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Billing code 15937: Pressure ulcer surgeryMedicare rate & RVUs

Reports excision of a sacral pressure ulcer with sacral bone removal and preparation of a muscle or myocutaneous flap for reconstruction.

CMS RVU26DEffective Oct 1, 2026109 payment localities667 Medicare services in 2024

Medicare pays $919.53 for 15937 nationally in a facility.

Medicare rate · 15937

Pressure ulcer surgery

Swap in your local Medicare rate.

Work RVUs
14.76
Total RVUs
27.53
Global days
090

National rate · 2026

$919.53

Facility setting, before claim adjustments.

See every locality for 15937 → · 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 15937 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 15937 covers

A surgeon excises a pressure ulcer over the sacrum, removes underlying sacral bone, and prepares a muscle or myocutaneous flap for closure and reconstruction. The service is typically performed in a facility by a surgeon, often as part of reconstructive care for a deep or persistent sacral wound. The operative report should establish the sacral site, ulcer excision, ostectomy, and muscle or myocutaneous flap work; routine wound debridement alone does not describe this service.

Report this code when the documented operation includes all of those elements. The 90-day global period 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% reduction. Modifier 50 is inappropriate for this code. Medicare does not pay an assistant at surgery; co-surgeons are paid only with 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 15937 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

15937 office and facility rates by payment locality
Payment localityOfficeFacility
AlabamaUnavailable$838.14
Alaska*Unavailable$1,147.05
ArizonaUnavailable$896.04
ArkansasUnavailable$828.13
AtlantaUnavailable$944.64
AustinUnavailable$929.63
BakersfieldUnavailable$925.60
Baltimore/Surr. CntysUnavailable$973.45
BeaumontUnavailable$882.87
BrazoriaUnavailable$900.46

15937 rates by state

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

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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
15937 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 15937 rate is calculated

Each of 15937’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 · 15937

RVUs × geographic indexes × conversion factor

Swap in your local Medicare rate.

Work 14.76Practice expense 10.05Malpractice 2.72

27.5300 adjusted RVUs×$33.4009 conversion factor=$919.53

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

Payment rules and modifiers for 15937

15937 has a 90-day global period: related visits in that window are included in the surgery payment.

CMS payment indicators · 15937

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)1Not paid (statutory restriction).
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 · 15937

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

15937 without 51 · national facility

$919.53

Pressure ulcer surgery

15937-51 · Second procedure: 50%

$459.77

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

15937 compared with similar codes

Compare codes

15937 vs 15936 vs 15935 vs 15933 vs 15945: national Medicare rates

Swap in your local Medicare rate.

  • 15937
    Pressure ulcer surgery · 14.76 wRVU
    —
  • 15936
    Pressure ulcer excision · 12.83 wRVU
    —
  • 15935
    Pressure ulcer surgery · 15.39 wRVU
    —
  • 15933
    Pressure ulcer excision · 11.48 wRVU
    —
  • 15945
    Skin flap closure · 13.41 wRVU
    —

How to choose

15936Pressure ulcer excision
Use 15937 when sacral bone is also removed. The related 15936 code describes the muscle or myocutaneous flap approach without ostectomy.
15935Pressure ulcer surgery
Both include sacral ostectomy, but 15935 describes skin-flap closure rather than preparation of a muscle or myocutaneous flap.
15933Pressure ulcer excision
Both include sacral ostectomy, but 15933 is for primary suture closure rather than muscle or myocutaneous flap preparation.
15945Skin flap closure
This code is for an ischial pressure ulcer treated with a skin flap and ostectomy; 15937 is for the sacral site and muscle or myocutaneous flap preparation.

Codes related to 15937

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

Codes related to 15937
CodeHow it relatesNational office range
Same family
15936Pressure ulcer excisionSacral ulcer excision with muscle or myocutaneous flap preparation, without ostectomy.No office rate
15935Pressure ulcer surgerySacral ulcer excision with skin-flap closure and ostectomy.No office rate
15933Pressure ulcer excisionSacral ulcer excision with ostectomy and primary suture closure.No office rate
15934Ulcer excisionSacral ulcer excision with skin-flap closure, without ostectomy.No office rate
Used instead
15945Skin flap closureIschial-site pressure ulcer excision with skin-flap closure and ostectomy.No office rate

15937 billing questions

How does this differ from 15936?

Both involve sacral ulcer excision and muscle or myocutaneous flap preparation. Report 15937 when the operation also includes ostectomy; 15936 is the related code without ostectomy.

Can the flap work be billed separately?

The code describes the ulcer excision with muscle or myocutaneous flap preparation. Review the operative report before considering separate reporting for other services performed during the same session.

Should modifier 50 be used for ulcers on both sides?

No. The descriptor and anatomy make bilateral adjustment inappropriate for this code.

Can an assistant surgeon be paid for this operation?

Medicare payment for an assistant at surgery is barred for this code. Co-surgeon payment is limited to cases with supporting documentation.

What documentation supports reporting 15937?

The operative report should identify the sacral ulcer, excision of the ulcer, removal of sacral bone, and preparation of a muscle or myocutaneous flap.

How are other procedures in the same session paid?

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 15937PPRRVU2026_Oct_nonQPP.csv, line 1,600 (RVU26D)

Open CMS sourceHow we calculate rates

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