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CMS RVU26D · Effective 2026-10-01

15952 Pressure ulcer excision Medicare reimbursement rates in Connecticut

Reports excision of a pressure ulcer over the greater trochanter when the resulting wound is closed with a flap of nearby tissue. Compare 15952 office and facility rates across CMS payment localities in Connecticut.

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 15952 in Connecticut?

Connecticut has 1 payment locality in this comparison. Use the service location to choose the applicable amount. These are the supported base rates for the payment area shown below, using the same CMS release.

Office / nonfacility

No supported rate

Facility setting

$884.18

1 of 1 localities have a supported rate.

Payment area: Connecticut

One mapped payment locality.

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.

Find 15952 in your payment locality →

Pressure ulcer surgery

About 15952: Trochanteric pressure ulcer excision with flap closure

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

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.

CMS billing rules for 15952

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
Assistant at surgery may be paid.
Co-surgeons
Co-surgeons paid only with supporting documentation.
Team surgery
Team surgery not permitted.

Where the value comes from

  • Work RVU12.00 · 48%
  • Practice expense (office) RVU10.72 · 43%
  • Malpractice RVU2.22 · 9%

24

Medicare services in 2024 · #5801 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.

15952 compared with similar codes

Office rates for Connecticut, from the same CMS release.

15950

Pressure ulcer excision

Trochanteric, primary closure

No office rate

Use 15950 when the trochanteric ulcer defect is closed with primary sutures. Use 15952 when a flap is used for closure.

15953

Pressure ulcer surgery

Trochanteric, flap and ostectomy

No office rate

Use 15953 for trochanteric ulcer excision with flap closure when ostectomy is also performed; 15952 describes flap closure without that ostectomy variant.

15956

Pressure ulcer excision

Trochanteric, muscle flap preparation

No office rate

15956 concerns trochanteric ulcer excision with preparation of a muscle or myocutaneous flap. Choose 15952 for the flap-closure service described by that code.

15944

Pressure ulcer excision

Ischial site, skin flap closure

No office rate

15944 describes flap closure for an ischial pressure ulcer. Use 15952 when the treated ulcer is over the greater trochanter.

Compare 15952 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.

1 of 1 payment localities

Office and facility base rates · shared scale starting at $0

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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 15952 in Connecticut.

PPRRVU2026_Oct_nonQPP.csv

1,608

Code
15952
Physician work
12.00
Practice expense
10.72
Malpractice
2.22

GPCI2026.csv

38

Locality
Connecticut
Physician work
1.020
Practice expense
1.077
Malpractice
1.210
Facility calculation for 15952 in Connecticut
ComponentRVULocality factorAdjusted
Physician work12.00× 1.02012.2400
Practice expense10.72× 1.07711.5454
Malpractice2.22× 1.2102.6862
Total RVUs26.4716
Conversion factor× 33.4009

Facility rate, Connecticut$884.18

Values as parsed from CMS release RVU26D, effective 2026-10-01. The amount is rounded to the nearest cent only at the end.
Explore RVUs, geographic factors and the full formula

Facility

Facility calculation inputs
ComponentRVULocal GPCI
Work121.02
Practice expense10.721.077
Malpractice2.221.21

(12 × 1.02 + 10.72 × 1.077 + 2.22 × 1.21) × $33.4009 = $884.18

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.

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 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.

RVUs for 15952PPRRVU2026_Oct_nonQPP.csv, line 1,608 (RVU26D)
Geographic factors for ConnecticutGPCI2026.csv, line 38 (RVU26D)
Open CMS sourceHow this rate is calculatedBuild a fee sheet