CPT 15937 Fee Schedule
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.
| 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 • 51 - Multiple procedures • 58 - Staged or related procedure during postoperative period |
| Complexity Level | High |
| Medicare Fee Schedule | View Medicare rates for 15937 |
National average reimbursement for CPT 15937 by major payers:
$1,251.84
$1,344.85
$1,311.29
$1,692.84
| Payer | Code | Rate | NPI | Tax ID | State | Specialty |
|---|---|---|---|---|---|---|
Select a payer to view fee schedule data Choose a payer from the options above to see rates for CPT 15937 | ||||||
United | 15937 | $900.00 | 1275206880 - RINCON ASC, LLC | 853078316 - (AZ) RINCON ASC LLC | AZ | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 15937 | $514.00 | 1386277069 - SOUTHWEST ENDOSCOPY LLC | 261261804 | AZ | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 15937 | $920.00 | 1336375930 - JACKSON SURGERY CENTER, LLC | 204173305 - (AL) JACKSON SURGERY CENTER LLC | AL | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 15937 | $581.00 | 1124116264 - BOSTON EYE SURGERY & LASER CENTER TRUST, BOSTON EYE SURGERY & LASER CENTER | 43092292 - (MA) BOSTON EYE SURGERY & LASER CENTER TRUST | MA | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 15937 | $565.00 | 1346862869 - NSPC SURGERY CENTER OF MARYLAND LLC | 842191141 - (MD) NSPC SURGERY CENTER OF MARYLAND LLC | MD | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 15937 | $1258.00 | 1730369802 - SHORELINE SURGERY CENTER LLP, CHRISTUS SPOHN-SURGICARE OF CORPUS CHRISTI | 204911604 | TX | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 15937 | $2975.00 | 1710207998 - PROVIDENCE SURGERY CENTERS LLC, CREEKSIDE SURGICAL CENTER | 203567411 - (AK) PROVIDENCE SURGERY CENTERS LLC DBA CREEKSIDE SURGERY CENTER | AK | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 15937 | $1283.00 | 1891750998 - CHARLOTTE SURGERY CENTER, LLC, CHARLOTTE SURGERY CENTER | 561449531 - (NC) CHARLOTTE SURGERY CENTER LLC | NC | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 15937 | $566.00 | 1235187972 - NOBLE SURGERY CENTER | 43732499 - (CA) NOBLE SURGERY CENTER | CA | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 15937 | $558.00 | 1669481255 - SURGERY CENTER OF CULLMAN LLC, HEALTHSOUTH/WOODLANDS SURGERY CENTER OF CULLMAN, LLC | 203489003 - (AL) SURGERY CENTER OF CULLMAN LLC | AL | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 15937 | $3787.00 | 1578561890 - THE ENDOSCOPY CENTER AT ST. FRANCIS, LLC | 351958962 - (IN) THE ENDOSCOPY CENTER AT ST FRANCIS LLC | IN | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 15937 | $1258.00 | 1962788059 - SURGCENTER OF SILVER SPRING, LLC | 452950933 - (MD) SURGCENTER OF SILVER SPRING LLC | MD | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 15937 | $475.00 | 1497723720 - JACKSONVILLE BEACH SURGERY CENTER, LLC, JACKSONVILLE BEACH SURGERY CENTER | 621825684 - (FL) JACKSONVILLE BEACH SURGERY CENTER LLC | FL | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 15937 | $500.00 | 1821372467 - THE EYE SURGICENTER OF NEW JERSEY, LLC | 453067378 | NJ | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 15937 | $543.00 | 1629576848 - CAROLINA INTERVENTIONAL PAIN INSTITUTE, LLC, CAROLINA INTERVENTIONAL PAIN INSTITUTE, LLC | 822281290 - (SC) CAROLINA INTERVENTIONAL PAIN INSTITUTE LLC | SC | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 99202 | $100.00 | 1234567890 | 1234567890 | CA | Cardiologist |
United | 99202 | $100.00 | 1234567890 | 1234567890 | CA | Cardiologist |
United | 99202 | $100.00 | 1234567890 | 1234567890 | CA | Cardiologist |
United | 99202 | $100.00 | 1234567890 | 1234567890 | CA | Cardiologist |
United | 99202 | $100.00 | 1234567890 | 1234567890 | CA | Cardiologist |
United | 99202 | $100.00 | 1234567890 | 1234567890 | CA | Cardiologist |
United | 99202 | $100.00 | 1234567890 | 1234567890 | CA | Cardiologist |
United | 99202 | $100.00 | 1234567890 | 1234567890 | CA | Cardiologist |
United | 99202 | $100.00 | 1234567890 | 1234567890 | CA | Cardiologist |
United | 99202 | $100.00 | 1234567890 | 1234567890 | CA | Cardiologist |
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CPT 15937 vs. Other Surgical Procedures on the Integumentary System Codes
The CPT 15937 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 15937 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 |
|---|---|---|
| 15934-CPT | High | Excision, Sacral Pressure Ulcer, With Local Or Regional Skin Flap Closure (Eg, Advancement, Rotation, Rhomboid, Bipe |
| 15935-CPT | High | Excision, Sacral Pressure Ulcer, With Local Or Regional Skin Flap Closure (Eg, Advancement, Rotation, Rhomboid, Bipe |
| 15936-CPT | High | Exc Sacral Ulcer W/Muscle Flap |
| 15937-CPT | High | Exc Decub Ulc Sacral Oth Flap+Ost |
What is a fee schedule?
A fee schedule is a list of fixed prices that healthcare providers charge for specific services, including CPT 15937. These prices vary depending on payer type (Medicare, Medicaid, private insurance), geographic location, and provider contracts.
Understanding the 15937 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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