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See a sample rate comparisonCPT 15931 Fee Schedule
Last Verified: October 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.
Repair Bed Sore On The Back, Surgery To Remove A Pressure Ulcer Or Bed Sore From The Base Of The Spine (Sacrum). A Portion Of The Bone May Be Removed As Well. The Surgical Wound Is Closed With Stitches Or A Skin Flap.
| Key Fact | Detail |
|---|---|
| Service Type | Surgery Surgical Procedures on the Integumentary System |
| Common Place of Service | 21 - Inpatient Hospital 22 - On Campus Outpatient Hospital |
| Common Modifiers | None 52 - Reduced Services 59 - Distinct Procedural Service |
| Complexity Level | Moderate |
| Medicare Fee Schedule | View Medicare rates for 15931 |
| Medicaid Fee Schedule | View Medicaid rates for 15931 |
National average reimbursement for CPT 15931 by major payers:
$831.97
$884.91
$871.25
$1,101.87
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CPT 15931
5 of 25 sample ratesHigher to lower in this preview
Austin Gi Surgicenter, LLC, Austin Endoscopy Center
Austin Gi Surgicenter LLC
$3,877.00Published rateBanner Surgery Center
$1,750.00Published rateQuan Do
Deaconess Hospital Inc
$1,195.48Published rateMidwest Nephrology Associates, Sc, Mna Surgery Center
Midwest Nephrology Associates, Sc
$687.00Published rateArizona Surgical Arts, Inc.
Arizona Surgical Arts Inc
$507.00Published rate
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See a sample payer proposalCPT 15931 vs. Other Surgical Procedures on the Integumentary System Codes
The CPT 15931 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 15931 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.
| Code | Complexity | Description |
|---|---|---|
| 15920-CPT | Moderate | Repair Bed Sore On Tailbone, Surgery To Remove A Pressure Ulcer Or Bed Sore From The Tailbone Including Removal Of The Bone. A Skin Flap May Be Used To Seal The Surgical Wound. |
| 15922-CPT | Moderate | Repair Bed Sore On Tailbone, Surgery To Remove A Pressure Ulcer Or Bed Sore From The Tailbone Including Removal Of The Bone. A Skin Flap May Be Used To Seal The Surgical Wound. |
| 15931-CPT | Moderate | Repair Bed Sore On The Back, Surgery To Remove A Pressure Ulcer Or Bed Sore From The Base Of The Spine (Sacrum). A Portion Of The Bone May Be Removed As Well. The Surgical Wound Is Closed With Stitches Or A Skin Flap. |
| 15933-CPT | High | Repair Bed Sore On The Back, Surgery To Remove A Pressure Ulcer Or Bed Sore From The Base Of The Spine (Sacrum). A Portion Of The Bone May Be Removed As Well. The Surgical Wound Is Closed With Stitches Or A Skin Flap. |
What is a fee schedule?
A fee schedule is a list of fixed prices that healthcare providers charge for specific services, including CPT 15931. These prices vary depending on payer type (Medicare, Medicaid, private insurance), geographic location, and provider contracts.
Understanding the 15931 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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