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CPT 15920: Sacrococcygeal Pressure Sore Debridement with Bone Excision

CPT code 15920 describes surgical debridement of a sacrococcygeal pressure sore with excision of infected underlying bone and primary wound closure. This procedure addresses advanced pressure ulcers with osteomyelitic involvement at or near the tailbone, requiring operative removal of necrotic soft tissue and bone followed by suturing to achieve wound closure. Nationally, this code represents an important sick-care intervention for patients with severe decubitus ulcers, with implications for surgical utilization, hospital resource use, and postoperative wound care pathways.

Key payers considered include Aetna, Blue Cross Blue Shield, Cigna Health, UnitedHealthcare, and Medicare. Readers will find a clinical and billing-focused overview that situates the procedure within surgical wound care, explains typical sites of service, and outlines related billing considerations. The publication presents benchmarks where available, notes relevant policy and coverage themes affecting reimbursement for complex wound procedures, and summarizes clinical context such as indications for bone excision and primary closure.

Intended audiences include hospital billing managers, surgical teams, coding professionals, and policy analysts who need a concise reference on coding and clinical context for operative management of sacrococcygeal pressure sores. Data not available in the input will be identified as such in detailed sections.

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Billing Code Overview

CPT code 15920 describes a surgical procedure in which the provider removes a pressure sore (decubitus ulcer) over the tailbone area (sacrococcygeal region) and excises a portion of underlying infected bone, then closes the wound with sutures.

Service type: Surgical debridement with excision of infected bone and primary wound closure
Typical site of service: Operating room or procedural suite in an acute care hospital or ambulatory surgical center

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CPT 15920: Sacrococcygeal Pressure Sore Debridement with Bone Excision

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Billing Code Overview

Service type: Surgical debridement with excision of infected bone and primary wound closure
Typical site of service: Operating room or procedural suite in an acute care hospital or ambulatory surgical center

Clinical & Coding Specifications

Clinical Context

A typical patient is an elderly, immobile individual with a chronic stage 4 sacral pressure ulcer complicated by underlying osteomyelitis of the coccyx. The patient presents with increased wound drainage, foul odor, local erythema, and intermittent fever. Prior conservative measures (pressure offloading, wound care, systemic antibiotics) have failed to resolve the deep infection. The surgical team (usually a general surgeon or plastic surgeon) performs sharp excision of the pressure sore, debridement of necrotic soft tissue, and sequestrectomy or partial removal of the infected coccygeal bone, followed by layered closure or primary closure of the wound when feasible. Typical workflow includes preoperative wound assessment and imaging (X-ray or MRI to evaluate bony involvement), informed consent emphasizing risks of persistent infection and need for wound care, perioperative antibiotics, intraoperative debridement with removal of infected bone, hemostasis and irrigation, and suturing of the surgical site. Postoperative plan includes wound monitoring, targeted antibiotic therapy guided by cultures, pressure redistribution strategies, and outpatient or skilled nursing follow-up for wound care and possible further reconstructive procedures.

Coding Specifications

Modifier	Description	When to Use
`11`	Normal or routine procedural service	Use when the procedure is performed as scheduled without complications and represents the provider's usual service.
`22`	Increased procedural services	Use when work required is substantially greater than typically required (extensive debridement beyond usual scope).
`52`	Reduced services	Use when the procedure is partially reduced or not completed as described.
`53`	Discontinued procedure	Use when the procedure is started but terminated due to extenuating circumstances.
`54`	Surgical care only	Use when only the surgical portion is billed and pre/postoperative care is billed by another provider.
`55`	Postoperative management only	Use when only postoperative care is billed by the reporting surgeon.
`62`	Two surgeons	Use when two surgeons work together as primary surgeons performing distinct operative work.
`63`	Procedure performed on infants less than 4 kg	Use when applicable by patient weight criteria.
`78`	Unplanned return to the OR for related procedure during global period	Use when the patient returns to the OR for a complication related to the original procedure.
`80`	Assistant surgeon	Use when an assistant-at-surgery performs part of the operation.
`81`	Minimum assistant surgeon	Use when a minimal assistant role is documented.
`82`	Assistant surgeon (when qualified resident not available)	Use when an assistant is required but a resident isn't available.
`26`	Professional component	Rarely used for this procedure; use when reporting only the professional component of a diagnostic service associated with the procedure.
`51`	Multiple procedures	Use when multiple procedures are performed during the same operative session and bundling rules apply.

Taxonomy Code	Specialty	Notes
207P00000X	General Surgery	Commonly performs debridement and bone removal for infected pressure ulcers.
208K00000X	Plastic Surgery	Performs complex soft-tissue excision and closure or reconstructive procedures after debridement.
208000000X	Colorectal Surgery	May be involved when sacral/coccygeal involvement requires specialized expertise.
207L00000X	Surgical Oncology	Occasionally involved when complex wound management overlaps with oncologic resections.
363A00000X	Wound Care Specialist	Provides perioperative wound management, debridement expertise, and follow-up care.

Related Diagnoses

ICD-10 Code	Description	Clinical Relevance
`L89.154`	Pressure ulcer of sacrum and coccyx, stage 4	Full-thickness tissue loss with exposed bone; primary indication for excision and partial coccygectomy for infected pressure sore.
`M86.171`	Osteomyelitis of other specified sites, sacrum and coccyx	Confirms bony infection requiring removal of infected bone during the procedure.
`L89.153`	Pressure ulcer of sacrum and coccyx, stage 3	Deep ulceration that may progress to stage 4 and necessitate surgical debridement.
`T81.4XXA`	Infection following a procedure, initial encounter	Relevant if the sacral wound is infected after prior interventions and requires further surgical management.
`R10.2`	Pelvic and perineal pain	Symptom code that may accompany deep sacral wounds and osteomyelitis, supporting clinical context.

Related CPT Codes

CPT Code	Description	Relationship to This Procedure
`11042`	Debridement, subcutaneous tissue (e.g., wound debridement), first 20 sq cm or less	Commonly billed for layered debridement of soft tissue in wounds; may be used when significant soft tissue debridement accompanies the pressure sore excision.
`11043`	Debridement, muscle and/or fascia, first 20 sq cm or less	Used when debridement extends into muscle or fascial layers beneath the pressure ulcer.
`11044`	Debridement, bone (including cortical bone) and/or cartilage, first 20 sq cm or less	Used when debridement explicitly includes removal of infected bone; may be reported in conjunction if documentation supports separate debridement coding.
`15271`	Wide local excision of subcutaneous tissue for sacral wound with primary closure (example skin flap codes vary)	Codes for closure or flap procedures that may follow debridement when primary closure or reconstruction is performed.
`10120`	Incision and drainage of pilonidal cyst; simple	May be performed for differential diagnoses or minor drainage procedures in the sacrococcygeal area prior to or instead of formal excision.

CPT 15922: Sacrococcygeal Pressure Ulcer Debridement with Flap Closure

CPT-15931-SACRAL-PRESSURE-SORE-EXCISION-PRIMARY-CLOSURE

CPT 15931: Excision of Sacral Pressure Sore with Primary Closure

CPT-15933-PRESSURE-SORE-AND-SACRAL-BONE-EXCISION-WITH-CLOSURE

CPT 15933: Excision of Pressure Sore and Underlying Sacral Bone with Closure

CPT-15934-PRESSURE-SORE-EXCISION-FLAP-CLOSURE-SACRAL

CPT 15934: Excision of Sacral Pressure Sore with Flap Closure

CPT-15935-SACRAL-PRESSURE-ULCER-EXCISION-WITH-FLAP-CLOSURE

CPT 15935: Excision of Sacral Pressure Ulcer with Flap Closure

CPT-15936-SACRAL-PRESSURE-SORE-EXCISION-WITH-GRAFT

CPT 15936: Excision of Sacral Pressure Sore with Skin or Muscle Graft

CPT-15937-SACRAL-PRESSURE-SORE-EXCISION-WITH-SKIN-MUSCLE-GRAFT

CPT 15937: Sacral Pressure Sore Excision with Skin/Muscle Graft

CPT-15940-HIP-PRESSURE-SORE-EXCISION-PRIMARY-CLOSURE

CPT 15940: Hip Pressure Sore Excision with Primary Closure

CPT-15941-PRESSURE-SORE-HIP-DEBRIDEMENT-BONE-REMOVAL-CLOSURE

CPT 15941: Excision of Hip Pressure Sore with Bone Removal and Closure

CPT-15944-HIP-PRESSURE-SORE-EXCISION-WITH-SKIN-FLAP-CLOSURE

CPT 15944: Hip Pressure Sore Excision with Skin Flap Closure

Showing 1–10 of 19

Frequently Asked Questions

References

1.CPT® Codes and Descriptions. AAPC. Retrieved Jul 29, 2026.
2.HCPCS Quarterly Update. Centers for Medicare & Medicaid Services (CMS). Retrieved Jul 29, 2026.
3.ICD-10-CM Full Code List. Centers for Medicare & Medicaid Services (CMS). Retrieved Jul 29, 2026.

Published by

Trek Health powers OpenPayer with a leading commercial payer intelligence platform, seamlessly converting fragmented payer data into actionable insights for provider organizations.

Trek Health ingests and normalizes Transparency in Coverage data and payer policy updates to give provider organizations a clear view of how commercial reimbursement behaves across markets, payers, and services. Our platform transforms raw payer disclosures into structured intelligence that supports contract evaluation, payer negotiations, and service line strategy. By combining market benchmarks with ongoing policy visibility, Trek helps teams identify variability, risk, and opportunity in commercial reimbursement. The result is faster insight, stronger negotiating positions, and more informed financial decisions.

Clinical & Coding Specifications

Clinical Context

Coding Specifications

Modifier	Description	When to Use
`11`	Normal or routine procedural service	Use when the procedure is performed as scheduled without complications and represents the provider's usual service.
`22`	Increased procedural services	Use when work required is substantially greater than typically required (extensive debridement beyond usual scope).
`52`	Reduced services	Use when the procedure is partially reduced or not completed as described.
`53`	Discontinued procedure	Use when the procedure is started but terminated due to extenuating circumstances.
`54`	Surgical care only	Use when only the surgical portion is billed and pre/postoperative care is billed by another provider.
`55`	Postoperative management only	Use when only postoperative care is billed by the reporting surgeon.
`62`	Two surgeons	Use when two surgeons work together as primary surgeons performing distinct operative work.
`63`	Procedure performed on infants less than 4 kg	Use when applicable by patient weight criteria.
`78`	Unplanned return to the OR for related procedure during global period	Use when the patient returns to the OR for a complication related to the original procedure.
`80`	Assistant surgeon	Use when an assistant-at-surgery performs part of the operation.
`81`	Minimum assistant surgeon	Use when a minimal assistant role is documented.
`82`	Assistant surgeon (when qualified resident not available)	Use when an assistant is required but a resident isn't available.
`26`	Professional component	Rarely used for this procedure; use when reporting only the professional component of a diagnostic service associated with the procedure.
`51`	Multiple procedures	Use when multiple procedures are performed during the same operative session and bundling rules apply.

Taxonomy Code	Specialty	Notes
207P00000X	General Surgery	Commonly performs debridement and bone removal for infected pressure ulcers.
208K00000X	Plastic Surgery	Performs complex soft-tissue excision and closure or reconstructive procedures after debridement.
208000000X	Colorectal Surgery	May be involved when sacral/coccygeal involvement requires specialized expertise.
207L00000X	Surgical Oncology	Occasionally involved when complex wound management overlaps with oncologic resections.
363A00000X	Wound Care Specialist	Provides perioperative wound management, debridement expertise, and follow-up care.

Related Diagnoses

ICD-10 Code	Description	Clinical Relevance
`L89.154`	Pressure ulcer of sacrum and coccyx, stage 4	Full-thickness tissue loss with exposed bone; primary indication for excision and partial coccygectomy for infected pressure sore.
`M86.171`	Osteomyelitis of other specified sites, sacrum and coccyx	Confirms bony infection requiring removal of infected bone during the procedure.
`L89.153`	Pressure ulcer of sacrum and coccyx, stage 3	Deep ulceration that may progress to stage 4 and necessitate surgical debridement.
`T81.4XXA`	Infection following a procedure, initial encounter	Relevant if the sacral wound is infected after prior interventions and requires further surgical management.
`R10.2`	Pelvic and perineal pain	Symptom code that may accompany deep sacral wounds and osteomyelitis, supporting clinical context.

Related CPT Codes

CPT Code	Description	Relationship to This Procedure
`11042`	Debridement, subcutaneous tissue (e.g., wound debridement), first 20 sq cm or less	Commonly billed for layered debridement of soft tissue in wounds; may be used when significant soft tissue debridement accompanies the pressure sore excision.
`11043`	Debridement, muscle and/or fascia, first 20 sq cm or less	Used when debridement extends into muscle or fascial layers beneath the pressure ulcer.
`11044`	Debridement, bone (including cortical bone) and/or cartilage, first 20 sq cm or less	Used when debridement explicitly includes removal of infected bone; may be reported in conjunction if documentation supports separate debridement coding.
`15271`	Wide local excision of subcutaneous tissue for sacral wound with primary closure (example skin flap codes vary)	Codes for closure or flap procedures that may follow debridement when primary closure or reconstruction is performed.
`10120`	Incision and drainage of pilonidal cyst; simple	May be performed for differential diagnoses or minor drainage procedures in the sacrococcygeal area prior to or instead of formal excision.

CPT 15922: Sacrococcygeal Pressure Ulcer Debridement with Flap Closure

CPT-15931-SACRAL-PRESSURE-SORE-EXCISION-PRIMARY-CLOSURE

CPT 15931: Excision of Sacral Pressure Sore with Primary Closure

CPT-15933-PRESSURE-SORE-AND-SACRAL-BONE-EXCISION-WITH-CLOSURE

CPT 15933: Excision of Pressure Sore and Underlying Sacral Bone with Closure

CPT-15934-PRESSURE-SORE-EXCISION-FLAP-CLOSURE-SACRAL

CPT 15934: Excision of Sacral Pressure Sore with Flap Closure

CPT-15935-SACRAL-PRESSURE-ULCER-EXCISION-WITH-FLAP-CLOSURE

CPT 15935: Excision of Sacral Pressure Ulcer with Flap Closure

CPT-15936-SACRAL-PRESSURE-SORE-EXCISION-WITH-GRAFT

CPT 15936: Excision of Sacral Pressure Sore with Skin or Muscle Graft

CPT-15937-SACRAL-PRESSURE-SORE-EXCISION-WITH-SKIN-MUSCLE-GRAFT

CPT 15937: Sacral Pressure Sore Excision with Skin/Muscle Graft

CPT-15940-HIP-PRESSURE-SORE-EXCISION-PRIMARY-CLOSURE

CPT 15940: Hip Pressure Sore Excision with Primary Closure

CPT-15941-PRESSURE-SORE-HIP-DEBRIDEMENT-BONE-REMOVAL-CLOSURE

CPT 15941: Excision of Hip Pressure Sore with Bone Removal and Closure

CPT-15944-HIP-PRESSURE-SORE-EXCISION-WITH-SKIN-FLAP-CLOSURE

CPT 15944: Hip Pressure Sore Excision with Skin Flap Closure

Showing 1–10 of 19

Frequently Asked Questions

References

1.CPT® Codes and Descriptions. AAPC. Retrieved Jul 29, 2026.
2.HCPCS Quarterly Update. Centers for Medicare & Medicaid Services (CMS). Retrieved Jul 29, 2026.
3.ICD-10-CM Full Code List. Centers for Medicare & Medicaid Services (CMS). Retrieved Jul 29, 2026.

Published by

Trek Health powers OpenPayer with a leading commercial payer intelligence platform, seamlessly converting fragmented payer data into actionable insights for provider organizations.

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CPT 15920: Sacrococcygeal Pressure Sore Debridement with Bone Excision

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Billing Code Overview

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CPT 15920: Sacrococcygeal Pressure Sore Debridement with Bone Excision

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Billing Code Overview

Clinical & Coding Specifications

Clinical Context

Coding Specifications

Related Diagnoses

Related CPT Codes

Related Codes

References

Clinical & Coding Specifications

Clinical Context

Coding Specifications

Related Diagnoses

Related CPT Codes

Related Codes

References

CPT 15920: Sacrococcygeal Pressure Sore Debridement with Bone Excision

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Billing Code Overview

CPT 15920: Sacrococcygeal Pressure Sore Debridement with Bone Excision

Sign up for cpt 15920 policy alerts

Billing Code Overview

Clinical & Coding Specifications

Clinical Context

Coding Specifications

Related Diagnoses

Related CPT Codes

Related Codes

What clinical procedure does CPT 15920 describe?

What is the typical clinical workflow before, during, and after a procedure billed with CPT 15920?

Which billing modifiers may apply to CPT 15920 and when should they be considered?

Are there related CPT codes that might be billed alongside or instead of CPT 15920?

Which specialties commonly perform CPT 15920 and which payers are referenced for coverage?

References

Clinical & Coding Specifications

Clinical Context

Coding Specifications

Related Diagnoses

Related CPT Codes

Related Codes

What clinical procedure does CPT 15920 describe?

What is the typical clinical workflow before, during, and after a procedure billed with CPT 15920?

Which billing modifiers may apply to CPT 15920 and when should they be considered?

Are there related CPT codes that might be billed alongside or instead of CPT 15920?

Which specialties commonly perform CPT 15920 and which payers are referenced for coverage?

References