CPT 15933Surgery

Exc sac pr ulc prim str ostc

CPT code 15933 covers the surgical removal of a pressure ulcer (bedsore) over the sacrum (tailbone area) with primary closure, meaning the surgeon closes the wound directly after removing damaged tissue.

Showing rates for

National Average

Base Medicare rate

$856.21

This calculator gives a typical-case estimate using standard Medicare modifier rules. Actual payment depends on payer policies, documentation, code-specific CMS status indicators, and locality. Verify before billing.

RVU breakdown

Work RVU

11.77

PE RVU (NF)

12.08

MP RVU

2.62

Total RVU

26.47

Conversion factor: 32.3465 · Source: CMS MPFS RVU25A · Confidence: High

NCCI bundling edits

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Billing tips

Document the specific depth and stage of pressure ulcer (Stage III or IV) with measurements of length, width, and depth in operative note
Impact: Prevents $856.21 denial; ulcer staging documentation is audited in 40% of pressure ulcer excision claims
Clearly document ostectomy performance with description of bone removal (amount, technique, specimens sent to pathology)
Impact: Differentiates 15933 from lower-paying codes without ostectomy (15931 pays $614.84, difference of $241.37)
Use modifier 22 with detailed operative note when removing >50 grams of bone or operative time exceeds 90 minutes
Impact: Can increase payment by $171-$428 when documentation supports unusual complexity or extended time
Separately bill for any flap or graft procedures if wound cannot be closed primarily and requires advancement flap
Impact: If primary closure fails and flap is needed, bill appropriate flap code (15734-15738) instead, which reimburses $1,200-$2,400
Verify patient has failed conservative wound care for minimum 30 days with documented treatment attempts before surgery
Impact: Medical necessity documentation prevents denials; include wound care notes, measurements, and failed treatment modalities
Bill facility vs non-facility setting correctly; verify place of service code matches actual location
Impact: Both rates are $856.21 for this code, but incorrect POS codes trigger audits and potential recoupment

Common denials

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Frequently asked questions

What is the Medicare reimbursement rate for CPT code 15933 in 2025?

The 2025 Medicare national average reimbursement for CPT 15933 is $856.21 for both facility and non-facility settings, based on 26.47 total RVUs and the 2025 conversion factor of 32.3465.

What is the difference between CPT 15933 and 15931?

CPT 15933 includes ostectomy (removal of underlying bone from the sacrum) with primary closure, while 15931 is excision of a sacral pressure ulcer without bone removal. Code 15933 reimburses $856.21 compared to 15931's lower rate due to the additional surgical complexity of bone removal.

Can CPT 15933 be billed with a skin graft or flap procedure?

No, CPT 15933 specifically describes primary closure (direct suturing of wound edges). If a flap or graft is required for closure, you should instead bill the appropriate flap code (15734-15738) or graft code, not 15933. Primary closure means no additional tissue transfer is needed.

What documentation is required to bill CPT 15933 without denials?

Required documentation includes pressure ulcer stage (III or IV) with measurements, specific documentation of ostectomy (bone removal with amount and technique), primary closure description, pathology reports confirming bone specimens, and evidence of failed conservative treatment for at least 30 days prior to surgery.

How many RVUs is CPT code 15933 worth in 2025?

CPT 15933 has 26.47 total RVUs in 2025, consisting of 11.77 work RVUs, 12.08 practice expense RVUs, and 2.62 malpractice RVUs, making it a high-value surgical procedure code.

What pressure ulcer stage is required to bill CPT 15933?

CPT 15933 is typically appropriate for Stage III or Stage IV pressure ulcers with bone involvement over the sacrum. The ostectomy component indicates bone damage or infection, which occurs in deep Stage IV ulcers or complicated Stage III ulcers with osteomyelitis.

Who can perform and bill CPT code 15933?

CPT 15933 must be performed and billed by a licensed physician (MD/DO) with surgical privileges, typically a plastic surgeon, general surgeon, or orthopedic surgeon with wound care expertise. Mid-level providers cannot bill this code as the primary surgeon but may assist.