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Billing code 15952: Pressure ulcer excisionMedicare rate & RVUs

Reports excision of a pressure ulcer over the greater trochanter when the resulting wound is closed with a flap of nearby tissue.

CMS RVU26DEffective Oct 1, 2026109 payment localities24 Medicare services in 2024

Medicare pays $833.02 for 15952 nationally in a facility.

Medicare rate · 15952

Pressure ulcer excision

Swap in your local Medicare rate.

Work RVUs
12
Total RVUs
24.94
Global days
090

National rate · 2026

$833.02

Facility setting, before claim adjustments.

See every locality for 15952 → · 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 15952 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 15952 covers

The surgeon removes pressure-damaged tissue over the greater trochanter and closes the resulting defect with a flap of nearby tissue. A plastic, reconstructive, or other surgeon experienced in pressure-injury reconstruction typically performs this operation in an operating room for a chronic deep wound when direct edge-to-edge closure is not planned. The excision and flap closure are reported together as one service.

Choose this code when the treated site is trochanteric and closure uses a flap; select a different family member when the documented closure method or bone work differs. The operative report should identify the site, ulcer excision, flap used to cover the defect, and any associated bone resection. The 90-day global includes the day-before preoperative visit and related postoperative care. For multiple procedures in one session, the highest-valued procedure is paid in full and others at 50%. Assistant-at-surgery payment may be made; co-surgeon payment requires supporting documentation, and team-surgery billing is not allowed. Report by treated trochanteric site; modifier 50 is inappropriate.

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 15952 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

15952 office and facility rates by payment locality
Payment localityOfficeFacility
AlabamaUnavailable$756.08
Alaska*Unavailable$1,023.40
ArizonaUnavailable$811.24
ArkansasUnavailable$746.57
AtlantaUnavailable$854.85
AustinUnavailable$846.13
BakersfieldUnavailable$846.01
Baltimore/Surr. CntysUnavailable$883.14
BeaumontUnavailable$795.53
BrazoriaUnavailable$816.69

15952 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
15952 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 15952 rate is calculated

Each of 15952’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 · 15952

RVUs × geographic indexes × conversion factor

Swap in your local Medicare rate.

Work 12.00Practice expense 10.72Malpractice 2.22

24.9400 adjusted RVUs×$33.4009 conversion factor=$833.02

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

Payment rules and modifiers for 15952

15952 has a 90-day global period: related visits in that window are included in the surgery payment.

CMS payment indicators · 15952

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 · 15952

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

15952 without 51 · national facility

$833.02

Pressure ulcer excision

15952-51 · Second procedure: 50%

$416.51

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

15952 compared with similar codes

Compare codes

15952 vs 15950 vs 15953 vs 15956 vs 15944: national Medicare rates

Swap in your local Medicare rate.

  • 15952
    Pressure ulcer excision · 12 wRVU
    —
  • 15950
    Pressure ulcer excision · 7.83 wRVU
    —
  • 15953
    Pressure ulcer surgery · 13.23 wRVU
    —
  • 15956
    Pressure ulcer excision · 16.37 wRVU
    —
  • 15944
    Pressure ulcer excision · 12.13 wRVU
    —

How to choose

15950Pressure ulcer excision
Use 15950 when the trochanteric ulcer defect is closed with primary sutures. Use 15952 when a flap is used for closure.
15953Pressure ulcer surgery
Use 15953 for trochanteric ulcer excision with flap closure when ostectomy is also performed; 15952 describes flap closure without that ostectomy variant.
15956Pressure ulcer excision
15956 concerns trochanteric ulcer excision with preparation of a muscle or myocutaneous flap. Choose 15952 for the flap-closure service described by that code.
15944Pressure ulcer excision
15944 describes flap closure for an ischial pressure ulcer. Use 15952 when the treated ulcer is over the greater trochanter.

Codes related to 15952

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

Codes related to 15952
CodeHow it relatesNational office range
Same family
15950Pressure ulcer excisionTrochanteric ulcer excision with primary suture closure.No office rate
15953Pressure ulcer surgeryTrochanteric ulcer excision with flap closure and ostectomy.No office rate
15956Pressure ulcer excisionTrochanteric ulcer excision involving preparation of a muscle or myocutaneous flap.No office rate
15944Pressure ulcer excisionIschial-site pressure ulcer excision with skin flap closure.No office rate
15934Ulcer excisionSacral-site pressure ulcer excision with skin flap closure.No office rate

15952 billing questions

How does this differ from 15950?

Both codes involve a trochanteric pressure ulcer, but 15952 is for closure with a flap. Code 15950 describes closure by primary suture.

Is the flap closure included?

Yes. This code combines ulcer excision and flap closure; do not separately report those components of the same operation.

What if the surgeon also removes bone?

For trochanteric ulcer excision with flap closure and ostectomy, compare 15953. The operative report should support the bone work performed.

How are multiple procedures in the same session paid?

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

What does the 90-day global include?

It includes the day-before preoperative visit and 90 days of related postoperative care.

Can an assistant or co-surgeon be reported?

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

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 15952PPRRVU2026_Oct_nonQPP.csv, line 1,608 (RVU26D)

Open CMS sourceHow we calculate rates

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