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See a sample rate comparisonCPT 15937 Fee Schedule
Last Verified: October 2026
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.
Surgical Repair Of Bed Sore, 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 A Flap Made Of Muscle Tissue From Near The Wound.
| 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 |
| Medicaid Fee Schedule | View Medicaid rates for 15937 |
National average reimbursement for CPT 15937 by major payers:
$1,251.84
$1,344.85
$1,311.29
$1,655.37
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CPT 15937
5 of 25 sample ratesHigher to lower in this preview
The Endoscopy Center At St. Francis, LLC
The Endoscopy Center At St Francis LLC
$3,787.00Published rateShoreline Surgery Center LLP, Christus Spohn-Surgicare Of Corpus Christi
$1,258.00Published rateWest Michigan Surgical Center, LLC
West Michigan Surgical Center, L
$590.00Published rateCarolina Interventional Pain Institute, LLC, Carolina Interventional Pain Institute, LLC
Carolina Interventional Pain Institute LLC
$543.00Published rateGurley Surgery Center, The Gyn Center
Gurley Surgery Center
$363.00Published rate
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See a sample payer proposalCPT 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 | 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. |
| 15935-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. |
| 15936-CPT | High | Surgical Repair Of Bed Sore, 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 A Flap Made Of Muscle Tissue From Near The Wound. |
| 15937-CPT | High | Surgical Repair Of Bed Sore, 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 A Flap Made Of Muscle Tissue From Near The Wound. |
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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