No office rate
Use 15937 when sacral bone is also removed. The related 15936 code describes the muscle or myocutaneous flap approach without ostectomy.
On this page
CMS RVU26D · Effective 2026-10-01
15937 Pressure ulcer surgery Medicare reimbursement rates in Kansas
Reports excision of a sacral pressure ulcer with sacral bone removal and preparation of a muscle or myocutaneous flap for reconstruction. Compare 15937 office and facility rates across CMS payment localities in Kansas.
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 15937 in Kansas?
Kansas 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
$842.24
1 of 1 localities have a supported rate.
Payment area: Kansas
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 15937: Sacral ulcer excision with muscle flap and ostectomy
Reports excision of a sacral pressure ulcer with sacral bone removal and preparation of a muscle or myocutaneous flap for reconstruction.
A surgeon excises a pressure ulcer over the sacrum, removes underlying sacral bone, and prepares a muscle or myocutaneous flap for closure and reconstruction. The service is typically performed in a facility by a surgeon, often as part of reconstructive care for a deep or persistent sacral wound. The operative report should establish the sacral site, ulcer excision, ostectomy, and muscle or myocutaneous flap work; routine wound debridement alone does not describe this service.
Report this code when the documented operation includes all of those elements. The 90-day global period includes 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 for this code. Medicare does not pay an assistant at surgery; co-surgeons are paid only with supporting documentation, and team surgery is not permitted.
CMS billing rules for 15937
- 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 RVU14.76 · 54%
- Practice expense (office) RVU10.05 · 37%
- Malpractice RVU2.72 · 10%
667
Medicare services in 2024 · #3304 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.
15937 compared with similar codes
Office rates for Kansas, from the same CMS release.
No office rate
Both include sacral ostectomy, but 15935 describes skin-flap closure rather than preparation of a muscle or myocutaneous flap.
No office rate
Both include sacral ostectomy, but 15933 is for primary suture closure rather than muscle or myocutaneous flap preparation.
No office rate
This code is for an ischial pressure ulcer treated with a skin flap and ostectomy; 15937 is for the sacral site and muscle or myocutaneous flap preparation.
Compare 15937 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
Kansas →
Office / nonfacility
Unavailable
Facility
$842.24
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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 15937 in Kansas.
PPRRVU2026_Oct_nonQPP.csv
1,600
- Code
- 15937
- Physician work
- 14.76
- Practice expense
- 10.05
- Malpractice
- 2.72
GPCI2026.csv
54
- Locality
- Kansas
- Physician work
- 1.000
- Practice expense
- 0.904
- Malpractice
- 0.504
| Component | RVU | Locality factor | Adjusted |
|---|---|---|---|
| Physician work | 14.76 | × 1.000 | 14.7600 |
| Practice expense | 10.05 | × 0.904 | 9.0852 |
| Malpractice | 2.72 | × 0.504 | 1.3709 |
| Total RVUs | 25.2161 | ||
| Conversion factor | × 33.4009 | ||
Facility rate, Kansas$842.24
Explore RVUs, geographic factors and the full formula
Facility
| Component | RVU | Local GPCI |
|---|---|---|
| Work | 14.76 | 1 |
| Practice expense | 10.05 | 0.904 |
| Malpractice | 2.72 | 0.504 |
(14.76 × 1 + 10.05 × 0.904 + 2.72 × 0.504) × $33.4009 = $842.24
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.
15937 billing questions
How does this differ from 15936?
Both involve sacral ulcer excision and muscle or myocutaneous flap preparation. Report 15937 when the operation also includes ostectomy; 15936 is the related code without ostectomy.
Can the flap work be billed separately?
The code describes the ulcer excision with muscle or myocutaneous flap preparation. Review the operative report before considering separate reporting for other services performed during the same session.
Should modifier 50 be used for ulcers on both sides?
No. The descriptor and anatomy make bilateral adjustment inappropriate for this code.
Can an assistant surgeon be paid for this operation?
Medicare payment for an assistant at surgery is barred for this code. Co-surgeon payment is limited to cases with supporting documentation.
What documentation supports reporting 15937?
The operative report should identify the sacral ulcer, excision of the ulcer, removal of sacral bone, and preparation of a muscle or myocutaneous flap.
How are other procedures in the same session paid?
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.
1,59715934,,Exc sacral pr ulc skn flap,A,,13.34,10.78,NA,10.78,,2.48,26.60,26.60,0,090,0.10,0.71,0.19,2,0,1,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
1,59815935,,Exc sac pr ulc skn flp ostc,A,,15.39,13.04,NA,13.04,,2.86,31.29,31.29,0,090,0.10,0.71,0.19,2,0,2,1,0,9,,33.4009,09,0,99,0.00,0.00,0.00
1,59915936,,Exc sac pr ulc prep mus flap,A,,12.83,9.28,NA,9.28,,2.98,25.09,25.09,0,090,0.10,0.71,0.19,2,0,1,1,0,9,,33.4009,09,0,99,0.00,0.00,0.00
1,60015937,,Exc sac pr ulc prep mus ostc,A,,14.76,10.05,NA,10.05,,2.72,27.53,27.53,0,090,0.10,0.71,0.19,2,0,1,1,0,9,,33.4009,09,0,99,0.00,0.00,0.00
1,60115940,,Exc ischial pr ulc prim sutr,A,,9.95,7.67,NA,7.67,,2.27,19.89,19.89,0,090,0.10,0.71,0.19,2,0,1,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
1,60215941,,Exc isch pr ulc prm sut ostc,A,,12.10,11.58,NA,11.58,,2.25,25.93,25.93,0,090,0.10,0.71,0.19,2,0,0,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
1,60315944,,Exc isch pr ulc skn flp clsr,A,,12.13,11.10,NA,11.10,,2.25,25.48,25.48,0,090,0.10,0.71,0.19,2,0,0,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
5106102,IL,99,REST OF ILLINOIS,1.000,0.913,1.563
5208102,IN,00,INDIANA,1.000,0.927,0.486
5305102,IA,00,IOWA,1.000,0.915,0.397
5405202,KS,00,KANSAS,1.000,0.904,0.504
5515102,KY,00,KENTUCKY,1.000,0.889,0.915
5607202,LA,01,NEW ORLEANS,1.000,0.941,1.136
5707202,LA,99,REST OF LOUISIANA,1.000,0.885,0.958