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Billing code 15953: Pressure ulcer surgeryMedicare rate & RVUs

Surgical removal of a pressure ulcer over the trochanter with underlying bone resection and flap closure, reported when all three elements are performed.

CMS RVU26DEffective Oct 1, 2026109 payment localities

Medicare pays $918.19 for 15953 nationally in a facility.

Medicare rate · 15953

Pressure ulcer surgery

Swap in your local Medicare rate.

Work RVUs
13.23
Total RVUs
27.49
Global days
090

National rate · 2026

$918.19

Facility setting, before claim adjustments.

See every locality for 15953 → · 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 15953 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 15953 covers

This operation treats a pressure ulcer over the greater trochanter, the bony prominence at the side of the hip. The surgeon removes the ulcerated tissue, resects underlying bone, and covers the resulting defect with a flap. It is generally performed in an operating room for a deep or persistent pressure injury, often in a patient with limited mobility. Plastic, general, or orthopedic surgeons may perform the reconstruction, depending on the case and the practice setting.

Select this code when the operative service includes trochanteric ulcer excision, ostectomy, and flap closure; the operative report should establish the site and document those surgical 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 paid at 50%. CMS does not provide a bilateral adjustment for this code, so modifier 50 is inappropriate. Assistant-at-surgery payment is statutorily restricted; 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 15953 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

15953 office and facility rates by payment locality
Payment localityOfficeFacility
AlabamaUnavailable$833.16
Alaska*Unavailable$1,127.69
ArizonaUnavailable$894.10
ArkansasUnavailable$822.65
AtlantaUnavailable$942.40
AustinUnavailable$932.51
BakersfieldUnavailable$932.13
Baltimore/Surr. CntysUnavailable$973.56
BeaumontUnavailable$876.89
BrazoriaUnavailable$900.03

15953 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
15953 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 15953 rate is calculated

Each of 15953’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 · 15953

RVUs × geographic indexes × conversion factor

Swap in your local Medicare rate.

Work 13.23Practice expense 11.79Malpractice 2.47

27.4900 adjusted RVUs×$33.4009 conversion factor=$918.19

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

Payment rules and modifiers for 15953

15953 has a 90-day global period: related visits in that window are included in the surgery payment.

CMS payment indicators · 15953

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 · 15953

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

15953 without 51 · national facility

$918.19

Pressure ulcer surgery

15953-51 · Second procedure: 50%

$459.10

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

15953 compared with similar codes

Compare codes

15953 vs 15952 vs 15951 vs 15956 vs 15945: national Medicare rates

Swap in your local Medicare rate.

  • 15953
    Pressure ulcer surgery · 13.23 wRVU
    —
  • 15952
    Pressure ulcer excision · 12 wRVU
    —
  • 15951
    Pressure ulcer excision · 11.29 wRVU
    —
  • 15956
    Pressure ulcer excision · 16.37 wRVU
    —
  • 15945
    Skin flap closure · 13.41 wRVU
    —

How to choose

15952Pressure ulcer excision
Choose 15952 for trochanteric ulcer excision with flap closure when ostectomy is not performed. Choose 15953 when the operation also includes bone resection.
15951Pressure ulcer excision
Both codes include trochanteric ulcer excision and ostectomy. Code 15951 uses primary closure; 15953 includes flap closure.
15956Pressure ulcer excision
This code is associated with preparation of a muscle or myocutaneous flap. Code 15953 captures flap closure with trochanteric ulcer excision and ostectomy.
15945Skin flap closure
The operative approach is comparable, but 15945 is for an ischial pressure-ulcer site; 15953 is for the trochanteric site.

Codes related to 15953

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

Codes related to 15953
CodeHow it relatesNational office range
Same family
15952Pressure ulcer excisionTrochanteric ulcer excision with flap closure, without the ostectomy element.No office rate
15951Pressure ulcer excisionTrochanteric ulcer excision with ostectomy and primary closure rather than flap closure.No office rate
15950Pressure ulcer excisionTrochanteric ulcer excision with primary closure, without ostectomy.No office rate
15956Pressure ulcer excisionTrochanteric ulcer surgery involving preparation of a muscle or myocutaneous flap.No office rate
15958Pressure ulcer surgeryTrochanteric ulcer surgery involving flap preparation and ostectomy.No office rate
Used instead
15945Skin flap closureSimilar pressure-ulcer excision and flap approach for an ischial rather than trochanteric site.No office rate

15953 billing questions

When is this code selected instead of 15952?

Use 15953 when the trochanteric ulcer excision includes both flap closure and ostectomy. Code 15952 describes flap closure without the ostectomy element.

Can the ulcer excision, ostectomy, and flap closure be billed separately?

Those elements are represented together by this code when performed as the described operation. The operative note should show the ulcer site, bone resection, and flap closure.

Does modifier 50 apply when ulcers are treated on both sides?

CMS provides no bilateral adjustment for this code, and modifier 50 is inappropriate. The operative documentation should identify the treated site and work performed.

What postoperative care is included?

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

Can an assistant surgeon or co-surgeon be reported?

Assistant-at-surgery payment is statutorily restricted. Co-surgeons are paid only when supporting documentation is submitted; 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 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 15953PPRRVU2026_Oct_nonQPP.csv, line 1,609 (RVU26D)

Open CMS sourceHow we calculate rates

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