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CMS RVU26D · Effective 2026-10-01

15922 Pressure ulcer excision Medicare reimbursement rates in Idaho

Excision of a coccygeal pressure ulcer with flap closure is reported when reconstruction uses a flap rather than direct primary suturing. Compare 15922 office and facility rates across CMS payment localities in Idaho.

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 15922 in Idaho?

Idaho 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

$671.63

1 of 1 localities have a supported rate.

Payment area: Idaho

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.

Find 15922 in your payment locality →

Wound surgery

About 15922: Coccygeal ulcer excision with flap

Excision of a coccygeal pressure ulcer with flap closure is reported when reconstruction uses a flap rather than direct primary suturing.

This operation removes a pressure ulcer over the coccyx, or tailbone, and closes the resulting defect with a flap. It is typically performed by a surgeon, such as a plastic or reconstructive surgeon, for a patient with a pressure wound requiring operative excision and tissue coverage. The service is generally provided in an operating room, often in a hospital setting.

Report 15922 when the ulcer is coccygeal and closure is by flap; documentation should establish the ulcer site, excision, and flap closure. The code carries 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 procedure is paid in full and other procedures are subject to the standard 50% reduction. Modifier 50 is inappropriate. Assistant-at-surgery payment may be made; co-surgeon payment requires supporting documentation, and team surgery is not permitted.

CMS billing rules for 15922

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
Assistant at surgery may be paid.
Co-surgeons
Co-surgeons paid only with supporting documentation.
Team surgery
Team surgery not permitted.

Where the value comes from

  • Work RVU10.12 · 46%
  • Practice expense (office) RVU9.89 · 45%
  • Malpractice RVU1.88 · 9%

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.

15922 compared with similar codes

Office rates for Idaho, from the same CMS release.

15920

Pressure ulcer excision

Coccygeal, direct closure

No office rate

Both are for coccygeal pressure ulcers. Select 15922 for flap closure and 15920 for primary suture closure.

15934

Ulcer excision

Sacral, skin flap closure

No office rate

This code describes sacral pressure ulcer excision with skin flap closure; 15922 is for the coccygeal site.

15936

Pressure ulcer excision

Sacral, muscle flap preparation

No office rate

This code is for sacral ulcer excision with preparation of a muscle flap. 15922 describes coccygeal ulcer excision with flap closure.

Compare 15922 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

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

  • Idaho →

    Office / nonfacility

    Unavailable

    Facility

    $671.63

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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 15922 in Idaho.

PPRRVU2026_Oct_nonQPP.csv

1,594

Code
15922
Physician work
10.12
Practice expense
9.89
Malpractice
1.88

GPCI2026.csv

47

Locality
Idaho
Physician work
1.000
Practice expense
0.920
Malpractice
0.473
Facility calculation for 15922 in Idaho
ComponentRVULocality factorAdjusted
Physician work10.12× 1.00010.1200
Practice expense9.89× 0.9209.0988
Malpractice1.88× 0.4730.8892
Total RVUs20.1080
Conversion factor× 33.4009

Facility rate, Idaho$671.63

Explore RVUs, geographic factors and the full formula

Facility

Facility calculation inputs
ComponentRVULocal GPCI
Work10.121
Practice expense9.890.92
Malpractice1.880.473

(10.12 × 1 + 9.89 × 0.92 + 1.88 × 0.473) × $33.4009 = $671.63

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.

15922 billing questions

How does 15922 differ from 15920?

Both describe excision of a coccygeal pressure ulcer. Use 15922 when the defect is closed with a flap; 15920 describes primary suture closure.

Does this code include flap closure?

Yes. The flap closure is part of the service represented by 15922; documentation should identify the flap reconstruction performed.

Which code applies to a sacral pressure ulcer?

Choose a sacral ulcer code, such as 15934 for sacral ulcer excision with skin flap closure. Code 15922 is for the coccygeal site.

Can modifier 50 be used for bilateral work?

No. CMS identifies bilateral adjustment as inappropriate for this code.

How are assistant and co-surgeon services handled?

Assistant-at-surgery payment may be made. Co-surgeon payment requires supporting documentation; team surgery is not permitted.

What happens when another procedure is performed in the same session?

Under the standard multiple procedure reduction, the highest-valued procedure is paid in full and other procedures are paid at 50%.

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 15922PPRRVU2026_Oct_nonQPP.csv, line 1,594 (RVU26D)
Geographic factors for IdahoGPCI2026.csv, line 47 (RVU26D)
Open CMS sourceHow this rate is calculatedBuild a fee sheet