No office rate
The closure method is similar, but this code is for a pressure ulcer over the coccyx. Choose 15931 for the sacral site.
On this page
CMS RVU26D · Effective 2026-10-01
15931 Pressure ulcer excision Medicare reimbursement rates in Delaware
Reports excision of a pressure ulcer over the sacrum when the surgeon closes the resulting wound directly with sutures. Compare 15931 office and facility rates across CMS payment localities in Delaware.
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 15931 in Delaware?
Delaware 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
$663.69
1 of 1 localities have a supported rate.
Payment area: Delaware
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.
Pressure ulcer surgery
About 15931: Sacral pressure ulcer excision with direct closure
Reports excision of a pressure ulcer over the sacrum when the surgeon closes the resulting wound directly with sutures.
A surgeon removes a pressure ulcer over the sacrum and closes the wound by bringing the edges together and suturing them. This service is typically performed in an operating room by a surgeon managing pressure-related wounds, such as a plastic or general surgeon. The sacral location and the method of closure distinguish this service from procedures for ulcers at other bony prominences or those reconstructed with a flap.
Select this code when the operative report supports sacral ulcer excision and direct suture closure, rather than bone removal or flap closure. Documentation should identify the site, the excision performed, and how the wound was closed. The day-before preoperative visit and 90 days of related postoperative care are included in the global period. When multiple procedures are performed in one session, the highest-valued procedure is paid in full and other procedures are subject to the standard 50% reduction. Medicare does not pay an assistant at surgery for this code; co-surgeons and team surgery are not permitted.
CMS billing rules for 15931
- 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 not permitted.
- Team surgery
- Team surgery not permitted.
Where the value comes from
- Work RVU9.82 · 49%
- Practice expense (office) RVU7.93 · 39%
- Malpractice RVU2.41 · 12%
258
Medicare services in 2024 · #4111 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.
15931 compared with similar codes
Office rates for Delaware, from the same CMS release.
No office rate
Both address sacral pressure ulcers with direct closure. Choose 15933 when the operative report documents ostectomy.
No office rate
Both address sacral pressure-ulcer excision, but 15934 involves skin-flap closure rather than direct suture closure.
No office rate
Both use direct closure, but 15940 is for an ischial pressure ulcer; 15931 is for a sacral ulcer.
Compare 15931 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
Delaware →
Office / nonfacility
Unavailable
Facility
$663.69
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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 15931 in Delaware.
PPRRVU2026_Oct_nonQPP.csv
1,595
- Code
- 15931
- Physician work
- 9.82
- Practice expense
- 7.93
- Malpractice
- 2.41
GPCI2026.csv
40
- Locality
- Delaware
- Physician work
- 1.005
- Practice expense
- 0.988
- Malpractice
- 0.899
| Component | RVU | Locality factor | Adjusted |
|---|---|---|---|
| Physician work | 9.82 | × 1.005 | 9.8691 |
| Practice expense | 7.93 | × 0.988 | 7.8348 |
| Malpractice | 2.41 | × 0.899 | 2.1666 |
| Total RVUs | 19.8705 | ||
| Conversion factor | × 33.4009 | ||
Facility rate, Delaware$663.69
Explore RVUs, geographic factors and the full formula
Facility
| Component | RVU | Local GPCI |
|---|---|---|
| Work | 9.82 | 1.005 |
| Practice expense | 7.93 | 0.988 |
| Malpractice | 2.41 | 0.899 |
(9.82 × 1.005 + 7.93 × 0.988 + 2.41 × 0.899) × $33.4009 = $663.69
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.
15931 billing questions
When should I choose this code instead of a sacral ulcer flap code?
Use this code when the sacral wound is closed directly with sutures. A flap code is appropriate when the operative report documents flap reconstruction.
How does this differ from the sacral code that includes ostectomy?
This code represents excision with direct closure. The related sacral ostectomy code is the closer choice when the surgeon also removes bone.
Can the closure be billed separately?
Direct suture closure is part of this service. The code describes the excision and direct closure together.
Does modifier 50 apply to ulcers on both sides of the sacrum?
No. CMS identifies bilateral adjustment as inappropriate for this code.
How are other procedures performed in the same session paid?
The highest-valued procedure is paid in full, with other procedures subject to the standard multiple procedure reduction. The code also has a 90-day global period.
Can an assistant surgeon or co-surgeon be reported?
Medicare does not pay an assistant at surgery for this code. Co-surgeons and team surgery are 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.
1,59215879,,Suction lipectomy lwr extrem,R,,0.00,0.00,,0.00,,0.00,0.00,0.00,0,000,0.00,0.00,0.00,2,1,0,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
1,59315920,,Exc coccygl pr ulc prim sutr,A,,8.08,8.57,NA,8.57,,2.16,18.81,18.81,0,090,0.10,0.71,0.19,2,0,0,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
1,59415922,,Exc coccygl pr ulc flap clsr,A,,10.12,9.89,NA,9.89,,1.88,21.89,21.89,0,090,0.10,0.71,0.19,2,0,2,1,0,9,,33.4009,09,0,99,0.00,0.00,0.00
1,59515931,,Exc sacral pr ulc prim sutr,A,,9.82,7.93,NA,7.93,,2.41,20.16,20.16,0,090,0.10,0.71,0.19,2,0,1,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
1,59615933,,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
3704112,CO,01,COLORADO,1.012,1.064,0.781
3813102,CT,00,CONNECTICUT,1.020,1.077,1.210
3912202,DC,01,DC + MD/VA SUBURBS,1.054,1.178,1.113
4012102,DE,01,DELAWARE,1.005,0.988,0.899
4109102,FL,03,FORT LAUDERDALE,1.000,1.013,1.808
4209102,FL,04,MIAMI,1.000,1.041,2.529
4309102,FL,99,REST OF FLORIDA,1.000,0.956,1.503