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See a sample rate comparisonCPT 15946 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 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 |
| Common Modifiers | None 79 - Unrelated procedure - postop period 58 - Staged or related procedure during postoperative period |
| Complexity Level | High |
| Medicare Fee Schedule | View Medicare rates for 15946 |
| Medicaid Fee Schedule | View Medicaid rates for 15946 |
National average reimbursement for CPT 15946 by major payers:
$2,127.25
$2,098.50
$2,054.34
$2,577.15
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CPT 15946
5 of 25 sample ratesHigher to lower in this preview
Aurora Surgery Centers, LLC
Aurora Surgery Centers LLC
$7,169.00Published rateHyde Park Surgery Center, LLC, Hyde Park Surgery Center, Lp
$2,859.00Published rateWest Shore Pain And Spine Institute, LLC
West Shore Pain And Spine Institute LLC
$1,192.00Published rateNovamed Surgery Center Of Columbus, LLC
Novamed Surgery Center Of Columbus LLC
$1,021.00Published rateStuart Cardon, Cascade Foot And Ankle PLLC
Stuart Cardon Dba Cascade Foot &
$672.00Published rate
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See a sample payer proposalCPT 15946 vs. Other Surgical Procedures on the Integumentary System Codes
The CPT 15946 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 15946 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 |
|---|---|---|
| 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. |
| 15944-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. |
| 15945-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. |
| 15946-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 15946. These prices vary depending on payer type (Medicare, Medicaid, private insurance), geographic location, and provider contracts.
Understanding the 15946 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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