No office rate
Both involve sacral ulcer excision and skin-flap closure. Choose 15935 when the operative service also includes ostectomy.
On this page
CMS RVU26D · Effective 2026-10-01
15935 Pressure ulcer surgery Medicare reimbursement rates in Michigan
Reports excision of a sacral pressure ulcer with skin-flap closure and removal of underlying bone as part of the reconstructive procedure. Compare 15935 office and facility rates across CMS payment localities in Michigan.
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 15935 in Michigan?
Michigan has 2 payment localities in this comparison. Use the service location to choose the applicable amount. These are the supported base rates for the 2 payment areas shown below, using the same CMS release.
Office / nonfacility
No supported rate
Facility setting
$1019.54–$1095.40
2 of 2 localities have a supported rate.
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.
Plastic surgery
About 15935: Sacral pressure ulcer excision with skin flap and bone removal
Reports excision of a sacral pressure ulcer with skin-flap closure and removal of underlying bone as part of the reconstructive procedure.
This operation treats a pressure ulcer over the sacrum by removing the ulcerated tissue, excising underlying bone, and closing the defect with a skin flap. Plastic and reconstructive surgeons commonly perform it in an operating room or surgical facility for wounds requiring operative reconstruction. The documented work must support the sacral site, flap closure, and bone removal; a skin flap without ostectomy or primary suture closure represents a different service in this code family.
Select the code based on the operative technique and anatomy, not simply the ulcer’s size or severity. The operative report should identify the ulcer site, excision, flap used for closure, and ostectomy. This major surgery has a 90-day global period, including the day-before preoperative visit and 90 days of related postoperative care. When other procedures are performed in the same session, the highest-valued procedure is paid in full and other procedures are subject to the standard 50% multiple-procedure reduction. Assistant-at-surgery services may be paid; co-surgeon payment requires supporting documentation, and team surgery is not permitted.
CMS billing rules for 15935
- 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 RVU15.39 · 49%
- Practice expense (office) RVU13.04 · 42%
- Malpractice RVU2.86 · 9%
35
Medicare services in 2024 · #5560 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.
15935 compared with similar codes
Office rates for Michigan, from the same CMS release.
No office rate
Both include sacral ulcer excision and ostectomy. Use 15933 for primary suture closure; use 15935 when closure uses a skin flap.
No office rate
This sacral code involves muscle-flap preparation and ostectomy. Code 15935 describes closure with a skin flap.
No office rate
This related procedure is for an ischial pressure ulcer with skin-flap closure and ostectomy; 15935 is for the sacral site.
Compare 15935 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.
2 of 2 payment localities
Detroit →
Office / nonfacility
Unavailable
Facility
$1095.40
Rest Of Michigan →
Office / nonfacility
Unavailable
Facility
$1019.54
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15935 billing questions
How does this differ from code 15934?
Code 15935 includes removal of underlying bone as well as skin-flap closure. Code 15934 describes sacral ulcer excision with skin-flap closure without that ostectomy.
When would code 15933 be more appropriate?
Use 15933 when the sacral pressure ulcer is excised, bone is removed, and the defect is closed with primary suture rather than a skin flap.
Is related postoperative care separately reported during the global period?
The 90-day global period includes related postoperative care, as well as the day-before preoperative visit. The global period begins with this major surgery.
Can an assistant surgeon be reported?
Assistant-at-surgery services may be paid. Co-surgeon payment requires supporting documentation, and team surgery is not permitted.
Should modifier 50 be used for a sacral ulcer on both sides?
No. Bilateral adjustment does not apply to this code, and the descriptor and sacral anatomy make modifier 50 inappropriate.
How are other procedures in the same session paid?
The highest-valued procedure is paid in full, and other procedures performed in that session are subject to the standard multiple-procedure reduction.
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.
1,59515931,,Exc sacral pr ulc prim sutr,A,,9.82,7.93,NA,7.93,,2.41,20.16,20.16,0,090,0.10,0.71,0.19,2,0,1,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
1,59615933,,Exc sac pr ulc prim str ostc,A,,11.48,10.51,NA,10.51,,2.65,24.64,24.64,0,090,0.10,0.71,0.19,2,0,0,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
1,59715934,,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