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CPT 15920 Fee Schedule

Last Verified: March 2026

Healthcare providers use this code to document and receive reimbursement for visits that address moderate-level medical decision-making, often including multiple diagnoses or prescription management.

Exc Coccy Ulcer Primary Suture
Key FactDetail
Service Type

Surgery

Surgical Procedures on the Integumentary System

Common Place of Service

21 - Inpatient Hospital

11 - Office

22 - On Campus Outpatient Hospital

Common Modifiers

None

59 - Distinct Procedural Service

51 - Multiple procedures

Complexity LevelModerate
Medicare Fee ScheduleView Medicare rates for 15920

National average reimbursement for CPT 15920 by major payers:

bcbs

$740.97

uhc

$788.99

aetna

$786.24

cigna

$1,011.09

Preview provider-level rates for...
For billing codeCPT 15920
PayerCodeRateNPITax IDStateSpecialty

Select a payer to view fee schedule data

Choose a payer from the options above to see rates for CPT 15920

United
15920$2307.001245287697 - EAGLE HIGHLANDS SURGERY CENTER LLC, EAGLE HIGHLANDS SURGERY CENTER352072586INAmbulatory Surgical Clinic/Center (261QA1903X)
United
15920$721.001730382789 - ENDOSCOPY CENTER260317060 - (NC) ENDOSCOPY CENTERNCAmbulatory Surgical Clinic/Center (261QA1903X)
United
15920$2218.001184009326 - AMBULATORY CENTER FOR ENDOSCOPY, LLC, HUDSON BERGEN ENDO-SURGICAL CENTER200064962NJAmbulatory Surgical Clinic/Center (261QA1903X)
United
15920$600.001811028293 - IEC SURGICAL CENTERS LLC, PHYSICIANS SURGERY CENTER204233454 - (MO) IEC SURGICAL CENTERS LLCMOAmbulatory Surgical Clinic/Center (261QA1903X)
United
15920$606.001497314181 - OPHTHALMOLOGY SURGERY CENTER OF ILLINOIS, LLC832118109 - (IL) OPHTHALMOLOGY SURGERY CENTER OF ILLINOIS LLCILAmbulatory Surgical Clinic/Center (261QA1903X)
United
15920$703.001396738936 - WARREN GASTRO ENDOSCOPY CTR INC341850936 - (OH) WARREN GASTRO ENDOSCOPY CTR INCPAAmbulatory Surgical Clinic/Center (261QA1903X)
United
15920$1558.001902204654 - DENVER SURGICENTER, LLC472340660COAmbulatory Surgical Clinic/Center (261QA1903X)
United
15920$493.191508238916 - ANDREA INFANTINO350593390 - DEACONESS HOSPITAL INCTNCertified Registered Nurse Anesthetist (367500000X)
United
15920$350.001043205040 - ST LUKES SURGICAL CENTER INC592407224 - (FL) ST LUKES SURGICAL CENTER INCFLAmbulatory Surgical Clinic/Center (261QA1903X)
United
15920$592.001922597517 - WGUASC, LLC824397113 - (GA) WGUASC LLCGAAmbulatory Surgical Clinic/Center (261QA1903X)
United
15920$717.001710151063 - HENDI AMBULATORY SURGERY CENTER, PC262238944 - (MD) HENDI AMBULATORY SURGERY CENTER PCMDAmbulatory Surgical Clinic/Center (261QA1903X)
United
15920$2989.001700057254 - NORTH STATE SURGERY CENTERS, LP, MERCY SURGERY CENTER300197423CAAmbulatory Surgical Clinic/Center (261QA1903X)
United
15920$611.001871052712 - KURESMART PAIN MANAGEMENT SURGERY CENTER-COLUMBIA LLC, CLEARWAY SURGERY CENTER OF COLUMBIA834028893 - (MD) KURESMART PAIN MANAGEMENT SURGERY CENTERCOLUMBIA LLCMDAmbulatory Surgical Clinic/Center (261QA1903X)
United
15920$497.001295847317 - DIGESTIVE HEALTH & ENDOSCOPY CENTER LLC204370189OHAmbulatory Surgical Clinic/Center (261QA1903X)
United
15920$2355.001699702050 - VIRGINIA MASON MEDICAL CENTER, VIRGINIA MASON BELLEVUE ASC910565539 - (WA) VIRGINIA MASON MEDICAL CENTERWAAmbulatory Surgical Clinic/Center (261QA1903X)
United
99202$100.0012345678901234567890CACardiologist
United
99202$100.0012345678901234567890CACardiologist
United
99202$100.0012345678901234567890CACardiologist
United
99202$100.0012345678901234567890CACardiologist
United
99202$100.0012345678901234567890CACardiologist
United
99202$100.0012345678901234567890CACardiologist
United
99202$100.0012345678901234567890CACardiologist
United
99202$100.0012345678901234567890CACardiologist
United
99202$100.0012345678901234567890CACardiologist
United
99202$100.0012345678901234567890CACardiologist

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CPT 15920 vs. Other Surgical Procedures on the Integumentary System Codes

The CPT 15920 code is part of the Surgery services used for Surgical Procedures on the Integumentary System. It represents a moderate-complexity encounter and is one of several codes that vary based on time spent, level of medical decision-making, and documentation requirements.

The CPT 15920 code involves more provider time and moderate medical decision-making, unlike lower-level codes that require less time and simpler assessments. It typically includes multiple diagnoses, medication management, or test interpretation, leading to higher reimbursement and more detailed documentation requirements.

CodeComplexityDescription
15920-CPTModerateExc Coccy Ulcer Primary Suture
15922-CPTModerateExc Decubit Ulc Coccyx W Flap Clos
15931-CPTModerateExc Sacral Ulcer Primary Suture
15933-CPTHighExc Decubit Ulc Sacral W Ostectomy

What is a fee schedule?

A fee schedule is a list of fixed prices that healthcare providers charge for specific services, including CPT 15920. These prices vary depending on payer type (Medicare, Medicaid, private insurance), geographic location, and provider contracts.

Understanding the 15920 fee schedule helps patients estimate costs and providers optimize billing for accurate reimbursements.

Factors that affect fee schedules


Medicare & Medicaid Rates

Government-set reimbursement amounts


Private Insurance Rates

Negotiated rates between providers and insurance companies


Geographic Location

Costs may be higher in urban areas.


Provider Type

Hospital providers may have different rates than private practice.

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