No office rate
Both address coccygeal pressure ulcers, but 15920 is for direct suture closure; 15922 is for flap closure.
On this page
CMS RVU26D · Effective 2026-10-01
15920 Pressure ulcer excision Medicare reimbursement rates in New Jersey
Reports surgical removal of a pressure ulcer at the coccyx when the resulting wound is closed directly with sutures rather than a flap. Compare 15920 office and facility rates across CMS payment localities in New Jersey.
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 15920 in New Jersey?
New Jersey 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
$672.40–$695.98
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.
Pressure ulcer surgery
About 15920: Coccygeal pressure ulcer excision with primary closure
Reports surgical removal of a pressure ulcer at the coccyx when the resulting wound is closed directly with sutures rather than a flap.
This operation removes a pressure ulcer centered over the coccyx and closes the wound directly with sutures. It is typically performed by a surgeon, such as a plastic or general surgeon, in an operating room for a patient whose ulcer requires operative excision and closure. The defining features are the coccygeal site and direct closure; a flap-based repair or an ulcer at another bony prominence calls for a different code.
Report the service when the operative record identifies the ulcer’s coccygeal location, excision performed, and primary closure. The closure is part of this service, not a separate flap repair. Medicare assigns 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 is paid in full and the others at 50%. Modifier 50 is not appropriate for this anatomy. Assistant-at-surgery payment requires documented medical necessity; co-surgeons and team surgery are not permitted.
CMS billing rules for 15920
- 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 is paid only with documentation of medical necessity.
- Co-surgeons
- Co-surgeons not permitted.
- Team surgery
- Team surgery not permitted.
Where the value comes from
- Work RVU8.08 · 43%
- Practice expense (office) RVU8.57 · 46%
- Malpractice RVU2.16 · 11%
57
Medicare services in 2024 · #5270 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.
15920 compared with similar codes
Office rates for New Jersey, from the same CMS release.
No office rate
This code is for a coccygeal ulcer. Code 15931 is for a sacral ulcer closed directly.
No office rate
Code 15933 addresses a sacral ulcer with ostectomy and direct closure; 15920 identifies the coccygeal site and does not describe ostectomy.
No office rate
Use 15940 for an ulcer at the ischial region closed directly, rather than an ulcer centered over the coccyx.
Compare 15920 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
Northern Nj →
Office / nonfacility
Unavailable
Facility
$695.98
Rest Of New Jersey →
Office / nonfacility
Unavailable
Facility
$672.40
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15920 billing questions
How is this code distinguished from 15922?
Use 15920 when the coccygeal wound is closed directly with sutures. Code 15922 describes a flap-based closure at the coccygeal site.
Can the closure be billed separately?
No. Direct suture closure is included in this service; a separate flap repair is not the closure method described here.
What documentation supports reporting this code?
The operative report should identify the ulcer as coccygeal, describe its excision, and document direct suture closure.
Should modifier 50 be reported?
No. The anatomy and descriptor make modifier 50 inappropriate for this service.
How does the 90-day global period affect postoperative billing?
The day-before preoperative visit and 90 days of related postoperative care are included in the global period.
When may an assistant-at-surgery be paid?
Assistant-at-surgery payment is available only when medical necessity is documented. Co-surgeons and team surgery are 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.
1,59015877,,Suction lipectomy trunk,R,,0.00,0.00,,0.00,,0.00,0.00,0.00,0,000,0.00,0.00,0.00,2,0,0,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
1,59115878,,Suction lipectomy upr extrem,R,,0.00,0.00,,0.00,,0.00,0.00,0.00,0,000,0.00,0.00,0.00,2,1,0,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
1,59215879,,Suction lipectomy lwr extrem,R,,0.00,0.00,,0.00,,0.00,0.00,0.00,0,000,0.00,0.00,0.00,2,1,0,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
1,59315920,,Exc coccygl pr ulc prim sutr,A,,8.08,8.57,NA,8.57,,2.16,18.81,18.81,0,090,0.10,0.71,0.19,2,0,0,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
1,59415922,,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