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Billing code 15945: Skin flap closureMedicare rate & RVUs

Reports excision of an ischial pressure ulcer with removal of underlying bone and closure using a skin flap, typically for a complex wound.

CMS RVU26DEffective Oct 1, 2026109 payment localities86 Medicare services in 2024

Medicare pays $926.87 for 15945 nationally in a facility.

Medicare rate · 15945

Skin flap closure

Swap in your local Medicare rate.

Work RVUs
13.41
Total RVUs
27.75
Global days
090

National rate · 2026

$926.87

Facility setting, before claim adjustments.

See every locality for 15945 → · 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 15945 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 15945 covers

This service treats a pressure ulcer over the ischium by excising the ulcer, removing underlying bone, and closing the defect with a skin flap. It is typically performed by a surgeon experienced in wound reconstruction, such as a plastic surgeon, in a hospital setting. The operation is generally used for a deep, complex wound requiring both bone removal and flap coverage; the operative report should identify the ischial site and describe the excision, ostectomy, and flap used.

Report this code when the documented procedure includes all three elements: ulcer excision, ostectomy, and skin-flap closure. A different code may be appropriate when the site, closure method, or inclusion of ostectomy differs. The service has a 90-day global period, including the day-before preoperative visit and related postoperative care during that period. When multiple procedures occur 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. 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.

Where 15945 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

15945 office and facility rates by payment locality
Payment localityOfficeFacility
AlabamaUnavailable$841.30
Alaska*Unavailable$1,139.21
ArizonaUnavailable$902.63
ArkansasUnavailable$830.73
AtlantaUnavailable$951.27
AustinUnavailable$941.25
BakersfieldUnavailable$940.86
Baltimore/Surr. CntysUnavailable$982.65
BeaumontUnavailable$885.35
BrazoriaUnavailable$908.60

15945 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
15945 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 15945 rate is calculated

Each of 15945’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 · 15945

RVUs × geographic indexes × conversion factor

Swap in your local Medicare rate.

Work 13.41Practice expense 11.85Malpractice 2.49

27.7500 adjusted RVUs×$33.4009 conversion factor=$926.87

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

Payment rules and modifiers for 15945

15945 has a 90-day global period: related visits in that window are included in the surgery payment.

CMS payment indicators · 15945

Skin flap closure

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 · 15945

Skin flap closure

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

15945 without 51 · national facility

$926.87

Skin flap closure

15945-51 · Second procedure: 50%

$463.44

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

15945 compared with similar codes

Compare codes

15945 vs 15944 vs 15941 vs 15946 vs 15935: national Medicare rates

Swap in your local Medicare rate.

  • 15945
    Skin flap closure · 13.41 wRVU
    —
  • 15944
    Pressure ulcer excision · 12.13 wRVU
    —
  • 15941
    Pressure ulcer excision · 12.1 wRVU
    —
  • 15946
    Pressure ulcer surgery · 23.52 wRVU
    —
  • 15935
    Pressure ulcer surgery · 15.39 wRVU
    —

How to choose

15944Pressure ulcer excision
Both describe ischial ulcer excision with skin-flap closure; this code includes ostectomy, while 15944 does not.
15941Pressure ulcer excision
Both include ischial ulcer excision and ostectomy. Choose 15941 when the defect is closed with primary suture rather than a skin flap.
15946Pressure ulcer surgery
This code specifies skin-flap closure. Code 15946 is for an ischial ulcer closed with a muscle or myocutaneous flap.
15935Pressure ulcer surgery
Both include skin-flap closure and ostectomy, but 15935 is for a sacral ulcer; this code is for an ischial ulcer.

Codes related to 15945

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

Codes related to 15945
CodeHow it relatesNational office range
Same family
15944Pressure ulcer excisionIschial ulcer excision with skin-flap closure, without the ostectomy element.No office rate
15941Pressure ulcer excisionIschial ulcer excision with ostectomy and primary suture closure rather than a skin flap.No office rate
15946Pressure ulcer surgeryIschial ulcer excision using a muscle or myocutaneous flap closure.No office rate
Used instead
15935Pressure ulcer surgerySkin-flap closure with ostectomy for a sacral rather than ischial pressure ulcer.No office rate

15945 billing questions

When should this code be chosen over 15944?

Use this code when ostectomy is performed along with excision of the ischial ulcer and skin-flap closure. Code 15944 describes the skin-flap approach without the ostectomy element.

Can the ostectomy or flap closure be reported separately?

The code describes the combined ulcer excision, ostectomy, and skin-flap closure service. Do not separately report one of those elements as though it were outside the described operation.

Does modifier 50 apply when both sides are treated?

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

What documentation supports reporting this code?

The operative report should identify the ischial pressure ulcer and document its excision, removal of underlying bone, and closure with a skin flap.

How are assistant surgeons and co-surgeons handled?

Assistant-at-surgery payment requires documentation of medical necessity. Co-surgeons and team surgery are not permitted for this code.

What postoperative care is included?

The 90-day global period includes the day-before preoperative visit and 90 days of related postoperative care.

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 15945PPRRVU2026_Oct_nonQPP.csv, line 1,604 (RVU26D)

Open CMS sourceHow we calculate rates

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