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See a sample rate comparisonHealthcare 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 23 - Emergency Room 20 - Urgent Care Facility |
| Common Modifiers | None 58 - Staged or related procedure during postoperative period LT - Left side of body |
| Complexity Level | High |
| Medicare Fee Schedule | View Medicare rates for 15953 |
| Medicaid Fee Schedule | View Medicaid rates for 15953 |
National average reimbursement for CPT 15953 by major payers:

$1,320.43

$1,273.50

$1,250.20

$1,628.63
Choose a payer to see a sample of rates for CPT 15953.
Vivere Health Dallas LLC
Ascent Surgery Center LLC
The Surgery Center Howland
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Rate Benchmarking
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See a sample payer proposalCPT 15953 vs. Other Surgical Procedures on the Integumentary System Codes
The CPT 15953 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 15953 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 |
|---|---|---|
| 15950-CPT | Moderate | Surgical Repair Of Bed Sore, Surgery To Remove A Pressure Ulcer (Bed Sore) From The Knobby Hip Bone (Trochanter). A Portion Of The Bone May Be Removed As Well. The Surgical Wound Is Closed With Stitches Or A Skin Flap. |
| 15951-CPT | High | Surgical Repair Of Bed Sore, Surgery To Remove A Pressure Ulcer (Bed Sore) From The Knobby Hip Bone (Trochanter). A Portion Of The Bone May Be Removed As Well. The Surgical Wound Is Closed With Stitches Or A Skin Flap. |
| 15952-CPT | High | Surgical Repair Of Bed Sore, Surgery To Remove A Pressure Ulcer (Bed Sore) From The Knobby Hip Bone (Trochanter). A Portion Of The Bone May Be Removed As Well. The Surgical Wound Is Closed With Stitches Or A Skin Flap. |
| 15953-CPT | High | Surgical Repair Of Bed Sore, Surgery To Remove A Pressure Ulcer (Bed Sore) From The Knobby Hip Bone (Trochanter). 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 15953. These prices vary depending on payer type (Medicare, Medicaid, private insurance), geographic location, and provider contracts.
Understanding the 15953 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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