Billing code 15920: Pressure ulcer excisionMedicare rate & RVUs in Florida
Reports surgical removal of a pressure ulcer at the coccyx when the resulting wound is closed directly with sutures rather than a flap.
CMS doesn’t publish an office rate for 15920 in Florida.
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 9 sections
What 15920 covers
This operation removes a pressure ulcer centered over the coccyx and closes the wound directly with sutures. It is typically performed by a surgeon, such as a plastic or general surgeon, in an operating room for a patient whose ulcer requires operative excision and closure. The defining features are the coccygeal site and direct closure; a flap-based repair or an ulcer at another bony prominence calls for a different code.
Report the service when the operative record identifies the ulcer’s coccygeal location, excision performed, and primary closure. The closure is part of this service, not a separate flap repair. Medicare assigns a 90-day global period, including the day-before preoperative visit and 90 days of related postoperative care. When multiple procedures are performed in the same session, the highest-valued is paid in full and the others at 50%. Modifier 50 is not appropriate for this anatomy. Assistant-at-surgery payment requires documented medical necessity; co-surgeons and team surgery are 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 15920 pays more and less in Florida
The same RVUs, adjusted for each area’s costs. Open a locality for its calculation, history and nearby areas.
| Payment locality | Office | Facility |
|---|---|---|
| Fort Lauderdale | Unavailable | $690.29 |
| Miami | Unavailable | $750.32 |
| Rest Of Florida | Unavailable | $651.97 |
How the 15920 rate is calculated
Each of 15920’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 · 15920
RVUs × geographic indexes × conversion factor
Swap in your local Medicare rate.
Work 8.08Practice expense 8.57Malpractice 2.16
All indexes start at 1.000 (the national rate). Enter a ZIP or drag a slider.
Payment rules and modifiers for 15920
15920 has a 90-day global period: related visits in that window are included in the surgery payment.
CMS payment indicators · 15920
Pressure ulcer excision
| Rule | CMS value | What it means |
|---|---|---|
| Global period | 090 | Major surgery: the day before, the day of, and 90 days after are included. |
| Multiple procedures | 2 | Standard reduction: highest-valued procedure at 100%, others at 50%. |
| Bilateral (modifier 50) | 0 | The 150% bilateral adjustment doesn’t apply. |
| Assistant at surgery (80/81/82/AS) | 0 | Not paid without supporting documentation. |
| Co-surgeons (62) | 0 | Not permitted. |
| Team surgery (66) | 0 | Not permitted. |
| Professional/technical | 0 | Physician service: no professional/technical split. |
| Split (54/55/56) | 0.10/0.71/0.19 | Share of the payment for pre-op, the procedure itself, and post-op care. |
Global surgery period · 15920
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.
Pre-op dayGlobal period
What modifiers do to the payment
Modifier 51 · payment effect
With and without the modifier
15920 without 51 · national facility
$628.27
Pressure ulcer excision
15920-51 · Second procedure: 50%
$314.14
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%).
15920 compared with similar codes
Compare codes
15920 vs 15922 vs 15931 vs 15933 vs 15940: national Medicare rates
Swap in your local Medicare rate.
How to choose
- 15922Pressure ulcer excision
- Both address coccygeal pressure ulcers, but 15920 is for direct suture closure; 15922 is for flap closure.
- 15931Pressure ulcer excision
- This code is for a coccygeal ulcer. Code 15931 is for a sacral ulcer closed directly.
- 15933Pressure ulcer excision
- Code 15933 addresses a sacral ulcer with ostectomy and direct closure; 15920 identifies the coccygeal site and does not describe ostectomy.
- 15940Pressure ulcer surgery
- Use 15940 for an ulcer at the ischial region closed directly, rather than an ulcer centered over the coccyx.
15920 billing questions
How is this code distinguished from 15922?
Use 15920 when the coccygeal wound is closed directly with sutures. Code 15922 describes a flap-based closure at the coccygeal site.
Can the closure be billed separately?
No. Direct suture closure is included in this service; a separate flap repair is not the closure method described here.
What documentation supports reporting this code?
The operative report should identify the ulcer as coccygeal, describe its excision, and document direct suture closure.
Should modifier 50 be reported?
No. The anatomy and descriptor make modifier 50 inappropriate for this service.
How does the 90-day global period affect postoperative billing?
The day-before preoperative visit and 90 days of related postoperative care are included in the global period.
When may an assistant-at-surgery be paid?
Assistant-at-surgery payment is available only when medical necessity is documented. 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 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
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