34
Baltimore/Surr. CntysUnavailable$1,107.77
BeaumontUnavailable$999.13
BrazoriaUnavailable$1,024.29

15935 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
15935 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 15935 rate is calculated

Each of 15935’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 · 15935

RVUs × geographic indexes × conversion factor

Swap in your local Medicare rate.

Work 15.39Practice expense 13.04Malpractice 2.86

31.2900 adjusted RVUs×$33.4009 conversion factor=$1,045.11

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

Payment rules and modifiers for 15935

15935 has a 90-day global period: related visits in that window are included in the surgery payment.

CMS payment indicators · 15935

Pressure ulcer surgery

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 · 15935

Pressure ulcer surgery

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

15935 without 51 · national facility

$1,045.11

Pressure ulcer surgery

15935-51 · Second procedure: 50%

$522.56

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

15935 compared with similar codes

Compare codes

15935 vs 15934 vs 15933 vs 15937 vs 15945: national Medicare rates

Swap in your local Medicare rate.

  • 15935
    Pressure ulcer surgery · 15.39 wRVU
    —
  • 15934
    Ulcer excision · 13.34 wRVU
    —
  • 15933
    Pressure ulcer excision · 11.48 wRVU
    —
  • 15937
    Pressure ulcer surgery · 14.76 wRVU
    —
  • 15945
    Skin flap closure · 13.41 wRVU
    —

How to choose

15934Ulcer excision
Both involve sacral ulcer excision and skin-flap closure. Choose 15935 when the operative service also includes ostectomy.
15933Pressure ulcer excision
Both include sacral ulcer excision and ostectomy. Use 15933 for primary suture closure; use 15935 when closure uses a skin flap.
15937Pressure ulcer surgery
This sacral code involves muscle-flap preparation and ostectomy. Code 15935 describes closure with a skin flap.
15945Skin flap closure
This related procedure is for an ischial pressure ulcer with skin-flap closure and ostectomy; 15935 is for the sacral site.

Codes related to 15935

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

Codes related to 15935
CodeHow it relatesNational office range
Same family
15934Ulcer excisionSacral ulcer excision with skin-flap closure, without the ostectomy described by 15935.No office rate
15933Pressure ulcer excisionSacral ulcer excision with ostectomy and primary suture closure rather than a skin flap.No office rate
15931Pressure ulcer excisionSacral ulcer excision with primary suture closure, without ostectomy.No office rate
15937Pressure ulcer surgerySacral ulcer procedure involving muscle-flap preparation and ostectomy rather than skin-flap closure.No office rate
15945Skin flap closureRelated pressure-ulcer excision with skin-flap closure and ostectomy at the ischial site.No office rate

15935 billing questions

How does this differ from code 15934?

Code 15935 includes removal of underlying bone as well as skin-flap closure. Code 15934 describes sacral ulcer excision with skin-flap closure without that ostectomy.

When would code 15933 be more appropriate?

Use 15933 when the sacral pressure ulcer is excised, bone is removed, and the defect is closed with primary suture rather than a skin flap.

Is related postoperative care separately reported during the global period?

The 90-day global period includes related postoperative care, as well as the day-before preoperative visit. The global period begins with this major surgery.

Can an assistant surgeon be reported?

Assistant-at-surgery services may be paid. Co-surgeon payment requires supporting documentation, and team surgery is not permitted.

Should modifier 50 be used for a sacral ulcer on both sides?

No. Bilateral adjustment does not apply to this code, and the descriptor and sacral anatomy make modifier 50 inappropriate.

How are other procedures in the same session paid?

The highest-valued procedure is paid in full, and other procedures performed in that session are subject to the standard multiple-procedure reduction.

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 15935PPRRVU2026_Oct_nonQPP.csv, line 1,598 (RVU26D)

Open CMS sourceHow we calculate rates

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