No office rate
Choose 15931 when the sacral ulcer defect is closed with primary suturing. Choose 15934 when the operative closure uses a skin flap.
On this page
CMS RVU26D · Effective 2026-10-01
15934 Ulcer excision Medicare reimbursement rates in Missouri
Reports surgical excision of a sacral pressure ulcer when the resulting defect is closed with a skin flap rather than primary suturing. Compare 15934 office and facility rates across CMS payment localities in Missouri.
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 15934 in Missouri?
Missouri has 3 payment localities in this comparison. Use the service location to choose the applicable amount. These are the supported base rates for the 3 payment areas shown below, using the same CMS release.
Office / nonfacility
No supported rate
Facility setting
$836.62–$871.35
3 of 3 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.
Where 15934 pays more and less in Missouri
Pressure ulcer surgery
About 15934: Sacral pressure ulcer excision with flap
Reports surgical excision of a sacral pressure ulcer when the resulting defect is closed with a skin flap rather than primary suturing.
Code 15934 represents operative removal of a sacral pressure ulcer followed by closure with a skin flap. The surgeon excises the ulcer and uses adjacent skin and soft tissue to cover the defect. Plastic or reconstructive surgeons and other surgeons may perform this procedure in an operating room when flap coverage is selected. The code distinguishes skin-flap closure from direct primary closure and from reconstruction using a prepared muscle flap; the related sacral code for skin-flap closure with ostectomy is 15935.
Select the code when the operative report supports the sacral site, ulcer excision, and skin-flap closure. Documentation should identify the closure performed and any bone resection so the appropriate related code can be selected. The 90-day global period 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 at 50%. Modifier 50 is inappropriate. An assistant at surgery is not paid, and co-surgeons and team surgery are not permitted.
CMS billing rules for 15934
- 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 not permitted.
- Team surgery
- Team surgery not permitted.
Where the value comes from
- Work RVU13.34 · 50%
- Practice expense (office) RVU10.78 · 41%
- Malpractice RVU2.48 · 9%
63
Medicare services in 2024 · #5205 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.
15934 compared with similar codes
Office rates for Missouri, from the same CMS release.
No office rate
Both describe sacral ulcer excision with skin-flap closure, but 15935 includes ostectomy. Use 15934 when the procedure does not include ostectomy.
No office rate
15936 describes preparation of a muscle flap for the sacral defect. 15934 describes closure with a skin flap.
No office rate
15922 applies to a coccygeal pressure ulcer with skin-flap closure; 15934 is for the sacral site.
Compare 15934 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.
3 of 3 payment localities
Metropolitan Kansas City →
Office / nonfacility
Unavailable
Facility
$864.59
Metropolitan St. Louis →
Office / nonfacility
Unavailable
Facility
$871.35
Rest Of Missouri →
Office / nonfacility
Unavailable
Facility
$836.62
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15934 billing questions
How does 15934 differ from 15931?
15934 is for sacral pressure-ulcer excision with skin-flap closure. 15931 describes the sacral procedure with primary suture closure.
When is 15935 a better choice?
Use 15935 when the sacral pressure-ulcer excision and skin-flap closure also include ostectomy. Code 15934 describes skin-flap closure without that bone resection.
Does 15934 include the skin-flap closure?
Yes. The procedure includes excision of the sacral pressure ulcer and closure with a skin flap; it is not a separate flap-only service.
Can modifier 50 be reported?
No. CMS identifies bilateral adjustment as inappropriate for this code.
Are assistant or co-surgeon services payable?
CMS does not pay an assistant at surgery for this code. Co-surgeons and team surgery are not permitted.
What postoperative care is included?
The 90-day global period includes the day-before preoperative visit and 90 days of related postoperative care.
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.
1,59415922,,Exc coccygl pr ulc flap clsr,A,,10.12,9.89,NA,9.89,,1.88,21.89,21.89,0,090,0.10,0.71,0.19,2,0,2,1,0,9,,33.4009,09,0,99,0.00,0.00,0.00
1,59515931,,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