Billing code 15940: Pressure ulcer surgeryMedicare rate & RVUs in Oregon
Excision of an ischial pressure ulcer with direct suture closure is reported when the wound can be closed primarily without flap reconstruction.
CMS doesn’t publish an office rate for 15940 in Oregon.
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 15940 covers
This operation removes a pressure ulcer over the ischial region and closes the resulting wound directly with sutures. It is selected when the surgeon can bring the wound edges together without using a skin or muscle flap. Surgeons commonly perform it in an operating room for patients with chronic pressure injuries, including people with limited mobility or paraplegia.
Report 15940 when the operative documentation identifies the ischial site, excision of the ulcer, and primary suture closure. The choice changes when the surgeon performs an ostectomy or uses flap reconstruction. The code has a 90-day global period, including 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 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 and team surgery are 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.
Where 15940 pays more and less in Oregon
| Payment locality | Office | Facility |
|---|---|---|
| Portland | Unavailable | $678.69 |
| Rest Of Oregon | Unavailable | $640.80 |
How the 15940 rate is calculated
Each of 15940’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 · 15940
RVUs × geographic indexes × conversion factor
Work9.95
9.95 RVUs× 1.000 GPCI
Practice expense7.67
7.67 RVUs× 1.000 GPCI
Malpractice2.27
2.27 RVUs× 1.000 GPCI
Adjusted RVUs
19.8900
Conversion factor
$33.4009
Medicare rate
$664.34
Every GPCI starts at 1.000, the national rate. Enter a ZIP or drag a slider.
Payment rules and modifiers for 15940
15940 has a 90-day global period: related visits in that window are included in the surgery payment.
CMS payment indicators · 15940
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) | 1 | Not paid (statutory restriction). |
| Co-surgeons (62) | 0 | Not permitted. |
| 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 · 15940
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
15940 without 51 · national facility
$664.34
Pressure ulcer surgery
15940-51 · Second procedure: 50%
$332.17
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%).
15940 compared with similar codes
Compare codes · National
4 codes, side by side
How to choose
- 15941Pressure ulcer excision
- Both address an ischial pressure ulcer, but 15941 includes ostectomy. Use 15940 when the documented procedure is excision with primary suture closure without ostectomy.
- 15944Pressure ulcer excision
- 15944 involves skin flap closure. Choose 15940 when the wound is closed directly by bringing the edges together with sutures.
- 15920Pressure ulcer excision
- 15920 is for a coccygeal pressure ulcer with primary closure; 15940 is for the ischial site.
15940 billing questions
When should 15940 be chosen over an ischial flap-closure code?
Use 15940 when the excised ischial ulcer is closed directly with sutures. A skin or muscle flap procedure belongs to the corresponding flap-closure code.
How does 15940 differ from 15941?
15940 describes primary suture closure. 15941 is the related ischial procedure that includes ostectomy.
Can modifier 50 be used for ulcers on both sides?
No. Modifier 50 is inappropriate for this code under the CMS bilateral rule. The documentation should identify the treated ischial site or sites.
Is postoperative care separately reported during the global period?
The day-before preoperative visit and 90 days of related postoperative care are included in the 90-day global period.
Can an assistant surgeon or co-surgeon be reported?
Medicare does not pay an assistant at surgery for this code. 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 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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