Summary & Overview

CPT 15940: Hip Pressure Sore Excision with Primary Closure

CPT code 15940 denotes surgical excision and primary closure of a pressure sore in the hip region. This code captures a common reconstructive procedure used to remove nonviable tissue from pressure ulcers and achieve wound closure to prevent infection and facilitate healing. Nationally, management of pressure ulcers is a high-cost, high-volume clinical issue due to the morbidity and resource intensity associated with advanced-stage sores and their surgical repair.

Key payers referenced in this analysis include Aetna, Blue Cross Blue Shield, Cigna Health, UnitedHealthcare, and Medicare. The publication outlines clinical context for the procedure, site-of-service considerations, and common billing modifiers when present in input data. Readers will find a concise summary of coding intent, expected sites of service, and typical clinical indications. The report also summarizes payer coverage patterns and benchmarks when available and highlights policy or coding guidance relevant to hospital and ambulatory surgical settings.

This national overview is intended to support coding accuracy and administrative clarity for clinicians, billing staff, and policy analysts by clarifying what CPT code 15940 represents and where it is typically performed.

AetnaBlue Cross Blue ShieldCigna HealthUnitedHealthcareMedicareCPT 15940pressure sore excisionhip ulcer surgerysurgical wound closureambulatory surgeryhospital procedurewound debridementprimary closure

Billing Code Overview

CPT code 15940 describes the surgical removal of a pressure sore located in the hip area with primary closure of the wound by suturing the skin edges. The procedure involves debridement of the ulcerated tissue and direct closure to promote healing and reduce infection risk.

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

Clinical & Coding Specifications

Clinical Context

A typical patient is an older adult or a person with limited mobility who presents with a stage II–IV pressure ulcer over the greater trochanter/hip region with nonviable tissue or wound edges that require debridement and closure. The patient is evaluated in an outpatient surgical clinic or hospital minor procedure room. After history, wound assessment, and optimization of medical issues (eg, glycemic control, anticoagulation review), regional or local anesthesia is administered. The provider excises the pressure sore and any necrotic tissue, approximates viable skin edges, and closes the wound with sutures to promote healing and reduce infection risk. Post‑procedure wound care instructions and dressing changes are documented, and follow‑up is arranged for suture removal and wound surveillance. Typical site of service: outpatient surgical clinic, ambulatory surgery center, or inpatient bedside procedure if performed during a hospital admission. Service type: minor surgical excision and primary closure of a pressure ulcer on the hip.

Coding Specifications

Modifier	Description	When to Use
`22`	Increased procedural services	Use when work required is substantially greater than usual for the procedure due to complexity or extensive debridement before closure
`23`

Taxonomy Code	Specialty	Notes
207P00000X	General Surgery	General surgeons frequently manage pressure ulcer excision and closure when complex tissue removal or flap coverage is required
208000000X	Plastic Surgery	Plastic surgeons perform excision and reconstruction, particularly when flap or complex closure is necessary
1835P0001X	Wound Care/Hyperbaric Medicine	Wound care specialists coordinate wound optimization, debridement planning, and postoperative management
207L00000X	Podiatry	Podiatrists manage pressure ulcers of lower extremity and peritrochanteric areas in some settings
207R00000X	Colon & Rectal Surgery	In select cases of sacral/near-hip pressure ulcers with complex local anatomy, colorectal surgeons may be involved

Related Diagnoses

ICD-10 Code	Description	Clinical Relevance
`L89.152`	Pressure ulcer of sacral region, stage II	Pressure ulcers near the hip/trochanteric area can be coded with specific site and stage; stage guides need for excision and closure
`L89.153`	Pressure ulcer of sacral region, stage III	Deeper tissue involvement may necessitate surgical debridement and closure
`L89.154`	Pressure ulcer of sacral region, stage IV	Full-thickness tissue loss with exposure of muscle, bone, or supporting structures often requires surgical management
`L89.152`	Pressure ulcer of hip, stage II	Hip/trochanteric pressure ulcers by stage indicate severity; higher stages commonly need operative intervention
`L89.153`	Pressure ulcer of hip, stage III	Deep ulcers involving subcutaneous tissue or muscle that may require excision and closure
`L89.154`	Pressure ulcer of hip, stage IV	Extensive tissue loss at the hip often managed surgically to remove necrotic tissue and close defect
`L89.9`	Pressure ulcer, unspecified site	Used when site specificity is not documented; less optimal for surgical claims but sometimes applied

Note: The table lists commonly associated pressure ulcer diagnosis codes used for coding surgical excision and closure on the hip.

Related CPT Codes

CPT Code	Description	Relationship to This Procedure
`11042`	Debridement, subcutaneous tissue, first 20 sq cm or less	May be performed immediately prior to closure if significant necrotic tissue requires sharp debridement
`11043`	Debridement, muscle and/or fascia, first 20 sq cm or less	Used when deeper debridement into muscle or fascia is required before wound closure
`15002`	Adjacent tissue transfer or rearrangement, trunk; first 30 sq cm	Used when local tissue rearrangement (eg, flap) is required after excision of a pressure ulcer on the hip
`15830`	Revision of skin graft, allograft or xenograft; major	May be relevant if previous grafts at the site fail and require revision in the same operative episode
`13160`	Secondary closure of surgical wound or dehisced wound, extensive or complicated	Used when a previously closed pressure ulcer site dehisces and requires more complex secondary closure
`12002`	Repair, intermediate, scalp, axillae, trunk and/or extremities; 2.6 cm to 7.5 cm	Common suture repair codes for closure when primary closure is performed for smaller defects on the hip