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

CPT code 15937 represents excision of a sacral pressure sore with removal of underlying bone and preparation of the wound for closure using a skin graft or combined skin-and-muscle graft. This is a significant reconstructive procedure used for complex, full-thickness decubitus ulcers that involve bone exposure or osteomyelitic risk, making it relevant to hospitals, surgical centers, and wound care programs nationwide.

Key national payers relevant to coverage and payment for this service include Aetna, Blue Cross Blue Shield, Cigna Health, UnitedHealthcare, and Medicare. Readers can expect an overview of clinical indications and procedural context, typical sites of service, and common billing considerations tied to this operative approach. The publication will also summarize available benchmarks and payer coverage themes, outline relevant clinical context for surgical reconstruction of pressure injuries, and note policy updates affecting authorization and coding practices when applicable.

Intended for clinicians, billing professionals, and policy analysts, the report explains the clinical role of CPT code 15937, how it fits within surgical wound management pathways, and what stakeholders typically evaluate for medical necessity and appropriate site of service.

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Billing Code Overview

CPT code 15937 describes a surgical procedure to remove a pressure sore (decubitus ulcer) in the sacral area along with the underlying bone, and to prepare the wound for closure using a skin graft or a combined skin and muscle graft. This procedure is a form of reconstructive soft-tissue surgery addressing complex, full-thickness pressure injuries.

Service type: Surgical debridement and reconstructive grafting for pressure sore excision
Typical site of service: Inpatient hospital or ambulatory surgical center, commonly performed in an operating room due to the extent of tissue removal and grafting required

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

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Billing Code Overview

Service type: Surgical debridement and reconstructive grafting for pressure sore excision
Typical site of service: Inpatient hospital or ambulatory surgical center, commonly performed in an operating room due to the extent of tissue removal and grafting required

Clinical & Coding Specifications

Clinical Context

A typical patient is a 68-year-old wheelchair-bound individual with a chronic, nonhealing stage IV sacral pressure ulcer exposing bone and recurrent osteomyelitis despite conservative care. The patient is evaluated by a multidisciplinary team including wound care, infectious disease, and plastic surgery. After preoperative optimization (nutritional support, glycemic control, and targeted antibiotics), the patient is taken to the operating room for surgical debridement. The surgeon performs excision of the pressure ulcer and partial sacrectomy of necrotic bone, followed by preparation of the wound bed and reconstruction using a myocutaneous or fasciocutaneous flap with skin grafting as indicated. Intraoperative documentation includes indication, ulcer stage and dimensions, extent of bone resection, method of wound bed preparation, type and source of flap or graft, estimated blood loss, complications, and specimens sent for culture and pathology. Typical postoperative workflow involves wound monitoring, flap viability assessment, continued targeted antibiotics if osteomyelitis was present, pressure offloading, and planned outpatient or inpatient wound care follow-up.

Coding Specifications

Modifier	Description	When to Use
`22`	Increased procedural services	Use when work or complexity substantially exceeds typical for `15937` and documentation supports reason for additional work.
`23`	Unusual anesthesia	Use when general anesthesia is medically contraindicated and unusual anesthesia circumstances are required for `15937`.
`26`	Professional component	Use if reporting only the surgeon's professional component separate from technical services (rare for `15937`).
`50`	Bilateral procedure	Use if symmetrical bilateral sacral procedures are performed (generally uncommon for `15937`).
`51`	Multiple procedures	Use when `15937` is performed in the same session with other distinct procedures; report modifier on secondary procedures per payer rules.
`52`	Reduced services	Use when the procedure is partially reduced or not completed; document reason.
`53`	Discontinued procedure	Use when `15937` is started but stopped due to extenuating circumstances; document why.
`58`	Staged or related procedure or service by the same physician during the postoperative period	Use when `15937` is the planned first stage of a staged reconstruction.
`59`	Distinct procedural service	Use to indicate a distinct procedural service when `15937` is performed with other procedures not typically bundled, with supporting documentation.
`62`	Two surgeons	Use when two surgeons operate together, each reporting their portion of `15937` as appropriate.
`73`	Discontinued outpatient procedure prior to anesthesia due to patient-related issues	Use when `15937` is cancelled after patient taken to OR but before anesthesia administered.
`76`	Repeat procedure by same physician	Use when `15937` is repeated by the same surgeon during the global period for a separate, documented reason.
`78`	Return to the operating room for a related procedure during the postoperative period	Use when reoperation related to the initial `15937` occurs during the global period.
`80`	Assistant surgeon	Use when an assistant surgeon is required for `15937` and payer allows assistant surgeon reimbursement.

Taxonomy Code	Specialty	Notes
208C00000X	General Surgery	Commonly performs debridement and reconstructive procedures for pressure ulcers.
208100000X	Colon & Rectal Surgery	May be involved for sacral area defects and complex pelvic wound issues.
208200000X	Plastic Surgery	Frequently performs myocutaneous flaps and complex soft tissue reconstruction after `15937`.
207P00000X	Physical Medicine & Rehabilitation	Involved in pre- and postoperative functional optimization and pressure offloading strategies.
208000000X	Surgery (General) - Wound Care specialist	Providers focusing on complex wound management who coordinate multidisciplinary care.

Related Diagnoses

ICD-10 Code	Description	Clinical Relevance
`L89.154`	Pressure ulcer of sacral region, stage 4	Stage IV sacral pressure ulcers with exposed bone are a primary indication for `15937`.
`M86.171`	Osteomyelitis of sacrum	Osteomyelitis of sacral bone can necessitate excision of infected bone as part of `15937`.
`L89.153`	Pressure ulcer of sacral region, stage 3	Deep ulcers approaching bone that may progress to stage IV and require surgical intervention.
`E11.9`	Type 2 diabetes mellitus without complications	Diabetes increases risk of poor wound healing and is a common comorbidity in patients undergoing `15937`.
`N18.3`	Chronic kidney disease, stage 3 (moderate)	CKD is a common comorbidity affecting healing and perioperative management in patients receiving `15937`.

Related CPT Codes

CPT Code	Description	Relationship to This Procedure
`11043`	Debridement, muscle and/or fascia (first 20 sq cm or less)	May be used for initial debridement of devitalized soft tissue in the sacral wound prior to or during flap reconstruction.
`15734`	Muscle, myocutaneous, or fasciocutaneous flap with microvascular anastomosis (secondary code for donor site)	Used when complex flap reconstruction with muscle is required in conjunction with `15937`; documents flap harvesting technique when applicable.
`15271`	Split-thickness autograft, trunk, arms, legs; 100 sq cm or less, first or major component site	Used when skin grafting is performed to cover donor or recipient sites during reconstruction after `15937`.
`20926`	Osteotomy, sacrum or coccyx	Used if additional bony procedures of the sacrum are performed beyond debridement and partial sacrectomy described in `15937`.
`99499`	Unlisted evaluation and management service	May be used for complex preoperative multidisciplinary coordination when no appropriate code exists (payer dependent).

CPT 15920: Sacrococcygeal Pressure Sore Debridement with Bone Excision

CPT-15922-SACROCOCCYGEAL-PRESSURE-ULCER-DEBRIDEMENT-FLAP-CLOSURE

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-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
`22`	Increased procedural services	Use when work or complexity substantially exceeds typical for `15937` and documentation supports reason for additional work.
`23`	Unusual anesthesia	Use when general anesthesia is medically contraindicated and unusual anesthesia circumstances are required for `15937`.
`26`	Professional component	Use if reporting only the surgeon's professional component separate from technical services (rare for `15937`).
`50`	Bilateral procedure	Use if symmetrical bilateral sacral procedures are performed (generally uncommon for `15937`).
`51`	Multiple procedures	Use when `15937` is performed in the same session with other distinct procedures; report modifier on secondary procedures per payer rules.
`52`	Reduced services	Use when the procedure is partially reduced or not completed; document reason.
`53`	Discontinued procedure	Use when `15937` is started but stopped due to extenuating circumstances; document why.
`58`	Staged or related procedure or service by the same physician during the postoperative period	Use when `15937` is the planned first stage of a staged reconstruction.
`59`	Distinct procedural service	Use to indicate a distinct procedural service when `15937` is performed with other procedures not typically bundled, with supporting documentation.
`62`	Two surgeons	Use when two surgeons operate together, each reporting their portion of `15937` as appropriate.
`73`	Discontinued outpatient procedure prior to anesthesia due to patient-related issues	Use when `15937` is cancelled after patient taken to OR but before anesthesia administered.
`76`	Repeat procedure by same physician	Use when `15937` is repeated by the same surgeon during the global period for a separate, documented reason.
`78`	Return to the operating room for a related procedure during the postoperative period	Use when reoperation related to the initial `15937` occurs during the global period.
`80`	Assistant surgeon	Use when an assistant surgeon is required for `15937` and payer allows assistant surgeon reimbursement.

Taxonomy Code	Specialty	Notes
208C00000X	General Surgery	Commonly performs debridement and reconstructive procedures for pressure ulcers.
208100000X	Colon & Rectal Surgery	May be involved for sacral area defects and complex pelvic wound issues.
208200000X	Plastic Surgery	Frequently performs myocutaneous flaps and complex soft tissue reconstruction after `15937`.
207P00000X	Physical Medicine & Rehabilitation	Involved in pre- and postoperative functional optimization and pressure offloading strategies.
208000000X	Surgery (General) - Wound Care specialist	Providers focusing on complex wound management who coordinate multidisciplinary care.

Related Diagnoses

ICD-10 Code	Description	Clinical Relevance
`L89.154`	Pressure ulcer of sacral region, stage 4	Stage IV sacral pressure ulcers with exposed bone are a primary indication for `15937`.
`M86.171`	Osteomyelitis of sacrum	Osteomyelitis of sacral bone can necessitate excision of infected bone as part of `15937`.
`L89.153`	Pressure ulcer of sacral region, stage 3	Deep ulcers approaching bone that may progress to stage IV and require surgical intervention.
`E11.9`	Type 2 diabetes mellitus without complications	Diabetes increases risk of poor wound healing and is a common comorbidity in patients undergoing `15937`.
`N18.3`	Chronic kidney disease, stage 3 (moderate)	CKD is a common comorbidity affecting healing and perioperative management in patients receiving `15937`.

Related CPT Codes

CPT Code	Description	Relationship to This Procedure
`11043`	Debridement, muscle and/or fascia (first 20 sq cm or less)	May be used for initial debridement of devitalized soft tissue in the sacral wound prior to or during flap reconstruction.
`15734`	Muscle, myocutaneous, or fasciocutaneous flap with microvascular anastomosis (secondary code for donor site)	Used when complex flap reconstruction with muscle is required in conjunction with `15937`; documents flap harvesting technique when applicable.
`15271`	Split-thickness autograft, trunk, arms, legs; 100 sq cm or less, first or major component site	Used when skin grafting is performed to cover donor or recipient sites during reconstruction after `15937`.
`20926`	Osteotomy, sacrum or coccyx	Used if additional bony procedures of the sacrum are performed beyond debridement and partial sacrectomy described in `15937`.
`99499`	Unlisted evaluation and management service	May be used for complex preoperative multidisciplinary coordination when no appropriate code exists (payer dependent).

CPT 15920: Sacrococcygeal Pressure Sore Debridement with Bone Excision

CPT-15922-SACROCOCCYGEAL-PRESSURE-ULCER-DEBRIDEMENT-FLAP-CLOSURE

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

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Billing Code Overview

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

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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 15937: Sacral Pressure Sore Excision with Skin/Muscle Graft

Sign up for cpt 15937 policy alerts

Billing Code Overview

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

Sign up for cpt 15937 policy alerts

Billing Code Overview

Clinical & Coding Specifications

Clinical Context

Coding Specifications

Related Diagnoses

Related CPT Codes

Related Codes

What does CPT 15937 describe and when is it typically used?

Which modifiers are commonly reported with 15937 and when would they apply?

What related CPT codes might be billed alongside or in relation to 15937?

Which ICD-10 diagnoses are most relevant to support medical necessity for 15937?

Which payers are mentioned as relevant for coverage and payment, and does the page provide reimbursement rates?

References

Clinical & Coding Specifications

Clinical Context

Coding Specifications

Related Diagnoses

Related CPT Codes

Related Codes

What does CPT 15937 describe and when is it typically used?

Which modifiers are commonly reported with 15937 and when would they apply?

What related CPT codes might be billed alongside or in relation to 15937?

Which ICD-10 diagnoses are most relevant to support medical necessity for 15937?

Which payers are mentioned as relevant for coverage and payment, and does the page provide reimbursement rates?

References