Billing code 15935: Pressure ulcer surgeryMedicare rate & RVUs in Ohio
Reports excision of a sacral pressure ulcer with skin-flap closure and removal of underlying bone as part of the reconstructive procedure.
CMS doesn’t publish an office rate for 15935 in Ohio.
Medicare allowed amount for participating (non-QP) physicians, before deductible, coinsurance and claim adjustments. Not a patient’s bill or a hospital charge.
On this page 9 sections
What 15935 covers
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.
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 in Ohio
| Payment locality | Office | Facility |
|---|---|---|
| Ohio | Unavailable | $1,007.99 |
How the 15935 rate is calculated
Each of 15935’s three RVUs is multiplied by a geographic index (GPCI) for the payment locality, added up, and multiplied by the conversion factor. Drag the indexes or enter a ZIP to see what moves the rate.
How the rate is built · 15935
RVUs × geographic indexes × conversion factor
Work15.39
15.39 RVUs× 1.000 GPCI
Practice expense13.04
13.04 RVUs× 1.000 GPCI
Malpractice2.86
2.86 RVUs× 1.000 GPCI
Adjusted RVUs
31.2900
Conversion factor
$33.4009
Medicare rate
$1,045.11
Every GPCI starts at 1.000, the national rate. Enter a ZIP or drag a slider.
Payment rules and modifiers for 15935
15935 has a 90-day global period: related visits in that window are included in the surgery payment.
CMS payment indicators · 15935
Pressure ulcer surgery
| Rule | CMS value | What it means |
|---|---|---|
| Global period | 090 | Major surgery: the day before, the day of, and 90 days after are included. |
| Multiple procedures | 2 | Standard reduction: highest-valued procedure at 100%, others at 50%. |
| Bilateral (modifier 50) | 0 | The 150% bilateral adjustment doesn’t apply. |
| Assistant at surgery (80/81/82/AS) | 2 | Paid. |
| Co-surgeons (62) | 1 | Permitted with supporting documentation. |
| Team surgery (66) | 0 | Not permitted. |
| Professional/technical | 0 | Physician service: no professional/technical split. |
| Split (54/55/56) | 0.10/0.71/0.19 | Share of the payment for pre-op, the procedure itself, and post-op care. |
Global surgery period · 15935
Pressure ulcer surgery
90-day global period ends
Dec 30, 2026
Covers Sep 30, 2026 through Dec 30, 2026 (92 days, including the day before surgery).
Visit on Oct 31, 2026
Day 30 of the 90-day post-op period: related follow-up care is included in the surgical payment.
Pre-op dayGlobal period
What modifiers do to the payment
Modifier 51 · payment effect
With and without the modifier
15935 without 51 · national facility
$1,045.11
Pressure ulcer surgery
15935-51 · Second procedure: 50%
$522.56
When this isn’t the highest-valued procedure in the session, Medicare pays 50% of its fee schedule amount (the highest is paid at 100%).
15935 compared with similar codes
Compare codes · National
5 codes, side by side
How to choose
- 15934Ulcer excision
- Both involve sacral ulcer excision and skin-flap closure. Choose 15935 when the operative service also includes ostectomy.
- 15933Pressure ulcer excision
- Both include sacral ulcer excision and ostectomy. Use 15933 for primary suture closure; use 15935 when closure uses a skin flap.
- 15937Pressure ulcer surgery
- This sacral code involves muscle-flap preparation and ostectomy. Code 15935 describes closure with a skin flap.
- 15945Skin flap closure
- This related procedure is for an ischial pressure ulcer with skin-flap closure and ostectomy; 15935 is for the sacral site.
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 indexes and the conversion factor. Services without a published rate are labeled, never given a made-up amount. Amounts are Medicare allowed amounts before claim adjustments: not a patient’s bill or a commercial rate.
CMS RVU26D · effective Oct 1, 2026 through the day before Jan 1, 2027
Show the CMS file lines behind this rate
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