No office rate
Both describe sacral pressure-ulcer excision with muscle-flap preparation. Choose 15937 when ostectomy is part of the procedure; 15936 is the option without that ostectomy distinction.
On this page
CMS RVU26D · Effective 2026-10-01
15936 in Modesto
Office / nonfacility
Not available in this setting
Base rate per service
Facility setting
$828.89
Base rate per service
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.
Pressure ulcer surgery
About 15936: Sacral ulcer excision with muscle flap preparation
Reports excision of a sacral pressure ulcer with preparation of a muscle or myocutaneous flap for reconstruction, without the ostectomy described by a related code.
This service involves removing a pressure ulcer from the sacral region and preparing a muscle or myocutaneous flap as part of reconstructive treatment. It is typically performed by a plastic or reconstructive surgeon in a hospital setting for a wound requiring more than primary closure or a skin flap. The operative report should make clear that the ulcer is sacral and that muscle-flap preparation was performed; the code distinguishes this approach from skin-flap closure and from procedures that include ostectomy.
Report the code for the documented sacral procedure, not simply because a muscle flap was considered or planned. 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. Medicare does not pay an assistant at surgery; co-surgeons require supporting documentation, and team surgery is not permitted.
CMS billing rules for 15936
- 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 RVU12.83 · 51%
- Practice expense (office) RVU9.28 · 37%
- Malpractice RVU2.98 · 12%
631
Medicare services in 2024 · #3350 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.
15936 compared with similar codes
Office rates for Modesto, from the same CMS release.
No office rate
This code describes sacral ulcer excision with skin-flap closure. Choose 15936 when the operative work is preparation of a muscle or myocutaneous flap instead.
No office rate
15935 describes sacral ulcer excision with skin-flap closure and ostectomy. It differs from 15936 in both the flap approach and the ostectomy distinction.
No office rate
The flap-preparation approach is similar, but 15946 is for an ischial pressure ulcer. Use 15936 for the sacral site.
The same code, a different location
How does Modesto compare?
15936 across payment areas
Same release and payment basis · bars start at $0
Modesto · This locality
Unavailable
Unavailable
No comparable rate is available in this setting.
Unavailable
No comparable rate is available in this setting.
Unavailable
No comparable rate is available in this setting.
Unavailable
No comparable rate is available in this setting.
Unavailable
No comparable rate is available in this setting.
No comparable rate is available in this setting.
Other payment areas listed in California appear first, followed by selected cross-country examples. The chart compares amounts, not distance.
The code’s RVUs stay the same in these comparisons. Geographic adjustments to work, practice expense and malpractice change the dollar amount. A city name alone may not identify the payment area for a service address.
Compare all 108 other payment areas
Madera
California · 15936
Office
Unavailable
Facility
$828.89
No comparable office rate is available.
Merced
California · 15936
Office
Unavailable
Facility
$828.89
No comparable office rate is available.
Napa
California · 15936
Office
Unavailable
Facility
$914.62
No comparable office rate is available.
Oxnard-Thousand Oaks-Ventura
California · 15936
Office
Unavailable
Facility
$868.92
No comparable office rate is available.
Redding
California · 15936
Office
Unavailable
Facility
$828.89
No comparable office rate is available.
Rest Of California
California · 15936
Office
Unavailable
Facility
$828.89
No comparable office rate is available.
Riverside-San Bernardino-Ontario
California · 15936
Office
Unavailable
Facility
$860.87
No comparable office rate is available.
Sacramento-Roseville-Folsom
California · 15936
Office
Unavailable
Facility
$857.80
No comparable office rate is available.
Salinas
California · 15936
Office
Unavailable
Facility
$854.41
No comparable office rate is available.
San Diego-Chula Vista-Carlsbad
California · 15936
Office
Unavailable
Facility
$866.05
No comparable office rate is available.
San Francisco-Oakland-Berkeley (Marin Cnty)
California · 15936
Office
Unavailable
Facility
$951.97
No comparable office rate is available.
San Francisco-Oakland-Berkeley (San Francisco/San Mateo/Alameda/Contra Costa Cnty)
California · 15936
Office
Unavailable
Facility
$948.59
No comparable office rate is available.
San Jose-Sunnyvale-Santa Clara (San Benito Cnty)
California · 15936
Office
Unavailable
Facility
$975.99
No comparable office rate is available.
San Jose-Sunnyvale-Santa Clara (Santa Clara Cnty)
California · 15936
Office
Unavailable
Facility
$962.15
No comparable office rate is available.
San Luis Obispo-Paso Robles
California · 15936
Office
Unavailable
Facility
$842.21
No comparable office rate is available.
Santa Cruz-Watsonville
California · 15936
Office
Unavailable
Facility
$867.49
No comparable office rate is available.
Santa Maria-Santa Barbara
California · 15936
Office
Unavailable
Facility
$855.30
No comparable office rate is available.
Santa Rosa-Petaluma
California · 15936
Office
Unavailable
Facility
$875.37
No comparable office rate is available.
Stockton
California · 15936
Office
Unavailable
Facility
$828.89
No comparable office rate is available.
Vallejo
California · 15936
Office
Unavailable
Facility
$909.75
No comparable office rate is available.
Visalia
California · 15936
Office
Unavailable
Facility
$828.89
No comparable office rate is available.
Yuba City
California · 15936
Office
Unavailable
Facility
$828.89
No comparable office rate is available.
Dc + Md/Va Suburbs
District of Columbia · 15936
Office
Unavailable
Facility
$927.59
No comparable office rate is available.
Miami
Florida · 15936
Office
Unavailable
Facility
$1002.93
No comparable office rate is available.
Chicago
Illinois · 15936
Office
Unavailable
Facility
$971.48
No comparable office rate is available.
Manhattan
New York · 15936
Office
Unavailable
Facility
$974.00
No comparable office rate is available.
Alaska*
Alaska · 15936
Office
Unavailable
Facility
$1027.75
No comparable office rate is available.
Alabama
Alabama · 15936
Office
Unavailable
Facility
$756.09
No comparable office rate is available.
Arkansas
Arkansas · 15936
Office
Unavailable
Facility
$746.05
No comparable office rate is available.
Arizona
Arizona · 15936
Office
Unavailable
Facility
$814.09
No comparable office rate is available.
Colorado
Colorado · 15936
Office
Unavailable
Facility
$841.21
No comparable office rate is available.
Connecticut
Connecticut · 15936
Office
Unavailable
Facility
$891.37
No comparable office rate is available.
Delaware
Delaware · 15936
Office
Unavailable
Facility
$826.40
No comparable office rate is available.
Fort Lauderdale
Florida · 15936
Office
Unavailable
Facility
$922.48
No comparable office rate is available.
Rest Of Florida
Florida · 15936
Office
Unavailable
Facility
$874.46
No comparable office rate is available.
Atlanta
Georgia · 15936
Office
Unavailable
Facility
$864.28
No comparable office rate is available.
Rest Of Georgia
Georgia · 15936
Office
Unavailable
Facility
$823.66
No comparable office rate is available.
Hawaii, Guam
Hawaii · 15936
Office
Unavailable
Facility
$838.59
No comparable office rate is available.
Iowa
Iowa · 15936
Office
Unavailable
Facility
$751.66
No comparable office rate is available.
Idaho
Idaho · 15936
Office
Unavailable
Facility
$760.78
No comparable office rate is available.
East St. Louis
Illinois · 15936
Office
Unavailable
Facility
$914.16
No comparable office rate is available.
Rest Of Illinois
Illinois · 15936
Office
Unavailable
Facility
$867.10
No comparable office rate is available.
Suburban Chicago
Illinois · 15936
Office
Unavailable
Facility
$926.24
No comparable office rate is available.
Indiana
Indiana · 15936
Office
Unavailable
Facility
$764.24
No comparable office rate is available.
Kansas
Kansas · 15936
Office
Unavailable
Facility
$758.90
No comparable office rate is available.
Kentucky
Kentucky · 15936
Office
Unavailable
Facility
$795.16
No comparable office rate is available.
New Orleans
Louisiana · 15936
Office
Unavailable
Facility
$833.28
No comparable office rate is available.
Rest Of Louisiana
Louisiana · 15936
Office
Unavailable
Facility
$798.20
No comparable office rate is available.
Metropolitan Boston
Massachusetts · 15936
Office
Unavailable
Facility
$904.78
No comparable office rate is available.
Rest Of Massachusetts
Massachusetts · 15936
Office
Unavailable
Facility
$841.11
No comparable office rate is available.
Baltimore/Surr. Cntys
Maryland · 15936
Office
Unavailable
Facility
$891.10
No comparable office rate is available.
Rest Of Maryland
Maryland · 15936
Office
Unavailable
Facility
$837.87
No comparable office rate is available.
Rest Of Maine
Maine · 15936
Office
Unavailable
Facility
$775.61
No comparable office rate is available.
Southern Maine
Maine · 15936
Office
Unavailable
Facility
$798.51
No comparable office rate is available.
Detroit
Michigan · 15936
Office
Unavailable
Facility
$895.46
No comparable office rate is available.
Rest Of Michigan
Michigan · 15936
Office
Unavailable
Facility
$823.90
No comparable office rate is available.
Minnesota
Minnesota · 15936
Office
Unavailable
Facility
$776.95
No comparable office rate is available.
Metropolitan Kansas City
Missouri · 15936
Office
Unavailable
Facility
$816.83
No comparable office rate is available.
Metropolitan St. Louis
Missouri · 15936
Office
Unavailable
Facility
$823.35
No comparable office rate is available.
Rest Of Missouri
Missouri · 15936
Office
Unavailable
Facility
$792.67
No comparable office rate is available.
Mississippi
Mississippi · 15936
Office
Unavailable
Facility
$768.97
No comparable office rate is available.
Montana**
Montana · 15936
Office
Unavailable
Facility
$837.83
No comparable office rate is available.
North Carolina
North Carolina · 15936
Office
Unavailable
Facility
$781.33
No comparable office rate is available.
North Dakota**
North Dakota · 15936
Office
Unavailable
Facility
$778.90
No comparable office rate is available.
Nebraska
Nebraska · 15936
Office
Unavailable
Facility
$752.25
No comparable office rate is available.
New Hampshire
New Hampshire · 15936
Office
Unavailable
Facility
$838.30
No comparable office rate is available.
Northern Nj
New Jersey · 15936
Office
Unavailable
Facility
$921.39
No comparable office rate is available.
Rest Of New Jersey
New Jersey · 15936
Office
Unavailable
Facility
$893.34
No comparable office rate is available.
New Mexico
New Mexico · 15936
Office
Unavailable
Facility
$832.31
No comparable office rate is available.
Nevada**
Nevada · 15936
Office
Unavailable
Facility
$821.72
No comparable office rate is available.
Nyc Suburbs/Long Island
New York · 15936
Office
Unavailable
Facility
$1009.34
No comparable office rate is available.
Poughkpsie/N Nyc Suburbs
New York · 15936
Office
Unavailable
Facility
$907.66
No comparable office rate is available.
Queens
New York · 15936
Office
Unavailable
Facility
$965.86
No comparable office rate is available.
Rest Of New York
New York · 15936
Office
Unavailable
Facility
$792.97
No comparable office rate is available.
Ohio
Ohio · 15936
Office
Unavailable
Facility
$811.86
No comparable office rate is available.
Oklahoma
Oklahoma · 15936
Office
Unavailable
Facility
$782.67
No comparable office rate is available.
Portland
Oregon · 15936
Office
Unavailable
Facility
$853.81
No comparable office rate is available.
Rest Of Oregon
Oregon · 15936
Office
Unavailable
Facility
$807.23
No comparable office rate is available.
Metropolitan Philadelphia
Pennsylvania · 15936
Office
Unavailable
Facility
$877.66
No comparable office rate is available.
Rest Of Pennsylvania
Pennsylvania · 15936
Office
Unavailable
Facility
$807.14
No comparable office rate is available.
Puerto Rico
Puerto Rico · 15936
Office
Unavailable
Facility
$839.95
No comparable office rate is available.
Rhode Island
Rhode Island · 15936
Office
Unavailable
Facility
$845.65
No comparable office rate is available.
South Carolina
South Carolina · 15936
Office
Unavailable
Facility
$799.54
No comparable office rate is available.
South Dakota**
South Dakota · 15936
Office
Unavailable
Facility
$771.94
No comparable office rate is available.
Tennessee
Tennessee · 15936
Office
Unavailable
Facility
$763.74
No comparable office rate is available.
Austin
Texas · 15936
Office
Unavailable
Facility
$845.52
No comparable office rate is available.
Beaumont
Texas · 15936
Office
Unavailable
Facility
$803.07
No comparable office rate is available.
Brazoria
Texas · 15936
Office
Unavailable
Facility
$816.77
No comparable office rate is available.
Dallas
Texas · 15936
Office
Unavailable
Facility
$826.51
No comparable office rate is available.
Fort Worth
Texas · 15936
Office
Unavailable
Facility
$824.71
No comparable office rate is available.
Galveston
Texas · 15936
Office
Unavailable
Facility
$822.17
No comparable office rate is available.
Houston
Texas · 15936
Office
Unavailable
Facility
$876.71
No comparable office rate is available.
Rest Of Texas
Texas · 15936
Office
Unavailable
Facility
$812.57
No comparable office rate is available.
Utah
Utah · 15936
Office
Unavailable
Facility
$809.28
No comparable office rate is available.
Virginia
Virginia · 15936
Office
Unavailable
Facility
$803.50
No comparable office rate is available.
Virgin Islands
United States Virgin Islands · 15936
Office
Unavailable
Facility
$839.95
No comparable office rate is available.
Vermont
Vermont · 15936
Office
Unavailable
Facility
$785.76
No comparable office rate is available.
Rest Of Washington
Washington · 15936
Office
Unavailable
Facility
$836.24
No comparable office rate is available.
Seattle (King Cnty)
Washington · 15936
Office
Unavailable
Facility
$911.60
No comparable office rate is available.
Wisconsin
Wisconsin · 15936
Office
Unavailable
Facility
$756.13
No comparable office rate is available.
West Virginia
West Virginia · 15936
Office
Unavailable
Facility
$840.32
No comparable office rate is available.
Wyoming**
Wyoming · 15936
Office
Unavailable
Facility
$812.15
No comparable office rate is available.
See how rates vary across the country
15936 · 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 |
Where does this rate apply?
Modesto is a Medicare payment area. Our Census mapping connects it to 33 cities and communities in California, including the examples shown here.
Some communities span more than one payment area. Follow a city link to compare all of its mapped areas, or check the service-location ZIP above for an address-level starting point.
Use this rate
What is a percentage of Medicare worth?
Turn a percentage into dollars for 15936 in Modesto. This uses the base rate on this page, so the locality and release stay consistent.
Reference amount per service
$911.78
$828.89 × 110% = $911.78
A contract may specify another Medicare year or additional adjustments. This is percentage arithmetic on the displayed base rate, not a claim adjudication.
Working with a whole code list?
Compare an offer across your annual code mix, including an older Medicare schedule or flat per-code rates.
How this local rate is calculated
Each RVU component is multiplied by its own geographic practice cost index (GPCI). The three adjusted components are added, then multiplied by the conversion factor. These are the inputs used for 15936 in Modesto.
PPRRVU2026_Oct_nonQPP.csv
1,599
- Code
- 15936
- Physician work
- 12.83
- Practice expense
- 9.28
- Malpractice
- 2.98
GPCI2026.csv
16
- Locality
- Modesto
- Physician work
- 1.017
- Practice expense
- 1.096
- Malpractice
- 0.536
| Component | RVU | Locality factor | Adjusted |
|---|---|---|---|
| Physician work | 12.83 | × 1.017 | 13.0481 |
| Practice expense | 9.28 | × 1.096 | 10.1709 |
| Malpractice | 2.98 | × 0.536 | 1.5973 |
| Total RVUs | 24.8163 | ||
| Conversion factor | × 33.4009 | ||
Facility rate, Modesto$828.89
Open 15936 in the RVU calculator →
Explore RVUs, geographic factors and the full formula
Facility
| Component | RVU | Local GPCI |
|---|---|---|
| Work | 12.83 | 1.017 |
| Practice expense | 9.28 | 1.096 |
| Malpractice | 2.98 | 0.536 |
(12.83 × 1.017 + 9.28 × 1.096 + 2.98 × 0.536) × $33.4009 = $828.89
The office and facility calculations use their respective practice-expense RVUs. The facility amount here is the physician fee, not a separate hospital or facility bill.
How this rate has changed
15936 · Office / nonfacility
Rate unavailable
Effective 2026-10-01
A rate is unavailable in one of these releases, so a change cannot be calculated.
One bar per available release, ordered by effective date. Missing rates remain gaps. These comparisons hold the code, setting and locality identifiers constant; they do not isolate which policy or input caused a change.
What changed, release by release
Explore release dates and calculate this code in an earlier period →
Each row uses the accepted CMS release effective on that date and the same contractor and locality identifiers. Missing rates stay visible. Historical boundaries may differ; verify the service address for an older claim.
Inspect every release and its CMS source
| Effective from | Office / nonfacility | Facility | CMS release |
|---|---|---|---|
| 2026-10-01 | Not available in this setting | $828.89 | RVU26D |
| 2026-07-01 | Not available in this setting | $828.89 | RVU26C |
| 2026-04-01 | Not available in this setting | $828.89 | RVU26B |
| 2026-01-01 | Not available in this setting | $828.89 | RVU26A |
| 2025-10-01 | Not available in this setting | $870.02 | RVU25D |
| 2025-07-01 | Not available in this setting | $870.02 | RVU25C |
| 2025-04-01 | Not available in this setting | $870.02 | RVU25B |
| 2025-01-01 | Not available in this setting | $870.02 | RVU25A |
15936 billing questions
How does this differ from 15934?
15936 is for sacral ulcer excision with preparation of a muscle or myocutaneous flap. Code 15934 describes sacral ulcer excision with skin-flap closure.
When is 15937 a better choice?
Use 15937 when the sacral pressure-ulcer procedure also includes ostectomy. Code 15936 describes muscle-flap preparation without that ostectomy distinction.
Can modifier 50 be used for a bilateral procedure?
No. The descriptor and anatomy make modifier 50 inappropriate for this code.
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% when performed in the same session.
What should the operative report document?
Document the sacral pressure-ulcer site, excision, and actual preparation of a muscle or myocutaneous flap. If ostectomy was performed, distinguish that work because 15937 describes the related sacral procedure with ostectomy.
Is an assistant or co-surgeon payable?
Medicare does not pay an assistant at surgery for this code. Co-surgeons are paid 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.
1,59615933,,Exc sac pr ulc prim str ostc,A,,11.48,10.51,NA,10.51,,2.65,24.64,24.64,0,090,0.10,0.71,0.19,2,0,0,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
1,59715934,,Exc sacral pr ulc skn flap,A,,13.34,10.78,NA,10.78,,2.48,26.60,26.60,0,090,0.10,0.71,0.19,2,0,1,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
1,59815935,,Exc sac pr ulc skn flp ostc,A,,15.39,13.04,NA,13.04,,2.86,31.29,31.29,0,090,0.10,0.71,0.19,2,0,2,1,0,9,,33.4009,09,0,99,0.00,0.00,0.00
1,59915936,,Exc sac pr ulc prep mus flap,A,,12.83,9.28,NA,9.28,,2.98,25.09,25.09,0,090,0.10,0.71,0.19,2,0,1,1,0,9,,33.4009,09,0,99,0.00,0.00,0.00
1,60015937,,Exc sac pr ulc prep mus ostc,A,,14.76,10.05,NA,10.05,,2.72,27.53,27.53,0,090,0.10,0.71,0.19,2,0,1,1,0,9,,33.4009,09,0,99,0.00,0.00,0.00
1,60115940,,Exc ischial pr ulc prim sutr,A,,9.95,7.67,NA,7.67,,2.27,19.89,19.89,0,090,0.10,0.71,0.19,2,0,1,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
1,60215941,,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
1301182,CA,18,LOS ANGELES-LONG BEACH-ANAHEIM (LOS ANGELES/ORANGE CNTY),1.041,1.183,0.664
1401112,CA,58,MADERA,1.017,1.096,0.536
1501112,CA,59,MERCED,1.017,1.096,0.536
1601112,CA,60,MODESTO,1.017,1.096,0.536
1701112,CA,51,NAPA,1.063,1.318,0.508
1801182,CA,17,OXNARD-THOUSAND OAKS-VENTURA,1.028,1.182,0.623
1901112,CA,61,REDDING,1.017,1.096,0.536