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CPT 15936 Fee Schedule

Last Verified: December 2025

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

Exc Sacral Ulcer W/Muscle Flap
Key FactDetail
Service Type

Surgery

Surgical Procedures on the Integumentary System

Common Place of Service

21 - Inpatient Hospital

22 - On Campus Outpatient Hospital

99 - Other POS

Common Modifiers

None

58 - Staged or related procedure during postoperative period

59 - Distinct Procedural Service

Complexity LevelHigh

National average reimbursement for CPT 15936 by major payers:

bcbs

$1,035.93

uhc

$1,158.22

aetna

$1,111.87

cigna

$1,457.82

Preview provider-level rates for...
For billing codeCPT 15936
PayerCodeRateNPITax IDStateSpecialty

Select a payer to view fee schedule data

Choose a payer from the options above to see rates for CPT 15936

United
15936$1367.001346289428 - PROLIANCE SURGEONS, INC., P.S., PROLIANCE SURGEONS SEATTLE ORTHOPEDIC CENTER-ASC911606533 - (WA) PROLIANCE SURGEONS, INC., P.S.WAAmbulatory Surgical Clinic/Center (261QA1903X)
United
15936$1039.001104933696 - WEST LAKES SURGERY CENTER LLC205345295 - (IA) WEST LAKES SURGERY CENTER, LLCIAAmbulatory Surgical Clinic/Center (261QA1903X)
United
15936$829.001922093293 - LEWIS & CLARK ORTHOPAEDIC INSTITUTE LLC352210163 - LEWIS & CLARK ORTHOPAEDIC, LLC 401(K) PLANIDAmbulatory Surgical Clinic/Center (261QA1903X)
United
15936$1438.001942230024 - LUTHERVILLE ENDOSCOPY CENTER LLC823193901MDAmbulatory Surgical Clinic/Center (261QA1903X)
United
15936$3787.001326046822 - SOUTH EMERSON SURGERY CENTER, LLC352087260 - (IN) SOUTH EMERSON SURGERY CENTER, LLCINAmbulatory Surgical Clinic/Center (261QA1903X)
United
15936$538.001013048461 - GASTROENTEROLOGY DIAGNOSTIC CENTER MEDICAL GROUP, A PROFESSIONAL, GASTROENTEROLOGY DIAGNOSTIC CENTER953921090 - (CA) GASTROENTEROLOGY DIAGNOSTIC CENTER MEDICAL GROUP A PROFESSIONALCAAmbulatory Surgical Clinic/Center (261QA1903X)
United
15936$5532.001396700159 - DOCTORS SAME DAY SURGERY CENTER, LTD621614361 - (FL) DOCTORS SAME DAY SURGERY CENTER LTDFLAmbulatory Surgical Clinic/Center (261QA1903X)
United
15936$434.001477876696 - KEY BISCAYNE SURGERY CENTER LLC271725488 - (FL) KEY BISCAYNE SURGERY CENTER LLCFLAmbulatory Surgical Clinic/Center (261QA1903X)
United
15936$433.001275501512 - NORTHWEST KANSAS SURGERY CENTER, LLC481209668 - (KS) NORTHWEST KANSAS SURGERY CENTER LLCKSAmbulatory Surgical Clinic/Center (261QA1903X)
United
15936$1809.001417534207 - MEDICAL CITY SURGERY CENTER OF FRISCO, LLC822432064 - (TX) MEDICAL CITY SURGERY CENTER OF FRISCO LLCTXAmbulatory Surgical Clinic/Center (261QA1903X)
United
15936$400.001346693124 - VILLAGES ENDOSCOPY CENTER LLC813250494FLAmbulatory Surgical Clinic/Center (261QA1903X)
United
15936$1352.001720407273 - BRONX SC LLC, EMPIRE STATE AMBULATORY SURGERY CENTER273045919 - (NY) BRONX SC LLC DBA EMPIRE STATE AMBULATORY SURGERY CENTERNYAmbulatory Surgical Clinic/Center (261QA1903X)
United
15936$1258.001063099190 - ASCENSION SAINT THOMAS LEBANON SURGERY CENTER LLC, LEBANON SURGERY CENTER862679471TNAmbulatory Surgical Clinic/Center (261QA1903X)
United
15936$1000.001316082365 - WEST WILSHIRE MEDICAL SURGICAL CENTER INC.954421811 - (CA) WEST WILSHIRE MEDICAL SURGICAL CCAAmbulatory Surgical Clinic/Center (261QA1903X)
United
15936$1081.001700842507 - ARCADIA OUTPATIENT SURGERY CENTER LP752285078 - (CA) ARCADIA OUTPATIENT SURGERY CENTER LPCAAmbulatory 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 15936 vs. Other Surgical Procedures on the Integumentary System Codes

The CPT 15936 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 15936 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
15931-CPTModerateExc Sacral Ulcer Primary Suture
15933-CPTHighExc Decubit Ulc Sacral W Ostectomy
15934-CPTHighExcision, Sacral Pressure Ulcer, With Local Or Regional Skin Flap Closure (Eg, Advancement, Rotation, Rhomboid, Bipe
15936-CPTHighExc Sacral Ulcer W/Muscle Flap

What is a fee schedule?

A fee schedule is a list of fixed prices that healthcare providers charge for specific services, including CPT 15936. These prices vary depending on payer type (Medicare, Medicaid, private insurance), geographic location, and provider contracts.

Understanding the 15936 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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