Billing code 15922: Pressure ulcer excisionMedicare rate & RVUs in Utah
Excision of a coccygeal pressure ulcer with flap closure is reported when reconstruction uses a flap rather than direct primary suturing.
CMS doesn’t publish an office rate for 15922 in Utah.
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 15922 covers
This operation removes a pressure ulcer over the coccyx, or tailbone, and closes the resulting defect with a flap. It is typically performed by a surgeon, such as a plastic or reconstructive surgeon, for a patient with a pressure wound requiring operative excision and tissue coverage. The service is generally provided in an operating room, often in a hospital setting.
Report 15922 when the ulcer is coccygeal and closure is by flap; documentation should establish the ulcer site, excision, and flap closure. The code carries 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 procedure is paid in full and other procedures are subject to the standard 50% reduction. Modifier 50 is inappropriate. Assistant-at-surgery payment may be made; 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.
15922 in Utah
| Payment locality | Office | Facility |
|---|---|---|
| Utah | Unavailable | $704.92 |
How the 15922 rate is calculated
Each of 15922’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 · 15922
RVUs × geographic indexes × conversion factor
Swap in your local Medicare rate.
Work 10.12Practice expense 9.89Malpractice 1.88
All indexes start at 1.000 (the national rate). Enter a ZIP or drag a slider.
Payment rules and modifiers for 15922
15922 has a 90-day global period: related visits in that window are included in the surgery payment.
CMS payment indicators · 15922
Pressure ulcer excision
| 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 · 15922
Pressure ulcer excision
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
15922 without 51 · national facility
$731.15
Pressure ulcer excision
15922-51 · Second procedure: 50%
$365.58
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%).
15922 compared with similar codes
Compare codes
15922 vs 15920 vs 15934 vs 15936: national Medicare rates
Swap in your local Medicare rate.
How to choose
- 15920Pressure ulcer excision
- Both are for coccygeal pressure ulcers. Select 15922 for flap closure and 15920 for primary suture closure.
- 15934Ulcer excision
- This code describes sacral pressure ulcer excision with skin flap closure; 15922 is for the coccygeal site.
- 15936Pressure ulcer excision
- This code is for sacral ulcer excision with preparation of a muscle flap. 15922 describes coccygeal ulcer excision with flap closure.
15922 billing questions
How does 15922 differ from 15920?
Both describe excision of a coccygeal pressure ulcer. Use 15922 when the defect is closed with a flap; 15920 describes primary suture closure.
Does this code include flap closure?
Yes. The flap closure is part of the service represented by 15922; documentation should identify the flap reconstruction performed.
Which code applies to a sacral pressure ulcer?
Choose a sacral ulcer code, such as 15934 for sacral ulcer excision with skin flap closure. Code 15922 is for the coccygeal site.
Can modifier 50 be used for bilateral work?
No. CMS identifies bilateral adjustment as inappropriate for this code.
How are assistant and co-surgeon services handled?
Assistant-at-surgery payment may be made. Co-surgeon payment requires supporting documentation; team surgery is not permitted.
What happens when another procedure is performed in the same session?
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
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