No office rate
Both describe trochanteric ulcer excision with muscle or myocutaneous flap coverage. Choose 15958 when an ostectomy is also performed.
On this page
CMS RVU26D · Effective 2026-10-01
15958 Pressure ulcer surgery Medicare reimbursement rates in Guam
Reports excision of a trochanteric pressure ulcer with underlying bone removal and muscle or myocutaneous flap coverage. Compare 15958 office and facility rates across CMS payment localities in Guam.
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 15958 in Guam?
Guam 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
$1097.61
1 of 1 localities have a supported rate.
Payment area: Hawaii, Guam
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 15958: Trochanteric ulcer excision with ostectomy and muscle flap
Reports excision of a trochanteric pressure ulcer with underlying bone removal and muscle or myocutaneous flap coverage.
This operation treats a pressure ulcer over the greater trochanter by removing the ulcer and performing an ostectomy, then covering the defect with a muscle or myocutaneous flap. Plastic and reconstructive surgeons commonly perform it for deep, complex wounds, including in patients with prolonged immobility or spinal cord injury. It is a facility-based reconstructive procedure rather than simple wound closure or surface debridement.
Choose this code when the operative report supports all three elements: trochanteric ulcer excision, bone removal, and muscle or myocutaneous flap coverage. Document the ulcer site, the ostectomy, and the flap used. The 90-day global includes the day-before preoperative visit and 90 days of related postoperative care. When multiple procedures occur in one session, the highest-valued procedure is paid in full and other procedures are subject to the standard 50% reduction. Modifier 50 is inappropriate. Assistant-at-surgery payment is barred; co-surgeons require supporting documentation, and team surgery is not permitted.
CMS billing rules for 15958
- 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 paid only with supporting documentation.
- Team surgery
- Team surgery not permitted.
Where the value comes from
- Work RVU16.33 · 50%
- Practice expense (office) RVU12.90 · 40%
- Malpractice RVU3.22 · 10%
113
Medicare services in 2024 · #4784 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.
15958 compared with similar codes
Office rates for Guam, from the same CMS release.
No office rate
Both include trochanteric ulcer excision and ostectomy. The distinguishing coverage is a skin flap for 15953 versus a muscle or myocutaneous flap for 15958.
No office rate
This is the trochanteric ostectomy option without the muscle or myocutaneous flap combination described by 15958.
No office rate
This code describes the analogous ostectomy and muscle-flap approach at a sacral pressure ulcer; 15958 is for the trochanteric site.
Compare 15958 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
Hawaii, Guam →
Office / nonfacility
Unavailable
Facility
$1097.61
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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 15958 in Hawaii, Guam.
PPRRVU2026_Oct_nonQPP.csv
1,611
- Code
- 15958
- Physician work
- 16.33
- Practice expense
- 12.90
- Malpractice
- 3.22
GPCI2026.csv
46
- Locality
- Hawaii, Guam
- Physician work
- 1.000
- Practice expense
- 1.137
- Malpractice
- 0.579
| Component | RVU | Locality factor | Adjusted |
|---|---|---|---|
| Physician work | 16.33 | × 1.000 | 16.3300 |
| Practice expense | 12.90 | × 1.137 | 14.6673 |
| Malpractice | 3.22 | × 0.579 | 1.8644 |
| Total RVUs | 32.8617 | ||
| Conversion factor | × 33.4009 | ||
Facility rate, Hawaii, Guam$1097.61
Explore RVUs, geographic factors and the full formula
Facility
| Component | RVU | Local GPCI |
|---|---|---|
| Work | 16.33 | 1 |
| Practice expense | 12.9 | 1.137 |
| Malpractice | 3.22 | 0.579 |
(16.33 × 1 + 12.9 × 1.137 + 3.22 × 0.579) × $33.4009 = $1097.61
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.
15958 billing questions
When is 15958 selected instead of 15956?
Use 15958 when the trochanteric ulcer excision includes both an ostectomy and muscle or myocutaneous flap coverage. Code 15956 describes the muscle or myocutaneous flap approach without the ostectomy element.
How does 15958 differ from 15953?
Both include trochanteric ulcer excision and ostectomy, but 15958 uses muscle or myocutaneous flap coverage; 15953 uses a skin flap.
What operative documentation supports 15958?
Document the ulcer's trochanteric location, excision, bone removal, and the muscle or myocutaneous flap used for coverage. The record should make clear that these elements were performed in the same operation.
Can modifier 50 be reported for bilateral trochanteric ulcers?
No. CMS identifies bilateral adjustment as inapplicable to this code, so modifier 50 is inappropriate.
How are additional same-session procedures and postoperative care handled?
The 90-day global includes the day-before preoperative visit and 90 days of related postoperative care. For multiple procedures in one session, the highest-valued procedure is paid in full and others are subject to the standard 50% reduction.
Can an assistant or co-surgeon be reported?
Assistant-at-surgery payment is barred for this code. Co-surgeons are paid only when supporting documentation is provided; team surgery is 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.
1,60815952,,Exc trchntr pr ulc flp clsr,A,,12.00,10.72,NA,10.72,,2.22,24.94,24.94,0,090,0.10,0.71,0.19,2,0,2,1,0,9,,33.4009,09,0,99,0.00,0.00,0.00
1,60915953,,Exc trchntr pr ulc flp ostc,A,,13.23,11.79,NA,11.79,,2.47,27.49,27.49,0,090,0.10,0.71,0.19,2,0,1,1,0,9,,33.4009,09,0,99,0.00,0.00,0.00
1,61015956,,Exc trchntr pr ulc prep flap,A,,16.37,12.71,NA,12.71,,3.65,32.73,32.73,0,090,0.10,0.71,0.19,2,0,1,1,0,9,,33.4009,09,0,99,0.00,0.00,0.00
1,61115958,,Exc trchntr pr ulc prep ostc,A,,16.33,12.90,NA,12.90,,3.22,32.45,32.45,0,090,0.10,0.71,0.19,2,0,1,1,0,9,,33.4009,09,0,99,0.00,0.00,0.00
1,61215999,,Unlisted px exc pressure ulc,C,,0.00,0.00,,0.00,,0.00,0.00,0.00,0,YYY,0.00,0.00,0.00,2,0,0,1,1,9,,33.4009,09,0,99,0.00,0.00,0.00
1,61316000,,Initial treatment of burn(s),A,,0.87,1.68,,0.24,,0.15,2.70,1.26,0,000,0.00,0.00,0.00,2,0,1,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
1,61416020,,Dress/debrid p-thick burn s,A,,0.69,1.97,,0.82,,0.12,2.78,1.63,0,000,0.00,0.00,0.00,2,0,1,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
4309102,FL,99,REST OF FLORIDA,1.000,0.956,1.503
4410212,GA,01,ATLANTA,1.003,1.016,1.201
4510212,GA,99,REST OF GEORGIA,1.000,0.892,1.192
4601212,HI,01,"HAWAII, GUAM",1.000,1.137,0.579
4702202,ID,00,IDAHO,1.000,0.920,0.473
4806102,IL,16,CHICAGO,1.007,1.005,2.295
4906102,IL,12,EAST ST. LOUIS,1.000,0.920,2.014