No office rate
Both address an ischial pressure ulcer, but 15944 describes skin-flap closure. Use 15946 when the documented reconstruction involves a muscle or myocutaneous flap.
On this page
CMS RVU26D · Effective 2026-10-01
15946 Pressure ulcer surgery Medicare reimbursement rates
Reports excision of an ischial pressure ulcer with preparation of a muscle or myocutaneous flap for reconstruction of the defect. Compare 15946 office and facility rates across CMS payment localities.
Amounts below use the non-QP conversion factor for participating physicians. These are base physician payments before claim-level adjustments, not patient costs or total hospital charges.
What does Medicare pay for 15946?
The service location and office or facility setting determine which base rate applies. These are the supported base rates for the 109 payment areas shown below, using the same CMS release.
Office / nonfacility
No supported rate
These are locality ranges, not averages or address-specific quotes. A facility-setting amount covers the physician service; it does not include a hospital’s separate bill. Choose a locality below to inspect its calculation, compare other payment areas, or price a percentage of Medicare.
Where 15946 pays more and less
Pressure ulcer surgery
About 15946: Ischial pressure ulcer excision with muscle flap
Reports excision of an ischial pressure ulcer with preparation of a muscle or myocutaneous flap for reconstruction of the defect.
This operation treats a pressure wound over the ischial region when reconstruction requires a muscle or myocutaneous flap. A reconstructive or plastic surgeon typically performs it in an operating room, often for a deep, chronic wound in a patient with limited mobility. The operative report should identify the ischial site, describe ulcer excision, and document preparation of the muscle or myocutaneous flap; wound depth alone does not establish the flap method.
Report the code for the documented ischial procedure and flap approach, rather than a skin-flap or primary-closure code. The 90-day global period includes the day-before preoperative visit and 90 days of related postoperative care. When multiple procedures occur in the same session, the highest-valued is paid in full and other procedures are subject to the standard 50% multiple-procedure reduction. Modifier 50 is inappropriate. Medicare does not pay an assistant at surgery; co-surgeons require supporting documentation, and team surgery is not permitted.
CMS billing rules for 15946
- Global period
- Major surgery with a 90-day global period: the day-before preoperative visit and 90 days of related postoperative care are included.
- Multiple procedures
- Standard multiple procedure reduction: the highest-valued procedure is paid in full and others at 50% when performed in the same session.
- Bilateral procedures
- Bilateral adjustment does not apply; the descriptor or anatomy makes modifier 50 inappropriate.
- Assistant at surgery
- Statutory restriction: assistant at surgery is not paid.
- Co-surgeons
- Co-surgeons paid only with supporting documentation.
- Team surgery
- Team surgery not permitted.
Where the value comes from
- Work RVU23.52 · 54%
- Practice expense (office) RVU15.33 · 35%
- Malpractice RVU4.88 · 11%
988
Medicare services in 2024 · #2979 by national volume
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.
15946 compared with similar codes
Office rate ranges across all CMS payment localities, from the same CMS release.
No office rate
This code describes an ischial skin-flap procedure with ostectomy. Distinguish it from 15946 by the flap type and whether the operative service includes ostectomy.
No office rate
The flap approach is similar, but 15936 is for a sacral pressure ulcer. Use 15946 for the ischial site.
See how rates vary across the country
15946 · Office / nonfacility · Non-QP. Choose a state to explore its payment localities. A range means the amount varies within that state.
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.
View all state and territory rates as a table
| State / territory | Rate range | Localities |
|---|---|---|
| AK | No published base rate | 1 |
| AL | No published base rate | 1 |
| AR | No published base rate | 1 |
| AZ | No published base rate | 1 |
| CA | No published base rate | 29 |
| CO | No published base rate | 1 |
| CT | No published base rate | 1 |
| DC | No published base rate | 1 |
| DE | No published base rate | 1 |
| FL | No published base rate | 3 |
| GA | No published base rate | 2 |
| GU | No published base rate | 1 |
| HI | No published base rate | 1 |
| IA | No published base rate | 1 |
| ID | No published base rate | 1 |
| IL | No published base rate | 4 |
| IN | No published base rate | 1 |
| KS | No published base rate | 1 |
| KY | No published base rate | 1 |
| LA | No published base rate | 2 |
| MA | No published base rate | 2 |
| MD | No published base rate | 3 |
| ME | No published base rate | 2 |
| MI | No published base rate | 2 |
| MN | No published base rate | 1 |
| MO | No published base rate | 3 |
| MS | No published base rate | 1 |
| MT | No published base rate | 1 |
| NC | No published base rate | 1 |
| ND | No published base rate | 1 |
| NE | No published base rate | 1 |
| NH | No published base rate | 1 |
| NJ | No published base rate | 2 |
| NM | No published base rate | 1 |
| NV | No published base rate | 1 |
| NY | No published base rate | 5 |
| OH | No published base rate | 1 |
| OK | No published base rate | 1 |
| OR | No published base rate | 2 |
| PA | No published base rate | 2 |
| PR | No published base rate | 1 |
| RI | No published base rate | 1 |
| SC | No published base rate | 1 |
| SD | No published base rate | 1 |
| TN | No published base rate | 1 |
| TX | No published base rate | 8 |
| UT | No published base rate | 1 |
| VA | No published base rate | 2 |
| VI | No published base rate | 1 |
| VT | No published base rate | 1 |
| WA | No published base rate | 2 |
| WI | No published base rate | 1 |
| WV | No published base rate | 1 |
| WY | No published base rate | 1 |
Compare 15946 by payment locality
Find the payment area for your service address, then open its rate page for calculation inputs, release history and the percentage-of-Medicare tool. A city may cross payment-area boundaries; the ZIP lookup above helps resolve the location.
109 of 109 payment localities
| Payment locality | Office | Facility |
|---|---|---|
| Alabama | Office Unavailable | Facility $1325.88 |
| Alaska* | Office Unavailable | Facility $1813.51 |
| Arizona | Office Unavailable | Facility $1421.28 |
| Arkansas | Office Unavailable | Facility $1309.37 |
| Atlanta | Office Unavailable | Facility $1503.93 |
| Austin | Office Unavailable | Facility $1473.31 |
| Bakersfield | Office Unavailable | Facility $1460.97 |
| Baltimore/Surr. Cntys | Office Unavailable | Facility $1549.20 |
| Beaumont | Office Unavailable | Facility $1402.97 |
| Brazoria | Office Unavailable | Facility $1426.44 |
| Chicago | Office Unavailable | Facility $1679.76 |
| Chico | Office Unavailable | Facility $1447.50 |
| Colorado | Office Unavailable | Facility $1467.12 |
| Connecticut | Office Unavailable | Facility $1549.99 |
| Dallas | Office Unavailable | Facility $1442.50 |
| Dc + Md/Va Suburbs | Office Unavailable | Facility $1612.60 |
| Delaware | Office Unavailable | Facility $1441.94 |
| Detroit | Office Unavailable | Facility $1554.52 |
| East St. Louis | Office Unavailable | Facility $1584.94 |
| El Centro | Office Unavailable | Facility $1448.32 |
| Fort Lauderdale | Office Unavailable | Facility $1598.98 |
| Fort Worth | Office Unavailable | Facility $1439.50 |
| Fresno | Office Unavailable | Facility $1447.50 |
| Galveston | Office Unavailable | Facility $1435.29 |
| Hanford-Corcoran | Office Unavailable | Facility $1447.50 |
| Hawaii, Guam | Office Unavailable | Facility $1462.15 |
| Houston | Office Unavailable | Facility $1524.61 |
| Idaho | Office Unavailable | Facility $1333.76 |
| Indiana | Office Unavailable | Facility $1339.46 |
| Iowa | Office Unavailable | Facility $1318.81 |
| Kansas | Office Unavailable | Facility $1330.62 |
| Kentucky | Office Unavailable | Facility $1389.93 |
| Los Angeles-Long Beach-Anaheim (Los Angeles/Orange Cnty) | Office Unavailable | Facility $1531.77 |
| Madera | Office Unavailable | Facility $1447.50 |
| Manhattan | Office Unavailable | Facility $1689.36 |
| Merced | Office Unavailable | Facility $1447.50 |
| Metropolitan Boston | Office Unavailable | Facility $1574.24 |
| Metropolitan Kansas City | Office Unavailable | Facility $1425.64 |
| Metropolitan Philadelphia | Office Unavailable | Facility $1527.21 |
| Metropolitan St. Louis | Office Unavailable | Facility $1436.37 |
| Miami | Office Unavailable | Facility $1730.84 |
| Minnesota | Office Unavailable | Facility $1360.72 |
| Mississippi | Office Unavailable | Facility $1346.91 |
| Modesto | Office Unavailable | Facility $1447.50 |
| Montana** | Office Unavailable | Facility $1460.30 |
| Napa | Office Unavailable | Facility $1592.75 |
| Nebraska | Office Unavailable | Facility $1319.81 |
| Nevada** | Office Unavailable | Facility $1433.91 |
| New Hampshire | Office Unavailable | Facility $1461.24 |
| New Mexico | Office Unavailable | Facility $1450.88 |
| New Orleans | Office Unavailable | Facility $1452.58 |
| North Carolina | Office Unavailable | Facility $1367.47 |
| North Dakota** | Office Unavailable | Facility $1363.80 |
| Northern Nj | Office Unavailable | Facility $1603.12 |
| Nyc Suburbs/Long Island | Office Unavailable | Facility $1747.36 |
| Ohio | Office Unavailable | Facility $1417.38 |
| Oklahoma | Office Unavailable | Facility $1369.49 |
| Oxnard-Thousand Oaks-Ventura | Office Unavailable | Facility $1514.36 |
| Portland | Office Unavailable | Facility $1488.30 |
| Poughkpsie/N Nyc Suburbs | Office Unavailable | Facility $1578.85 |
| Puerto Rico | Office Unavailable | Facility $1463.81 |
| Queens | Office Unavailable | Facility $1676.13 |
| Redding | Office Unavailable | Facility $1447.50 |
| Rest Of California | Office Unavailable | Facility $1447.50 |
| Rest Of Florida | Office Unavailable | Facility $1520.08 |
| Rest Of Georgia | Office Unavailable | Facility $1436.62 |
| Rest Of Illinois | Office Unavailable | Facility $1507.84 |
| Rest Of Louisiana | Office Unavailable | Facility $1394.89 |
| Rest Of Maine | Office Unavailable | Facility $1358.05 |
| Rest Of Maryland | Office Unavailable | Facility $1461.26 |
| Rest Of Massachusetts | Office Unavailable | Facility $1467.24 |
| Rest Of Michigan | Office Unavailable | Facility $1437.10 |
| Rest Of Missouri | Office Unavailable | Facility $1385.72 |
| Rest Of New Jersey | Office Unavailable | Facility $1554.96 |
| Rest Of New York | Office Unavailable | Facility $1386.61 |
| Rest Of Oregon | Office Unavailable | Facility $1410.16 |
| Rest Of Pennsylvania | Office Unavailable | Facility $1409.67 |
| Rest Of Texas | Office Unavailable | Facility $1418.70 |
| Rest Of Washington | Office Unavailable | Facility $1459.02 |
| Rhode Island | Office Unavailable | Facility $1474.84 |
| Riverside-San Bernardino-Ontario | Office Unavailable | Facility $1499.96 |
| Sacramento-Roseville-Folsom | Office Unavailable | Facility $1496.73 |
| Salinas | Office Unavailable | Facility $1490.76 |
| San Diego-Chula Vista-Carlsbad | Office Unavailable | Facility $1509.90 |
| San Francisco-Oakland-Berkeley (Marin Cnty) | Office Unavailable | Facility $1657.01 |
| San Francisco-Oakland-Berkeley (San Francisco/San Mateo/Alameda/Contra Costa Cnty) | Office Unavailable | Facility $1651.46 |
| San Jose-Sunnyvale-Santa Clara (San Benito Cnty) | Office Unavailable | Facility $1697.73 |
| San Jose-Sunnyvale-Santa Clara (Santa Clara Cnty) | Office Unavailable | Facility $1675.07 |
| San Luis Obispo-Paso Robles | Office Unavailable | Facility $1469.52 |
| Santa Cruz-Watsonville | Office Unavailable | Facility $1511.58 |
| Santa Maria-Santa Barbara | Office Unavailable | Facility $1491.99 |
| Santa Rosa-Petaluma | Office Unavailable | Facility $1525.30 |
| Seattle (King Cnty) | Office Unavailable | Facility $1586.30 |
| South Carolina | Office Unavailable | Facility $1397.26 |
| South Dakota** | Office Unavailable | Facility $1352.39 |
| Southern Maine | Office Unavailable | Facility $1395.87 |
| Stockton | Office Unavailable | Facility $1447.50 |
| Suburban Chicago | Office Unavailable | Facility $1605.78 |
| Tennessee | Office Unavailable | Facility $1338.56 |
| Utah | Office Unavailable | Facility $1413.27 |
| Vallejo | Office Unavailable | Facility $1584.76 |
| Vermont | Office Unavailable | Facility $1374.98 |
| Virgin Islands | Office Unavailable | Facility $1463.81 |
| Virginia | Office Unavailable | Facility $1404.00 |
| Visalia | Office Unavailable | Facility $1447.50 |
| West Virginia | Office Unavailable | Facility $1463.80 |
| Wisconsin | Office Unavailable | Facility $1326.32 |
| Wyoming** | Office Unavailable | Facility $1418.24 |
| Yuba City | Office Unavailable | Facility $1447.50 |
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15946 billing questions
How does this differ from the ischial skin-flap code?
Choose this code when the operative report documents preparation of a muscle or myocutaneous flap. The skin-flap code describes reconstruction using a skin flap instead.
Is ulcer excision reported separately?
The code encompasses the ischial ulcer excision with preparation of the specified flap. Do not separately report the excision as though it were an independent procedure.
Does this code include an ostectomy?
The code selection distinguishes procedures that include ostectomy from those that do not. Use the operative report to determine whether bone was removed and select the corresponding code.
Can modifier 50 be used for ulcers on both sides?
No. CMS identifies bilateral adjustment as inappropriate for this code; modifier 50 is not the way to report bilateral anatomy.
How does the global period affect postoperative visits?
The 90-day global period includes the day-before preoperative visit and 90 days of related postoperative care.
Can an assistant or co-surgeon be reported?
Medicare does not pay an assistant at surgery for this code. Co-surgeons are payable only with supporting documentation; team surgery is not permitted.
Where these rates come from
FeeBase calculates base physician payments from CMS work, practice-expense, and malpractice RVUs, adjusted by each locality’s geographic indices and the applicable conversion factor. Unavailable or separately priced services are labeled rather than assigned a made-up amount.
Source: RVU26D. Effective 2026-10-01 through the day before 2027-01-01.
1,60215941,,Exc isch pr ulc prm sut ostc,A,,12.10,11.58,NA,11.58,,2.25,25.93,25.93,0,090,0.10,0.71,0.19,2,0,0,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
1,60315944,,Exc isch pr ulc skn flp clsr,A,,12.13,11.10,NA,11.10,,2.25,25.48,25.48,0,090,0.10,0.71,0.19,2,0,0,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
1,60415945,,Exc isch pr ulc skn flp ostc,A,,13.41,11.85,NA,11.85,,2.49,27.75,27.75,0,090,0.10,0.71,0.19,2,0,0,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
1,60515946,,Exc isch pr ulc prep mus flp,A,,23.52,15.33,NA,15.33,,4.88,43.73,43.73,0,090,0.10,0.71,0.19,2,0,1,1,0,9,,33.4009,09,0,99,0.00,0.00,0.00
1,60615950,,Exc trchntr pr ulc prim sutr,A,,7.83,8.34,NA,8.34,,1.45,17.62,17.62,0,090,0.10,0.71,0.19,2,0,1,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
1,60715951,,Exc trchntr pr ulc ostc,A,,11.29,11.28,NA,11.28,,2.09,24.66,24.66,0,090,0.10,0.71,0.19,2,0,0,1,0,9,,33.4009,09,0,99,0.00,0.00,0.00
1,60815952,,Exc trchntr pr ulc flp clsr,A,,12.00,10.72,NA,10.72,,2.22,24.94,24.94,0,090,0.10,0.71,0.19,2,0,2,1,0,9,,33.4009,09,0,99,0.00,0.00,0.00