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CMS RVU26D · Effective 2026-10-01

15931 Pressure ulcer excision Medicare reimbursement rates in Florida

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 Florida.

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 Florida?

Florida has 3 payment localities in this comparison. Use the service location to choose the applicable amount. These are the supported base rates for the 3 payment areas shown below, using the same CMS release.

Office / nonfacility

No supported rate

Facility setting

$702.20–$807.30

3 of 3 localities have a supported rate.

Lowest: Rest Of Florida

Highest: Miami

A spread of $105.10 per service.

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 15931 in your payment locality →

Where 15931 pays more and less in Florida

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 Florida, from the same CMS release.

15920

Pressure ulcer excision

Coccygeal, direct closure

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.

15933

Pressure ulcer excision

Sacral, primary closure with ostectomy

No office rate

Both address sacral pressure ulcers with direct closure. Choose 15933 when the operative report documents ostectomy.

15934

Ulcer excision

Sacral, skin flap closure

No office rate

Both address sacral pressure-ulcer excision, but 15934 involves skin-flap closure rather than direct suture closure.

15940

Pressure ulcer surgery

Ischial, primary 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.

3 of 3 payment localities

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

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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.

RVUs for 15931PPRRVU2026_Oct_nonQPP.csv, line 1,595 (RVU26D)