No office rate
Choose 15956 when the service includes preparation of a muscle or myocutaneous flap. Choose 15952 when the documented service is flap closure.
On this page
CMS RVU26D · Effective 2026-10-01
15956 Pressure ulcer excision Medicare reimbursement rates in Washington
Reports excision of a pressure ulcer over the greater trochanter when the surgeon also prepares a muscle or myocutaneous flap for reconstruction. Compare 15956 office and facility rates across CMS payment localities in Washington.
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 15956 in Washington?
Washington 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
$1093.68–$1194.61
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 15956: Trochanteric ulcer excision with flap preparation
Reports excision of a pressure ulcer over the greater trochanter when the surgeon also prepares a muscle or myocutaneous flap for reconstruction.
This service involves removing a pressure ulcer over the greater trochanter and preparing a muscle or myocutaneous flap for reconstruction. It is typically performed by a surgeon, such as a plastic or reconstructive surgeon, in an operating room for a patient with a deep, persistent pressure injury requiring operative treatment. The code identifies flap preparation as part of the ulcer excision service; it is distinct from excision followed by primary closure or a code describing flap closure.
Report the service when the operative record supports both excision at the trochanteric site and preparation of a muscle or myocutaneous flap. The code does not describe ostectomy; select a code that includes bone removal when that is performed and supported. Medicare assigns a 90-day global period, including the day-before preoperative visit and 90 days of related postoperative care. In a same-session multiple-procedure case, 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 is barred; co-surgeon payment requires supporting documentation, and team surgery is not permitted.
CMS billing rules for 15956
- 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
- Statutory restriction: assistant at surgery is not paid.
- Co-surgeons
- Co-surgeons paid only with supporting documentation.
- Team surgery
- Team surgery not permitted.
Where the value comes from
- Work RVU16.37 · 50%
- Practice expense (office) RVU12.71 · 39%
- Malpractice RVU3.65 · 11%
113
Medicare services in 2024 · #4783 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.
15956 compared with similar codes
Office rates for Washington, from the same CMS release.
No office rate
15953 describes trochanteric ulcer excision with flap closure and ostectomy. 15956 describes muscle or myocutaneous flap preparation, without the ostectomy service in its descriptor.
No office rate
15950 applies to trochanteric ulcer excision with primary suture closure. Use 15956 when the surgeon prepares a muscle or myocutaneous flap instead.
No office rate
Both describe excision with muscle-flap preparation, but 15946 is for an ischial pressure ulcer; 15956 is for a trochanteric pressure ulcer.
Compare 15956 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
Rest Of Washington →
Office / nonfacility
Unavailable
Facility
$1093.68
Seattle (King Cnty) →
Office / nonfacility
Unavailable
Facility
$1194.61
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15956 billing questions
How is this code different from 15952?
15956 describes excision with preparation of a muscle or myocutaneous flap. 15952 describes trochanteric ulcer excision with flap closure.
Does this code include ostectomy?
No. This code identifies flap preparation, not bone removal. Use a code that describes ostectomy when the operative service includes it.
Can the flap closure be separately reported?
The code describes excision with flap preparation, while 15952 describes excision with flap closure. Choose the code matching the documented service rather than reporting both for the same work.
Can modifier 50 be used for ulcers on both sides?
No. CMS identifies bilateral adjustment as inappropriate for this code. Modifier 50 should not be used.
Is an assistant surgeon payable?
No. CMS lists a statutory restriction on assistant-at-surgery payment for this code. Co-surgeon payment is limited to cases with supporting documentation.
What postoperative care is included?
The 90-day global period includes the day-before preoperative visit and 90 days of related postoperative care.
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.
1,60715951,,Exc trchntr pr ulc ostc,A,,11.29,11.28,NA,11.28,,2.09,24.66,24.66,0,090,0.10,0.71,0.19,2,0,0,1,0,9,,33.4009,09,0,99,0.00,0.00,0.00
1,60815952,,Exc trchntr pr ulc flp clsr,A,,12.00,10.72,NA,10.72,,2.22,24.94,24.94,0,090,0.10,0.71,0.19,2,0,2,1,0,9,,33.4009,09,0,99,0.00,0.00,0.00
1,60915953,,Exc trchntr pr ulc flp ostc,A,,13.23,11.79,NA,11.79,,2.47,27.49,27.49,0,090,0.10,0.71,0.19,2,0,1,1,0,9,,33.4009,09,0,99,0.00,0.00,0.00
1,61015956,,Exc trchntr pr ulc prep flap,A,,16.37,12.71,NA,12.71,,3.65,32.73,32.73,0,090,0.10,0.71,0.19,2,0,1,1,0,9,,33.4009,09,0,99,0.00,0.00,0.00
1,61115958,,Exc trchntr pr ulc prep ostc,A,,16.33,12.90,NA,12.90,,3.22,32.45,32.45,0,090,0.10,0.71,0.19,2,0,1,1,0,9,,33.4009,09,0,99,0.00,0.00,0.00
1,61215999,,Unlisted px exc pressure ulc,C,,0.00,0.00,,0.00,,0.00,0.00,0.00,0,YYY,0.00,0.00,0.00,2,0,0,1,1,9,,33.4009,09,0,99,0.00,0.00,0.00
1,61316000,,Initial treatment of burn(s),A,,0.87,1.68,,0.24,,0.15,2.70,1.26,0,000,0.00,0.00,0.00,2,0,1,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00