Billing code 15933: Pressure ulcer excisionMedicare rate & RVUs in Guam
Reports operative removal of a sacral pressure ulcer, underlying bone, and primary closure when the wound can be closed directly.
CMS doesn’t publish an office rate for 15933 in Guam.
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 15933 covers
This service covers surgical removal of a pressure ulcer over the sacrum, removal of underlying bone, and direct closure with sutures. It is generally performed in an operating room by a surgeon, such as a plastic or general surgeon, for a wound requiring operative excision and bone removal. The documented site must be sacral, and the operation must include both ostectomy and primary closure; a different closure method or site points to another code in the pressure-ulcer excision family.
The operative report should identify the sacral ulcer, describe the excision and bone removal, and document direct suture closure. This major surgery has a 90-day global period that includes the day-before preoperative visit and 90 days of related postoperative care. When multiple procedures occur in the same session, the highest-valued procedure is paid in full and other procedures are subject to the standard 50% multiple-procedure reduction. Modifier 50 is inappropriate for this midline sacral service. 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.
15933 in Hawaii, Guam
| Payment locality | Office | Facility |
|---|---|---|
| Hawaii, Guam | Unavailable | $833.83 |
How the 15933 rate is calculated
Each of 15933’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 · 15933
RVUs × geographic indexes × conversion factor
Swap in your local Medicare rate.
Work 11.48Practice expense 10.51Malpractice 2.65
All indexes start at 1.000 (the national rate). Enter a ZIP or drag a slider.
Payment rules and modifiers for 15933
15933 has a 90-day global period: related visits in that window are included in the surgery payment.
CMS payment indicators · 15933
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 · 15933
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
15933 without 51 · national facility
$823.00
Pressure ulcer excision
15933-51 · Second procedure: 50%
$411.50
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%).
15933 compared with similar codes
Compare codes
15933 vs 15931 vs 15935 vs 15941: national Medicare rates
Swap in your local Medicare rate.
How to choose
- 15931Pressure ulcer excision
- Both concern a sacral pressure ulcer closed primarily, but this code also includes ostectomy. Use 15931 when underlying bone is not removed.
- 15935Pressure ulcer surgery
- Both include sacral ulcer excision and ostectomy; 15935 uses skin-flap closure, while this code uses direct suture closure.
- 15941Pressure ulcer excision
- This code is for a sacral ulcer. Code 15941 is for an ischial pressure ulcer treated with primary closure and ostectomy.
15933 billing questions
How does this differ from 15931?
This service includes removal of underlying bone. Code 15931 describes sacral pressure-ulcer excision with primary closure without the ostectomy component.
Can the primary closure be billed separately?
No separate closure code is indicated for the direct suture closure included in this service. The code represents the excision, ostectomy, and primary closure together.
Should modifier 50 be used for a sacral ulcer?
No. The sacral site is midline, and modifier 50 is inappropriate for this service.
What should the operative note establish?
Document the sacral location, ulcer excision, removal of underlying bone, and closure by direct suturing. The note should distinguish this approach from a skin or muscle flap.
When is an assistant at surgery payable?
Assistant-at-surgery payment is allowed only when the record documents medical necessity. Co-surgeons and team surgery are not permitted for this code.
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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