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 |
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 | $788.00 | 1013468586 - LAKEWAY AMBULATORY SURGERY CENTER, LLC, LAKEWAY SURGERY CENTER | 383992761 - (TX) LAKEWAY AMBULATORY SURGERY CENTER LLC | TX | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 15937 | $589.00 | 1437623626 - PRIME SURGICAL SUITES, LLC, SCSV, LLC | 463556921 - (NC) PRIME SURGICAL SUITES LLC | NC | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 15937 | $764.00 | 1639498579 - INTERVENTIONAL SPINE CENTER, LLC | 263161503 - (CA) INTERVENTIONAL SPINE CENTER LLC | CA | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 15937 | $460.00 | 1720833163 - MIDWEST EYE CENTER | 363010536 - (IL) MIDWEST EYE CENTER | IL | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 15937 | $396.00 | 1023055001 - ZION AMBULATORY CENTER LLC | 203243084 - (MD) ZION AMBULATORY CENTER LLC | MD | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 15937 | $564.00 | 1548374267 - DALLAS SURGI CENTER, INC. | 752199927 - (TX) DALLAS SURGI CENTER INC | TX | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 15937 | $2392.00 | 1407592769 - TEXAS HEALTH SURGERY CENTER WILLOW PARK LLC, TEXAS HEALTH ORTHOPEDIC AND SPINE SURGERY CENTER | 841953918 - (TX) TEXAS HEALTH SURGERY CENTER WILLOW PARK LLC | TX | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 15937 | $525.00 | 1609030774 - SARASOTA PHYSICIANS SURGICAL CENTER, LLC | 432110985 - (FL) SARASOTA PHYSICIANS SURGICAL CENTER | FL | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 15937 | $1179.00 | 1790344182 - BRISTOL AMBULATORY SURGERY CENTER, LLC | 834345983 | TN | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 15937 | $799.00 | 1972911030 - SOUTHEASTERN AMBULATORY SURGERY CENTER, LLC, THE SURGERY CENTER AT SOUTHEASTERN HEALTH PARK | 452413077 - (NC) SOUTHEASTERN AMBULATORY SURGERY CENTER, LLC | NC | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 15937 | $1375.00 | 1619971082 - KU MEDWEST AMBULATORY SURGERY CENTER, LLC | 20664568 - (KS) KU MEDWEST AMBULATORY SURGERY CENTER LLC | KS | 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 | $1258.00 | 1962788059 - SURGCENTER OF SILVER SPRING, LLC | 452950933 - (MD) SURGCENTER OF SILVER SPRING LLC | MD | 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 | 15937 | $2880.00 | 1457379158 - HUDSON CROSSING SURGERY CENTER, LLC, HUDSON CROSSING SURGERY CENTER | 364533553 - (NJ) HUDSON CROSSING SURGICAL CENTER | NJ | 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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