Billing code 15937: Pressure ulcer surgeryMedicare rate & RVUs in Texas
Reports excision of a sacral pressure ulcer with sacral bone removal and preparation of a muscle or myocutaneous flap for reconstruction.
CMS doesn’t publish an office rate for 15937 in Texas.
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 15937 covers
A surgeon excises a pressure ulcer over the sacrum, removes underlying sacral bone, and prepares a muscle or myocutaneous flap for closure and reconstruction. The service is typically performed in a facility by a surgeon, often as part of reconstructive care for a deep or persistent sacral wound. The operative report should establish the sacral site, ulcer excision, ostectomy, and muscle or myocutaneous flap work; routine wound debridement alone does not describe this service.
Report this code when the documented operation includes all of those elements. The 90-day global period includes the day-before preoperative visit and 90 days of related postoperative care. When multiple procedures are performed in the same 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 are paid only with 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.
Where 15937 pays more and less in Texas
The same RVUs, adjusted for each area’s costs. Open a locality for its calculation, history and nearby areas.
8 of 8 payment localities
| Payment locality | Office | Facility |
|---|---|---|
| Austin | Unavailable | $929.63 |
| Beaumont | Unavailable | $882.87 |
| Brazoria | Unavailable | $900.46 |
| Dallas | Unavailable | $909.72 |
| Fort Worth | Unavailable | $907.54 |
| Galveston | Unavailable | $905.49 |
| Houston | Unavailable | $955.28 |
| Rest Of Texas | Unavailable | $893.59 |
How the 15937 rate is calculated
Each of 15937’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 · 15937
RVUs × geographic indexes × conversion factor
Swap in your local Medicare rate.
Work 14.76Practice expense 10.05Malpractice 2.72
All indexes start at 1.000 (the national rate). Enter a ZIP or drag a slider.
Payment rules and modifiers for 15937
15937 has a 90-day global period: related visits in that window are included in the surgery payment.
CMS payment indicators · 15937
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) | 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 · 15937
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
15937 without 51 · national facility
$919.53
Pressure ulcer surgery
15937-51 · Second procedure: 50%
$459.77
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%).
15937 compared with similar codes
Compare codes
15937 vs 15936 vs 15935 vs 15933 vs 15945: national Medicare rates
Swap in your local Medicare rate.
How to choose
- 15936Pressure ulcer excision
- Use 15937 when sacral bone is also removed. The related 15936 code describes the muscle or myocutaneous flap approach without ostectomy.
- 15935Pressure ulcer surgery
- Both include sacral ostectomy, but 15935 describes skin-flap closure rather than preparation of a muscle or myocutaneous flap.
- 15933Pressure ulcer excision
- Both include sacral ostectomy, but 15933 is for primary suture closure rather than muscle or myocutaneous flap preparation.
- 15945Skin flap closure
- This code is for an ischial pressure ulcer treated with a skin flap and ostectomy; 15937 is for the sacral site and muscle or myocutaneous flap preparation.
15937 billing questions
How does this differ from 15936?
Both involve sacral ulcer excision and muscle or myocutaneous flap preparation. Report 15937 when the operation also includes ostectomy; 15936 is the related code without ostectomy.
Can the flap work be billed separately?
The code describes the ulcer excision with muscle or myocutaneous flap preparation. Review the operative report before considering separate reporting for other services performed during the same session.
Should modifier 50 be used for ulcers on both sides?
No. The descriptor and anatomy make bilateral adjustment inappropriate for this code.
Can an assistant surgeon be paid for this operation?
Medicare payment for an assistant at surgery is barred for this code. Co-surgeon payment is limited to cases with supporting documentation.
What documentation supports reporting 15937?
The operative report should identify the sacral ulcer, excision of the ulcer, removal of sacral bone, and preparation of a muscle or myocutaneous flap.
How are other procedures in the same session paid?
Under the standard multiple-procedure reduction, the highest-valued procedure is paid in full and other procedures are paid at 50%.
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
Fee sheets
Put 15937 and the rest of your codes on one sheet
Build a fee sheet from your own code list at your locality, put your payer contracts beside Medicare, and see what changed each quarter.
Build my fee sheetOr price your code list free →