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See a sample rate comparisonCPT 15940 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.
Surgical Repair Of Bed Sore, Surgery To Remove A Pressure Ulcer Or Bed Sore From The Lower Back Hip. 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 24 - Ambulatory Surgical Center |
| Common Modifiers | None RT - Right side of body 51 - Multiple procedures |
| Complexity Level | Moderate |
| Medicare Fee Schedule | View Medicare rates for 15940 |
| Medicaid Fee Schedule | View Medicaid rates for 15940 |
National average reimbursement for CPT 15940 by major payers:
$905.51
$898.60
$890.40
$1,117.03
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CPT 15940
5 of 25 sample ratesHigher to lower in this preview
Bellaire Outpatient Surgery Center, LLP, Baylor Scott & White Surgicare - Oakmont
Bellaire Outpatient Surgery Center LLP
$3,500.00Published rateGulfshore Endoscopy Center LLC
$2,388.00Published rateChelmsford Surgery Center LLC
$1,854.00Published rateMemphis Surgery Center Ltd, Lp, Memphis Surgery Center
Memphis Surgery Center, Ltd, Lp
$1,083.00Published rateBrooklyn Endoscopy Sc, LLC, Gnyesc
Brooklyn Endoscopy Sc LLC
$432.00Published rate
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See a sample payer proposalCPT 15940 vs. Other Surgical Procedures on the Integumentary System Codes
The CPT 15940 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 15940 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. |
| 15940-CPT | Moderate | Surgical Repair Of Bed Sore, Surgery To Remove A Pressure Ulcer Or Bed Sore From The Lower Back Hip. A Portion Of The Bone May Be Removed As Well. The Surgical Wound Is Closed With Stitches Or A Skin Flap. |
| 15941-CPT | High | Surgical Repair Of Bed Sore, Surgery To Remove A Pressure Ulcer Or Bed Sore From The Lower Back Hip. 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 15940. These prices vary depending on payer type (Medicare, Medicaid, private insurance), geographic location, and provider contracts.
Understanding the 15940 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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